Prognostic relevance of serum vascular endothelial growth factor in ovarian cancer

Background: The vascular endothelial growth factor (VEGF) is the angiogenic growth factor most strongly implicated in tumor angiogenesis. Its special role in the pathophysiology of ovarian cancer emerges from its dual functio nal capability as an endothelial cell mitogen and a potent stimulator of va scular permeability lending to the characteristic ascites accumulation in t his disease. The aim of our study was to analyze the prognostic value of se rum VEGF (sVEGF) as a tumor. marker in ovarian cancer. Patients and Methods .. 41 patients with ovarian carcinomas were included in the study. Venous b lood was taken from all patients preoperatively. From 15 patients an additi onal postoperative blood sample was drawn. sVEGF was measured in duplicate using a commercially available ELISA-kit. Results. The mean sVEGF level for the ovarian cancer patients was 522 +/- 321 pg/ml (SD) (median: 440; range : 55-1263 pg/ml) No statistically significant correlation could be found be tween sVEGF concentrations and age, histologic type or FIGO-stage. sVEGF va lues four week after surgery were significantly lower than those before tre atment (p = 0.002). In patients after radical surgery sVEGF values dropped or stayed stable below the cut-off more often than in patients with residua l disease. In the univariate analysis, improved overall survival (OS) was f ound for ovarian cancer patients with a sVEGF below the cut-off value of 44 0 pg/ml (p = 0.017). sVEGF was also tested in a multivariate analysis toget her with residual disease and FIGO-stage using the Cox's proportional hazar d model. In the final model only residual disease had nit independent influ ence on OS (p = 0.018). Conclusion: sVEGF levels decrease significantly aft er cytoreductive therapy and might indicate treatment efficiency. According to our study, sVEGF is not an independent prognosticator of survival for o varian cancer.