Profile of Plasma Angiogenic Factors Before and After Hepatectomy for Colorectal Cancer Liver Metastases |
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Authors: | Sam S Yoon MD Sung H Kim MD PhD Mithat Gonen PhD Nancy M Heffernan RN BSN Kara Y Detwiller BS William R Jarnagin MD Michael D’Angelica MD Leslie H Blumgart MD Kenneth K Tanabe MD Ronald P DeMatteo MD |
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Institution: | (1) Department of Surgery, Division of Surgical Oncology, Massachusetts General Hospital, Harvard Medical School, Yawkey 7B-7926, 55 Fruit Street, Boston, Massachusetts, 02114;(2) Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, New York, 10021;(3) Department of Surgery, Hepatobiliary Service, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, New York, 10021 |
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Abstract: | Background Circulating angiogenic factors in patients with colorectal cancer liver metastases may promote tumor growth and contribute
to liver regeneration after partial hepatectomy.
Methods We analyzed blood samples from 26 patients with colorectal cancer liver metastases before and after liver resection and used
samples from 20 healthy controls as a reference. Plasma levels of vascular endothelial growth factor (VEGF), basic fibroblast
growth factor (bFGF), epidermal growth factor (EGF), and hepatocyte growth factor (HGF) were measured, and levels were correlated
with recurrence.
Results The median preoperative levels of all four factors were significantly higher and more variable in colorectal cancer liver
metastasis patients than in controls. HGF and bFGF levels increased significantly 3 days and 1 month after hepatectomy, respectively,
and returned to near preoperative levels at 3 months. Postoperative VEGF and EGF levels remained relatively stably increased
over 3 months. After a median follow-up of 19 months, 10 patients (42%) experienced recurrence. Higher preoperative VEGF and
HGF levels correlated with subsequent recurrence (P = .018 and .021, respectively), and a preoperative adjusted total value of all four factors accurately identified patients
at low, moderate, and high risk of recurrence (P = .034). Patients who experienced disease recurrence also had relatively higher bFGF levels 3 months after operation (P = .035).
Conclusions Plasma angiogenic factors are increased in patients with colorectal cancer liver metastases and remain increased at least
3 months after partial hepatectomy. Measurement of certain factors before and after hepatic resection can predict recurrence.
Targeted biological agents may counteract the tumor-promoting effects of these circulating factors on subclinical disease. |
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Keywords: | Colorectal cancer Liver metastases Angiogenesis Vascular endothelial growth factor Basic fibroblast growth factor Hepatocyte growth factor |
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