title: Predictive value of vascular endothelial growth factor overexpression in early relapse of colorectal cancer patients after curative resection.
abstract: BACKGROUND
  Preclinical and clinical studies have indicated that vascular endothelial growth factor (VEGF) is the predominant angiogenic factor. Recently, there was a consistent trend of poorer survival rates in colorectal cancer (CRC) patients of earlier relapse. The purpose of this study was to investigate novel predictors of early relapse in stage I-III CRC and further to determine their correlation with disease outcomes.
  
  
  METHODS
  We retrospectively analyzed clinicopathological features and VEGF expression by immunohistochemical staining in 100 stage I-III CRC patients undergoing curative resection to identify predictors of postoperative early relapse.
  
  
  RESULTS
  Among 100 patients, 40 patients were classified into early relapse group, and 60 patients were categorized into non-early relapse group. A multivariate logistic regression analysis showed that vascular invasion (P = 0.048), perineural invasion (P = 0.042), VEGF overexpression (P = 0.023), and high postoperative carcinoembryonic antigen (CEA) levels (P = 0.004) were independent predictors of early relapse. Additionally, we found that with more predictors such as the combined incidence of vascular invasion, perineural invasion, VEGF overexpression, and postoperative CEA levels are involved, the incidence of early postoperative relapse increases. Moreover, VEGF overexpression predicted not only early postoperative relapse but also disease-free survival (P < 0.001) and overall survival (P = 0.002).
  
  
  CONCLUSIONS
  This study suggests that VEGF overexpression is an important predictor of early postoperative relapse in patients with stage I-III CRC and may help identify patients who would benefit from intensive follow-up and therapeutic programs.
authors.affiliation: Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Hsiang-Lin
authors.initials: HL
authors.lastname: Tsai
authors.forename: I-Ping
authors.initials: IP
authors.lastname: Yang
authors.forename: Chih-Hung
authors.initials: CH
authors.lastname: Lin
authors.forename: Chee-Yin
authors.initials: CY
authors.lastname: Chai
authors.forename: Yu-Ho
authors.initials: YH
authors.lastname: Huang
authors.forename: Chin-Fan
authors.initials: CF
authors.lastname: Chen
authors.forename: Ming-Feng
authors.initials: MF
authors.lastname: Hou
authors.forename: Chao-Hung
authors.initials: CH
authors.lastname: Kuo
authors.forename: Suh-Hang
authors.initials: SH
authors.lastname: Juo
authors.forename: Jaw-Yuan
authors.initials: JY
authors.lastname: Wang
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D015179:Colorectal Neoplasms / Q000378:metabolism* / Q000473:pathology / Q000601:surgery*; D003710:Demography; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D011184:Postoperative Period; D012008:Recurrence; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism*
chemical_list: C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A