Vascular endothelial growth factor (VEGF) expression is a prognostic factor for radiotherapy outcome in advanced carcinoma of the cervix

The aim of the study was to evaluate VEGF expression in tumour biopsies as a prognostic factor for radiotherapy outcome in advanced carcinoma of the c ervix. A retrospective study was carried out on 100 patients. Pre-treatment tumour VEGF expression was examined immunohistochemically in formalin-fixe d, paraffin-embedded biopsies using a widely available commercial antibody. A semiquantitative analysis was made using a scoring system of 0, 1, 2, an d 3, for increasing intensity of staining. High VEGF expression was associa ted with a poor prognosis. A univariate log rank analysis found a significa nt relationship with overall survival (P = 0.0008) and metastasis-free surv ival (P = 0.0062), but not local control (P = 0.23). There was no correlati on between VEGF expression and disease stage, tumour differentiation, patie nt age, or tumour radiosensitivity (SF2). In a Cox multivariate analysis of survival VEGF expression was the most significant independent prognostic f actor (P = 0.001). After allowing for VEGF only SF2 was a significant progn ostic factor (P = 0.003). In conclusion, immunohistochemical analysis of VE GF expression is a highly significant and independent prognostic indicator of overall and metastasis-free survival for patients treated with radiother apy for advanced carcinoma of the cervix. It is also a rapid and easy metho d that could be used in the clinical setting, to identify patients at high risk of failure with conventional radiotherapy who may benefit from novel a pproaches or chemoradiotherapy. (C) 2000 Cancer Research Campaign.