Predictive value of vascular endothelial growth factor overexpression in early relapse of colorectal cancer patients after curative resection |
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Authors: | Hsiang-Lin Tsai I-Ping Yang Chih-Hung Lin Chee-Yin Chai Yu-Ho Huang Chin-Fan Chen Ming-Feng Hou Chao-Hung Kuo Suh-Hang Juo Jaw-Yuan Wang |
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Institution: | 1. Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan 2. Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No. 100, Tzyou 1st Road, Kaohsiung, 807, Taiwan 3. Program of Bachelor of Health Beauty, School of Medical and Health Sciences, Fooyin University, Kaohsiung, Taiwan 4. Department of Nursing, Shu-Zen College of Medicine and Management, Kaohsiung, Taiwan 5. Department of Pathology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan 6. Department of Pathology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan 7. Department of Anatomy, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan 8. Department of Emergency Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan 10. Cancer Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan 9. Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan 11. Department of Internal medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan 12. Department of Medical Genetics, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan 13. Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan 14. Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Abstract: | Background Preclinical and clinical studies have indicated that vascular endothelial growth factor (VEGF) is the predominant angiogenic factor. Recently, there was a consistent trend of poorer survival rates in colorectal cancer (CRC) patients of earlier relapse. The purpose of this study was to investigate novel predictors of early relapse in stage I–III CRC and further to determine their correlation with disease outcomes. Materials and methods We retrospectively analyzed clinicopathological features and VEGF expression by immunohistochemical staining in 100 stage I–III CRC patients undergoing curative resection to identify predictors of postoperative early relapse. Results Among 100 patients, 40 patients were classified into early relapse group, and 60 patients were categorized into non-early relapse group. A multivariate logistic regression analysis showed that vascular invasion (P?=?0.048), perineural invasion (P?=?0.042), VEGF overexpression (P?=?0.023), and high postoperative carcinoembryonic antigen (CEA) levels (P?=?0.004) were independent predictors of early relapse. Additionally, we found that with more predictors such as the combined incidence of vascular invasion, perineural invasion, VEGF overexpression, and postoperative CEA levels are involved, the incidence of early postoperative relapse increases. Moreover, VEGF overexpression predicted not only early postoperative relapse but also disease-free survival (P?<?0.001) and overall survival (P?=?0.002). Conclusions This study suggests that VEGF overexpression is an important predictor of early postoperative relapse in patients with stage I–III CRC and may help identify patients who would benefit from intensive follow-up and therapeutic programs. |
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