Clinical significance of urinary vascular endothelial growth factor in patients with superficial bladder tumors

Vascular endothelial growth factor (VEGF) is an important mediator of tumor angiogenesis and has been shown to be excreted in the urine of bladder can cer patient. The goal of this study was to evaluate urinary VEGF levels of patients with superficial bladder transitional cell carcinoma (TCC) and to determine its predictive value for recurrence. Pre-operative urinary VEGF l evels were determined in 31 patients with superficial bladder TCC and 10 co ntrol patients. A quantitative enzyme immunoassay was used to measure urina ry VEGF levels and the urine VEGF concentration was corrected by the creati nine concentration in a 24-h urine specimen. The corrected urinary VEGF lev els were higher in patients than controls (p=0.003). Ten of 31 patients had TCC recurrences during this study. Corrected urinary VEGF levels were sign ificantly higher in recurrent vs. non-recurrent patients (p=0.001). A cut-o ff value of 0.32 (corrected urinary VEGF levels) was valuable for predictin g recurrences in this prospective study. However, there was no statistical correlation between VEGF levels and tumor stage (Ta or TI), tumor size or t umor grade. Pre-operative urinary VEGF levels are associated with a risk of recurrence in patient with superficial bladder TCC. Quantification of urin ary VEGF may prove to be a valuable, non-invasive indicator of carcinoma re currence in patients with superficial bladder TCC. Urinary VEGF may be a th erapeutic target for intravesical therapy. However, because of the small nu mber of cases, further studies with larger number of patients will be neede d to clarify this issue.