title: [Serum vascular endothelial growth factor levels in patients with colorectal cancer and its prognostic significance].
abstract: OBJECTIVE
  Thirty per cent of patients with histologically node-negative colorectal cancer die from disseminated disease. Actually disease stage is the most useful prognostic parameter although it is not sufficient. Vascular endothelial growth factor (VEGF) is an angiogenic cytokine involved in the progression of tumors. In our study we tried to know the prognostic significance of pre and postoperative serum VEGF levels in patients with colorectal cancer.
  
  
  METHODS
  Cohort study that included 52 patients with colorectal cancer surgically treated in our Department from 1998 to 2000. Serum VEGF and CEA levels were determined the day before surgery and 30 days after it.
  
  
  RESULTS
  Preoperative serum VEGF levels (428.5 [38.5] pg/ml) were higher than in control patients (p=0.008). Serum VEGF levels fallen significantly after surgery (343 [31.2] pg/ml; p=0.001). Pre and postoperative serum VEGF levels in poorly differentiated neoplasms were higher than in well differentiated ones (p=0.009 and p=0.008 respectively). Pre and postoperative serum CEA and VEGF levels were significantly associated with cancer relapse (p=0.037, p=0.017, p=0.048 and p=0.001, respectively). In multivariate analysis only postoperative serum VEGF levels were associated with colorectal cancer relapse (p=0.003; HR=1.007; 95% CI, 1.002-1.012). Pre and postoperative CEA levels (p<0.001 and p=0.001 respectively) and postoperative VEGF levels (p=0.001), were associated with mortality. In multivariate analysis only tumor stage (p=0.01) and postoperative serum VEGF levels (p=0.02) were associated with mortality. Postoperative serum VEGF determination and pre and postoperative CEA levels raise specificity and positive predictive values to 100% in relation to mortality.
  
  
  CONCLUSIONS
  Pre and postoperative serum VEGF determination has prognostic significance, regardless of tumor stage, in patients with colorectal cancer. In survival methods, postoperative VEGF levels >343 pg/ml are significantly with tumor relapse and mortality. These results suggest the use of serum VEGF levels as a prognostic and monitoring factor besides CEA.
authors.affiliation: Servicio de Cirugía General y del Aparato Digestivo, Complejo Hospitalario de Ciudad Real, Ciudad Real, España.
authors.forename: Teófilo
authors.initials: T
authors.lastname: Cubo
authors.forename: David
authors.initials: D
authors.lastname: Padilla
authors.forename: Gabriel
authors.initials: G
authors.lastname: de la Osa
authors.forename: Teodoro
authors.initials: T
authors.lastname: Palomino
authors.forename: Marcial
authors.initials: M
authors.lastname: García
authors.forename: Ricardo
authors.initials: R
authors.lastname: Pardo
authors.forename: Jesús
authors.initials: J
authors.lastname: Martín
authors.forename: Eugenio
authors.initials: E
authors.lastname: Arévalo
authors.forename: José
authors.initials: J
authors.lastname: Hernández
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000453:epidemiology; D011379:Prognosis; D042461:Vascular Endothelial Growth Factor A / Q000097:blood*
chemical_list: D042461:Vascular Endothelial Growth Factor A