Serum vascular endothelial growth factor in epithelial ovarian neoplasms: Correlation with patient survival

Objective. To investigate the relationship between serum vascular endotheli al growth factor (VEGF) and clinicopathological factors and to determine wh ether VEGF is an independent prognostic factor of ovarian cancer patients. Methods. Fifty-six women with International Federation of Gynecology and Ob stetrics stages I to IV epithelial ovarian cancer undergoing surgery were e nrolled. Clinical and pathologic items were recorded. Pretreatment VEGF ser um samples of the 56 women were measured by an enzyme-linked immunosorbent assay. The results were correlated to clinical data. The histopathologic it ems and serum VEGF influencing clinical outcome were evaluated comparativel y. Results. The median VEGF serum level in ovarian cancer patients was 458.7 p g/mL. The 75% quatile was defined as the cutoff level. Elevated vascular en dothelial growth factor serum levels before therapy correlated significantl y with poorer disease-free survival (DFS) (log rank test, P = 0.001) and ov erall survival (OS) (log rank test, P < 0.001) on all of the 56 patients. B esides, significantly reduced DFS (log rank test, P = 0.001) and OR (log ra nk test, P = 0.006) were also observed on 40 patients with residual disease less than 2 cm. High histologic grade (RR = 2.24 for DFS; RR = 2.38 for OS ) and elevated serum VEGF levels (RR = 3.34 for DFS; RR = 4.47 for OS) are the prognostic factors on the 56 ovarian carcinoma patients by multivariate analyses. The advanced surgical staging (RR = 3.28 for DFS; RR = 3.84 for OS), high histologic grade (RR = 2.55 for DFS; RR = 2.44 for OS), and eleva ted serum VEGF levels (RR = 5.62 for DFS; RR = 5.37 for OS) are the prognos tic factors for 40 ovarian carcinoma patients with residual disease less th an 2 cm by multivariate analyses. Conclusions. Pretreatment VEGF serum levels might be regarded as an additio nal factor in predicting the outcome of ovarian cancer patients. It also co uld provide prognostic information in clinically relevant subsets, such as those of residual disease less than 2 cm. Anti-angiogenic therapy, if is av ailable, might be a new treatment modality for ovarian cancer patients with poor prognosis predicted by VEGF and other clinical parameters. (C) 1999 A cademic Press.