title: Intraperitoneal Vascular Endothelial Growth Factor: A Prognostic Factor and the Potential for Intraperitoneal Bevacizumab Use in Peritoneal Surface Malignancies.
abstract: BACKGROUND
  Intraperitoneal (IP) vascular endothelial growth factor (VEGF) levels have been shown to vary in the peritoneal cavity of patients with peritoneal surface malignancies. Our purpose was to correlate levels of IP VEGF with overall and disease-free survival to identify whether IP VEGF can be used to prognosticate patients and the possible role of IP bevacizumab.
  
  
  METHODS
  From February to October 2012, 97 consecutive patients with peritoneal carcinomatosis were treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Intravenous (IV) VEGF levels were taken before surgery, whereas IP VEGF levels were taken at various time points during and after surgery.
  
  
  RESULTS
  Median follow-up was 19.48 months. On univariate analysis, a lower IP VEGF taken just after incision (T1) was associated with improved overall (P = 0.0004) and disease-free survival (P = 0.0006) at 2 years. A lower T1/IV VEGF ratio also was associated with improved overall (P = 0.004) and disease-free survival (P = 0.0051). On multivariate analysis, a lower T1 was associated with improved overall survival, whereas a lower T1/IV VEGF was associated with improved disease-free survival. On subset analysis, these two variables were associated with improved survival in colorectal cancers.
  
  
  CONCLUSIONS
  A lower IP VEGF level prior to surgery is associated with improved survival. The use of preoperative intraperitoneal bevacizumab for patients with a heavy disease load should be considered, especially in colorectal cancers.
authors.affiliation: Department of Surgical Oncology, National Cancer Centre Singapore, Singapore, Singapore. clamchia@gmail.com.
authors.forename: Claramae Shulyn
authors.initials: CS
authors.lastname: Chia
authors.affiliation: Department of Oncologic and General Surgery, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud Pierre Bénite, Lyon, France.|UMR 37-38, Université Lyon 1, Lyon, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Glehen
authors.affiliation: Department of Gynaecology, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud Pierre Bénite, Lyon, France.|UMR 37-38, Université Lyon 1, Lyon, France.
authors.forename: Naoual
authors.initials: N
authors.lastname: Bakrin
authors.affiliation: Hospices Civils de Lyon, Pole IMER, Lyon, France.|Health Information and Clinical Research, Lyon, France.
authors.forename: Evelyne
authors.initials: E
authors.lastname: Decullier
authors.affiliation: UMR 37-38, Université Lyon 1, Lyon, France.|Department of Oncology, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud Pierre Bénite, Lyon, France.
authors.forename: Benoit
authors.initials: B
authors.lastname: You
authors.affiliation: Department of Oncologic and General Surgery, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud Pierre Bénite, Lyon, France.|UMR 37-38, Université Lyon 1, Lyon, France.
authors.forename: François Noël
authors.initials: FN
authors.lastname: Gilly
authors.affiliation: Department of Oncologic and General Surgery, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud Pierre Bénite, Lyon, France. guillaume.passot@chu-lyon.fr.|UMR 37-38, Université Lyon 1, Lyon, France. guillaume.passot@chu-lyon.fr.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Passot
mesh_terms: D000328:Adult; D000368:Aged; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D001202:Ascitic Fluid / Q000378:metabolism*; D000068258:Bevacizumab / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007274:Injections, Intraperitoneal; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009369:Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D010534:Peritoneal Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000556:secondary; D011379:Prognosis; D015996:Survival Rate; D042461:Vascular Endothelial Growth Factor A / Q000097:blood*
chemical_list: D020533:Angiogenesis Inhibitors; D014408:Biomarkers, Tumor; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab