title: A prognostic evaluation of vascular endothelial growth factor in children and young adults with osteosarcoma.
abstract: BACKGROUND
  The potential role of VEGF in osteosarcoma has been evaluated in several studies. The majority of them included heterogeneous and limited series of patients, giving conflicting results. The aim of presented study is to evaluate the prognostic role of VEGF-A in biopsy samples of clinically homogeneous group of osteosarcoma patients with at least 5 years of follow up.
  
  
  METHODS
  VEGF-A was assessed immunohistochemically in the pre-treatment biopsy samples of 91 patients (mean age 14 years; range, 4-23 years) with primary, high-grade, non-metastatic osteosarcoma localized in extremities. The survival of each patient was assessed after at least 5-year follow-up period.
  
  
  RESULTS
  VEGF-A over 50% of positive tumor cells was observed in 39% of cases and was linked to patients age below 14-year old (P = 0.025) and tumor size more than 8 cm (P = 0.054). VEGF-A was associated with a significantly decreased both overall survival (P = 0.006) and progression-free survival (P = 0.011). In the Cox proportional hazard model it was confirmed that VEGF-A expression in the biopsy samples was an independent prognostic factor of unfavorable survival in osteosarcoma (HR 2.51; 95% CI: 1.12-5.66).
  
  
  CONCLUSIONS
  The expression of VEGF-A in the biopsy sample is the potential marker for predicting the course and outcome of osteosarcoma.
authors.affiliation: Institute of Mother and Child, Department of Pediatrics and Adolescent Oncological Surgery, Warsaw, Poland. kiwonka@wp.pl
authors.forename: Iwona
authors.initials: I
authors.lastname: Ługowska
authors.forename: Wojciech
authors.initials: W
authors.lastname: Woźniak
authors.forename: Teresa
authors.initials: T
authors.lastname: Klepacka
authors.forename: Elżbieta
authors.initials: E
authors.lastname: Michalak
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Szamotulska
mesh_terms: D000293:Adolescent; D000328:Adult; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D008297:Male; D012516:Osteosarcoma / Q000378:metabolism* / Q000401:mortality* / Q000473:pathology; D016016:Proportional Hazards Models; D015996:Survival Rate; D042461:Vascular Endothelial Growth Factor A / Q000096:biosynthesis*; D055815:Young Adult
chemical_list: C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A