The role of VEGFR-2 expression in outcomes and survival of patients with peritoneal carcinomatosis from appendiceal cancer.
BACKGROUND
Vascular endothelial growth factor (VEGF) is a prognostic factor and target treatment for metastatic colorectal and ovarian cancer. Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) has improved survival on peritoneal carcinomatosis (PC) from appendiceal cancer. We hypothesize that tumoral high expression of VEGF receptor 2 (VEGFR-2) is a negative prognostic factor for survival in patients with PC from appendiceal cancer.


METHODS
A retrospective study of a prospective database revealed 89 patients with PC from appendiceal cancer who underwent 127 CRS/HIPECs. Surgical specimens from 59 patients were tested to identify high vs. low VEGFR-2 expression. Patient outcomes and survival were analyzed.


RESULTS
There were 26 males and 33 females. Mean age was 51 years. Forty-seven VEGFR-2 high expressers and 15 low expressers were identified. Mean follow-up of high and low expressers was 25.1 and 26.6 months, respectively (p = 0.806). At follow-up, 33 (70%) high expressers were alive and 14 (30%) deceased, while 11 (92%) low expressers were alive and 1 (8%) deceased. Recurrence, use of bevacizumab, CC score, PCI, and LN status showed no differences between high and low expressers. OS for high expressers was 90.5%, 59.8%, and 47.1% at 1-, 3-, and 5-years, respectively, while OS for low expressers remained stable at 91.7% at 1-, 3-, and 5-years (p = 0.133).


CONCLUSIONS
There is a trend towards better outcomes and survival in patients with PC from appendiceal cancer who have low expression of VEGFR-2 compared to high expression. More studies are encouraged to confirm this trend.
Institute for Cancer Care, Mercy Medical Center, 227 St. Paul Place, Baltimore, MD 21202-2001, USA. Electronic address: w.jimenez.md@gmail.com.
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Jimenez
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Sardi
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Ledakis
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Nieroda
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Sittig
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Gushchin
D000230:Adenocarcinoma / Q000235:genetics* / Q000556:secondary / Q000628:therapy*; D000328:Adult; D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000008:administration & dosage; D001063:Appendiceal Neoplasms / Q000473:pathology*; D000068258:Bevacizumab; D017024:Chemotherapy, Adjuvant; D010478:Chemotherapy, Cancer, Regional Perfusion; D005260:Female; D015870:Gene Expression; D006801:Humans; D006979:Hyperthermia, Induced; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000235:genetics* / Q000556:secondary / Q000628:therapy*; D011379:Prognosis; D012333:RNA, Messenger / Q000032:analysis; D012334:RNA, Neoplasm / Q000032:analysis; D012189:Retrospective Studies; D015996:Survival Rate; D040301:Vascular Endothelial Growth Factor Receptor-2 / Q000235:genetics*
D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D012333:RNA, Messenger; D012334:RNA, Neoplasm; D000068258:Bevacizumab; D040301:Vascular Endothelial Growth Factor Receptor-2
Angiogenesis; Appendiceal cancer; Bevacizumab; Cytoreductive surgery; HIPEC; VEGFR-2 expression