title: High preoperative serum vascular endothelial growth factor levels predict poor clinical outcome after curative resection of gastric cancer.
abstract: BACKGROUND
  Tumour vascular endothelial growth factor (VEGF) and tumour urokinase-type plasminogen activator (uPA) are prognostic factors in gastric cancer but surgical specimens are required for testing. The prognostic value of preoperative serum VEGF (s-VEGF) and serum uPA (s-uPA) levels was evaluated in patients undergoing potentially curative (R0) gastric cancer resection.
  
  
  METHODS
  Concentrations of s-VEGF and s-uPA were measured 97 patients with gastric cancer and 20 controls. Angiogenesis was measured in vitro based on human endothelial cell tube formation.
  
  
  RESULTS
  Levels of s-VEGF were higher in patients with gastric cancer than controls (median 288 versus 189 pg/ml respectively; P = 0.002). They were associated with pathological tumour node metastasis (pTNM) stage, pT, pN, lymph node ratio and perineural invasion, and correlated with platelet counts. In multivariable analysis, s-VEGF over 320 pg/ml was the only preoperative predictor of both recurrence and disease-specific survival. Serum from patients with raised s-VEGF levels enhanced angiogenesis in vitro significantly more than serum from those with a s-VEGF level of 320 pg/ml or less.
  
  
  CONCLUSIONS
  High preoperative s-VEGF level is an independent prognostic factor for recurrence and survival after R0 resection of gastric cancer. This may provide a useful guide to decision making regarding neoadjuvant and adjuvant therapies.
authors.affiliation: Service of General and Digestive Surgery, Institut de Malalties Digestives i Metabolisme, Barcelona, Spain.
authors.forename: O
authors.initials: O
authors.lastname: Vidal
authors.forename: J-P
authors.initials: JP
authors.lastname: Metges
authors.forename: I
authors.initials: I
authors.lastname: Elizalde
authors.forename: M
authors.initials: M
authors.lastname: Valentíni
authors.forename: A
authors.initials: A
authors.lastname: Volant
authors.forename: R
authors.initials: R
authors.lastname: Molina
authors.forename: A
authors.initials: A
authors.lastname: Castells
authors.forename: M
authors.initials: M
authors.lastname: Pera
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood*; D013274:Stomach Neoplasms / Q000097:blood / Q000401:mortality / Q000601:surgery*; D014568:Urokinase-Type Plasminogen Activator / Q000097:blood*; D042461:Vascular Endothelial Growth Factor A / Q000097:blood*
chemical_list: D014408:Biomarkers, Tumor; D042461:Vascular Endothelial Growth Factor A; D014568:Urokinase-Type Plasminogen Activator