Original Article

High preoperative serum vascular endothelial growth factor levels predict poor clinical outcome after curative resection of gastric cancer†‡

  1. Ó. Vidal1,
  2. J.-P. Metges5,
  3. I. Elizalde3,
  4. M. Valentíni1,
  5. A. Volant6,
  6. R. Molina2,
  7. A. Castells3,
  8. M. Pera4,*

Article first published online: 13 NOV 2009

DOI: 10.1002/bjs.6780

Issue

British Journal of Surgery

British Journal of Surgery

Volume 96, Issue 12, pages 1443–1451, December 2009

Additional Information

How to Cite

Vidal, Ó., Metges, J.-P., Elizalde, I., Valentíni, M., Volant, A., Molina, R., Castells, A. and Pera, M. (2009), High preoperative serum vascular endothelial growth factor levels predict poor clinical outcome after curative resection of gastric cancer. British Journal of Surgery, 96: 1443–1451. doi: 10.1002/bjs.6780

Author Information

  1. 1

    Service of General and Digestive Surgery, Institut de Malalties Digestives i Metabolisme, Barcelona, Spain

  2. 2

    Department of Biochemistry, Hospital Clínic, Barcelona, Spain

  3. 3

    Department of Gastroenterology, Institut de Malalties Digestives i Metabolisme, Institut d'Investigacions Biomèdiques August Pi i Sunyer, CIBERehd, University of Barcelona Medical School, Barcelona, Spain

  4. 4

    Section of Gastrointestinal Surgery, Hospital Universitario del Mar–Institut Municipal d'Investigació Mèdica, Universitat Autónoma de Barcelona, Barcelona, Spain

  5. 5

    Institut de Cancérologie et d'Hématologie, Institut National de la Santé et de la Recherche Médicale U613, Brest, France

  6. 6

    Department of Pathology, Centre Hospitalier Universitaire Cavale Blanche et Morvan, Brest, France

*Section of Gastrointestinal Surgery, Hospital Universitario del Mar–Institut Municipal d'Investigació Mèdica, Passeig Marítim 25–29, 08003 Barcelona, Spain

  1. †

    The Editors are satisfied that all authors have contributed significantly to this publication

  2. ‡

    Presented in part to the 42nd Annual Meeting of the American Society of Clinical Oncology, Atlanta, Georgia, USA, June 2006

Publication History

  1. Issue published online: 13 NOV 2009
  2. Article first published online: 13 NOV 2009
  3. Manuscript Accepted: 1 JUL 2009

Funded by

  • Fundació ‘La Caixa’. Grant Number: LC 02/126-00
  • Ministerio de Educación y Ciencia. Grant Number: SAF 07-64873

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A useful marker of poor prognosis

Abstract

Background:

Tumour vascular endothelial growth factor (VEGF) and tumour urokinase-type plasminogen activator (uPA) are prognostic factors in gastric cancer but surgical specimens are required for testing. The prognostic value of preoperative serum VEGF (s-VEGF) and serum uPA (s-uPA) levels was evaluated in patients undergoing potentially curative (R0) gastric cancer resection.

Methods:

Concentrations of s-VEGF and s-uPA were measured 97 patients with gastric cancer and 20 controls. Angiogenesis was measured in vitro based on human endothelial cell tube formation.

Results:

Levels of s-VEGF were higher in patients with gastric cancer than controls (median 288 versus 189 pg/ml respectively; P = 0·002). They were associated with pathological tumour node metastasis (pTNM) stage, pT, pN, lymph node ratio and perineural invasion, and correlated with platelet counts. In multivariable analysis, s-VEGF over 320 pg/ml was the only preoperative predictor of both recurrence and disease-specific survival. Serum from patients with raised s-VEGF levels enhanced angiogenesis in vitro significantly more than serum from those with a s-VEGF level of 320 pg/ml or less.

Conclusion:

High preoperative s-VEGF level is an independent prognostic factor for recurrence and survival after R0 resection of gastric cancer. This may provide a useful guide to decision making regarding neoadjuvant and adjuvant therapies. Copyright © 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

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