Expression of vascular endothelial growth factor can predict event-free survival in stage II colon cancer

The usefulness of chemotherapy in patients with stage II disease continues to be debated. Biological prognostic factors may allow further insight into the optimal treatment strategy for patients with node-negative disease. Va scular endothelial growth factor (VEGF) seems to be essential for angiogene sis and for the growth of colorectal cancer. Recently, it was shown able to predict disease recurrence in patients with stage II colon cancer. Specime ns of surgically resected colon cancer were immunostained for VEGF, Consecu tive patients referred to the study institutions were considered eligible f or this study. The main inclusion criteria were stage LI tumor, sufficient tumor material, and adequate follow-up information. Analysis was performed on 121 patients. The recurrence rate in the patients with VEGF-positive tum ors was 50% (18 of 36 patients), which was significantly higher than that o bserved in patients with VEGF-negative tumors [11.7% (10 of 85 patients); P = 0.001]. Also the degree of VEGF immunoreactivity was significantly highe r in 28 relapsing patients compared with 93 disease-free patients (mean VEG F score, 2.84 +/- 0.38 versus 0.66 +/- 0.17; P = 0.0001). VEGF may be used in a clinical setting to identify patients at high risk for relapse who may benefit from adjuvant treatment including new therapeutic strategies such as monoclonal antibody neutralizing VEGF.