Angiogenic markers show high prognostic impact on survival in marginally operable non-small cell lung cancer patients treated with adjuvant radiotherapy.
BACKGROUND
Protein expressions of angiogenic markers provide prognostic information on patients with non-small cell lung cancer (NSCLC). Both expression and its prognostic impact may be associated with patient selection. Data addressing the prognostic relevance of angiogenic marker expression in NSCLC patients treated with postoperative radiotherapy (PORT) is warranted.


METHODS
In 55 patients with stage I-IIIA NSCLC administered PORT between 1990 and 2005, we have reviewed the clinicopathological variables and investigated the expression of angiogenic markers in tumor and stroma in tissue micro arrays.


RESULTS
The median follow-up was 114 months and the major end point disease-specific survival (DSS). Univariate analysis showed that high expression of vascular endothelial growth factor A (VEGF-A) (p = 0.004), VEGF receptor-1 (VEGFR-1, p = 0.028), VEGFR-2 (p = 0.021), VEGFR-3 (p = 0.001) and platelet derived growth factor (PDGF) in tumors correlated significantly with a poor survival. Inversely, high basic fibroblast growth factor (bFGF) expression in stroma was associated with significantly improved DSS (p = 0.017). In multivariate analyses, tumor PDGF expression appeared independently associated with a shorter DSS (hazard ratio 5.42, p = 0.002) and stromal bFGF expression an increased DSS (hazard ratio 0.077, p < 0.001).


CONCLUSIONS
Tumor PDGF expression was an independent negative prognostic factor and stromal bFGF expression an independent positive prognostic factor for survival in NSCLC receiving PORT.
Andersen
Sigve
S
Institute of Clinical Medicine, University of Tromso, Tromso, Norway. sigve.andersen@unn.no
Donnem
Tom
T
Al-Saad
Samer
S
Al-Shibli
Khalid
K
Busund
Lill-Tove
LT
Bremnes
Roy M
RM
D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000737:chemistry / Q000401:mortality* / Q000532:radiotherapy; D018572:Disease-Free Survival; D005260:Female; D016222:Fibroblast Growth Factor 2 / Q000032:analysis; D006801:Humans; D007150:Immunohistochemistry; D008175:Lung Neoplasms / Q000737:chemistry / Q000401:mortality* / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D010982:Platelet-Derived Growth Factor / Q000032:analysis*; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D040262:Receptors, Vascular Endothelial Growth Factor / Q000032:analysis*; D042461:Vascular Endothelial Growth Factor A / Q000032:analysis*
D010982:Platelet-Derived Growth Factor; D042461:Vascular Endothelial Growth Factor A; D016222:Fibroblast Growth Factor 2; D040262:Receptors, Vascular Endothelial Growth Factor