Expression of vascular endothelial growth factor (VEGF) in locally invasive prostate cancer is prognostic for radiotherapy outcome.
OBJECTIVE
Vascular endothelial growth factor (VEGF) is an important hypoxia-inducible pro-angiogenic protein that has been linked with an adverse survival outcome after radiotherapy in other cancer types: we hypothesized that this may also occur in prostate cancer. A retrospective study was, therefore, carried out to evaluate the potential of tumor VEGF expression to predict radiotherapy outcome in patients with high-risk prostate cancer.


METHODS
Fifty patients with locally advanced (T3 N0 M0) tumors of Gleason score > or =6, and who received radiotherapy alone as primary treatment for their disease, were studied. Vascular endothelial growth factor expression was assessed on pretreatment diagnostic tumor biopsies using a semiquantitative immunohistochemical scoring system. The results were analyzed in relation to clinicopathologic factors and patient outcome including biochemical failure and disease-specific mortality.


RESULTS
High VEGF expression was associated with a poor prognosis: in univariate log rank analysis, VEGF was the only significant prognostic factor for disease-specific survival (p = 0.035). High VEGF expression also associated with increased Gleason score (p = 0.02), but not posttreatment biochemical failure.


CONCLUSIONS
High tumor expression of VEGF identified patients at high risk of failure of treatment with radiotherapy. These patients might benefit from additional treatment approaches incorporating anti-angiogenic or hypoxia-specific agents.
Green
Melanie M L
MM
Department of Pharmacy and Pharmaceutical Sciences, Coupland III, University of Manchester, Oxford Road, Manchester, UK.
Hiley
Crispin T
CT
Shanks
Jonathan H
JH
Bottomley
Ian C
IC
West
Catharine M L
CM
Cowan
Richard A
RA
Stratford
Ian J
IJ
D000368:Aged; D018572:Disease-Free Survival; D006801:Humans; D016014:Linear Models; D008297:Male; D009363:Neoplasm Proteins / Q000378:metabolism*; D011379:Prognosis; D011467:Prostate / Q000378:metabolism / Q000528:radiation effects; D011471:Prostatic Neoplasms / Q000378:metabolism* / Q000532:radiotherapy*; D012189:Retrospective Studies; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism*
D009363:Neoplasm Proteins; D042461:Vascular Endothelial Growth Factor A