title: VEGF-C as a decision-making biomarker for selected patients with invasive bladder cancer who underwent bladder-preserving radical surgery.
abstract: OBJECTIVE
  We proved the feasibility of radical transurethral resection in selected patients with muscle-invasive bladder cancer with a minimum follow-up of >5 years. A follow-up schedule was developed based on progression and recurrence during this period.
  
  
  METHODS
  The study included 93 patients with invasive bladder cancer treated by radical transurethral resection. Student t test was used for continuous variables to establish clinical progression predictive factors. VEGF-C protein expressions were tested by immunohistochemistry postsurgery.
  
  
  RESULTS
  The overall survival and disease-specific survival rates for all 93 patients were 59.1% and 65.2%, respectively. The clinical stage of the tumor influenced overall survival (p = 0.024) and disease-specific survival (p = 0.047). A significantly higher overall survival and disease-specific survival rate for patients with low levels of VEGF-C was 69.6% and 75.0%, respectively, than for those with high levels of VEGF-C (45.9 and 54.1%, respectively, p <0.05).The presence of bladder Tis reduced the survival rate (41.2 vs. 65.3%) and disease-specific survival (45.4 vs. 72.1%). Sensitivity, specificity and accuracy of VEGF-C in the evaluation of disease progression were 76.7, 77.8, 77.4%, respectively.
  
  
  CONCLUSIONS
  Patients with T2 stage, low level of VEGF-C and absence of bladder Tis were associated with high overall survival and disease-specific survival rate. VEGF-C level can evaluate disease progression and assist in choosing the appropriate treatment.
authors.affiliation: Department of Urology, Xiangya Hospital, Central South University, Changsha city, Hunan province, China.
authors.forename: Zhuo
authors.initials: Z
authors.lastname: Li
authors.forename: Fan
authors.initials: F
authors.lastname: Qi
authors.forename: Lin
authors.initials: L
authors.lastname: Qi
authors.forename: Huihui
authors.initials: H
authors.lastname: Zhang
authors.forename: Minfeng
authors.initials: M
authors.lastname: Chen
authors.forename: Long
authors.initials: L
authors.lastname: Wang
authors.forename: Xiongbing
authors.initials: X
authors.lastname: Zu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood*; D018572:Disease-Free Survival; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016019:Survival Analysis; D001749:Urinary Bladder Neoplasms / Q000601:surgery*; D042582:Vascular Endothelial Growth Factor C / Q000097:blood*
chemical_list: D015415:Biomarkers; D042582:Vascular Endothelial Growth Factor C