title: Preoperative serum vascular endothelial growth factor as a prognostic parameter in ovarian cancer.
abstract: OBJECTIVE
  Serum vascular endothelial growth factor (VEGF) levels have been shown to be associated with an adverse outcome in patients with ovarian cancer. We studied the clinical value of serum VEGF as an independent prognostic parameter.
  
  
  METHODS
  In the present study, we ascertained preoperative serum VEGF in a series of 314 patients with ovarian cancer: 45 new cases and 269 from four previously published studies. Serum VEGF was evaluated prior to primary surgery, results were correlated with clinical data.
  
  
  RESULTS
  Median serum VEGF was 407 (238-746) pg/mL. In a univariate Kaplan-Meier analysis, FIGO stage, residual tumor mass, tumor grade, patients' age, serum CA 125, and preoperative serum VEGF were associated with overall survival. In a multivariate Cox regression model, higher FIGO stage, presence of residual tumor mass after primary surgery, and higher serum VEGF were independently associated with a shortened overall survival. Planned subgroup analysis was performed for patients with ovarian cancer FIGO stage I. In a multivariate Cox regression model, higher tumor grade and higher serum VEGF were the only independent prognosticators for overall survival. Patients with FIGO stage I ovarian cancer and a serum VEGF > or = 380 pg/mL had an 8-fold increased risk for experiencing cancer-related death.
  
  
  CONCLUSIONS
  Serum VEGF is an independent prognostic parameter in patients with all stages of ovarian cancer.
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of Vienna, A-1090 Vienna, Währinger Gürtel, Austria. lukas.hefler@meduniwien.ac.at
authors.forename: Lukas A
authors.initials: LA
authors.lastname: Hefler
authors.forename: Robert
authors.initials: R
authors.lastname: Zeillinger
authors.forename: Christoph
authors.initials: C
authors.lastname: Grimm
authors.forename: Anil K
authors.initials: AK
authors.lastname: Sood
authors.forename: Wen Fang
authors.initials: WF
authors.lastname: Cheng
authors.forename: Angiolo
authors.initials: A
authors.lastname: Gadducci
authors.forename: Clemens B
authors.initials: CB
authors.lastname: Tempfer
authors.forename: Alexander
authors.initials: A
authors.lastname: Reinthaller
mesh_terms: D018394:CA-125 Antigen / Q000097:blood; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000097:blood* / Q000473:pathology; D011300:Preoperative Care; D011379:Prognosis; D042461:Vascular Endothelial Growth Factor A / Q000097:blood*
chemical_list: D018394:CA-125 Antigen; D042461:Vascular Endothelial Growth Factor A