Clinical significance of serum vascular endothelial growth factor in esophageal squamous cell carcinoma

BACKGROUND. Vascular endothelial growth factor (VEGF) is a potent inducer o f angiogenesis in malignant tumors. An increased in the serum VEGF concentr ation (S-VEGF) has been found in patients with various solid tumors and app ears to be correlated with tumor burden. The objective of the current study was to determine the correlation between pretreatment S-VEGF and clinicopa thologic features in patients with esophageal squamous cell carcinoma. METHODS. Pretreatment S-VEGF was measured by enzyme-linked immunoadsorbent assay in 24 healthy controls and 96 patients with esophageal squamous cell carcinoma (82 patients with primary tumors and 14 with recurrent tumors). C hemoradiotherapy was performed in 35 patients followed by response evaluati on. RESULTS. S-VEGF was found to be significantly elevated in patients with pri mary esophageal. carcinoma (P = 0.0011). Significant differences were obser ved when S-VEGF was categorized by tumor size (P = 0.0002), tumor depth (P = 0.0082), lymph node metastasis (P = 0.0002), distant metastasis (P = 0.02 8), and International Union Against Cancer TNM stage (P < 0.0001). The pati ents who achieved a partial or complete response to chemoradiotherapy showe d significantly less S-VEGF than those patients who were nonresponders (P = 0.018). A high (> 451 pg/mL) S-VEGF level was associated with poor surviva l (P < 0.001). Multivariate analysis found S-VEGF to be a significant and i ndependent prognostic factor (P < 0.001). CONCLUSIONS. In the current study, a high S-VEGF was found to be associated with tumor progression, poor treatment response, and poor survival in pati ents with squamous cell carcinoma of the esophagus. Cancer 2001;92:663-9. ( C) 2001 American Cancer Society.