title: Preoperative serum vascular endothelial growth factor-a is a marker for subsequent recurrence in colorectal cancer patients.
abstract: OBJECTIVE
  Serum vascular endothelial growth factor-A has been associated with stage of disease and prognosis in colorectal cancer. In this study, the clinical usefulness of preoperative serum vascular endothelial growth factor-A concentrations in the long-term follow-up of colorectal cancer patients was evaluated.
  
  
  METHODS
  Serum vascular endothelial growth factor-A levels were determined by quantitative enzyme-linked immunosorbent assay in 93 patients prior to resection for colorectal cancer: node-negative (n = 41) and node-positive (n = 52). Median follow-up for patients without cancer death was 54 (interquartile range, 24-63.5) months.
  
  
  RESULTS
  The median preoperative serum vascular endothelial growth factor-A level of these patients was 168 (interquartile range, 48-414) pg/ml. Seven patients had local recurrences with a median time of 6 (interquartile range, 4-12) months. Patients (n = 17) that developed metastasis had a median time of 17 (interquartile range, 7-42) months. Patients with local recurrence had significantly higher levels of serum vascular endothelial growth factor-A (P = 0.01). By classifying the patients into two groups, using the maximal chi-squared value of the Cox's regression based on our previous work, it was found that a serum vascular endothelial growth factor-A level >575 pg/ml is an independent prognostic factor for predicting tumor recurrence.
  
  
  CONCLUSIONS
  Patients with colorectal cancer who have preoperative serum vascular endothelial growth factor-A levels >575 pg/ml are more likely to develop recurrence. Trials are warranted to investigate the efficacy of adjuvant therapy for this high-risk group.
authors.affiliation: Academic Surgical Unit, Division of Cancer, Postgraduate Medical Institute in association with Hull and York Medical School, University of Hull, Hull, United Kingdom.
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Alabi
authors.forename: Aravind
authors.initials: A
authors.lastname: Suppiah
authors.forename: Leigh A
authors.initials: LA
authors.lastname: Madden
authors.forename: John R
authors.initials: JR
authors.lastname: Monson
authors.forename: John
authors.initials: J
authors.lastname: Greenman
mesh_terms: D000230:Adenocarcinoma / Q000097:blood* / Q000401:mortality / Q000601:surgery; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D015179:Colorectal Neoplasms / Q000097:blood* / Q000401:mortality / Q000601:surgery; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000097:blood*; D011300:Preoperative Care; D011379:Prognosis; D012044:Regression Analysis; D042461:Vascular Endothelial Growth Factor A / Q000097:blood*
chemical_list: D014408:Biomarkers, Tumor; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A