J. Cancer Mol. 2: 161-167, 2006

[Research Paper] 

Prognostic Significance of Vascular Endothelial Growth Factor-A Expression in Colorectal Cancer 

Yalcin Kekec, Semra Paydas, Suzan Zorludemir, Cem Kaan Parsak, Gurhan Sakman, and Gulsah Seydaoglu

Departments of General Surgery [Y. Kekec, C. K. Parsak, G. Sakman], Medical Oncology [S. Paydas], Pathology [S. Zorludemir], and Biostatistics [G. Seydaoglu], Faculty of Medicine, Cukurova University, Adana, Balcali, Turkey

Abstract:

AIM: To study the expression status and clinical relevance of vascular endothelial growth factor-A (VEGF-A) in colorectal cancer (CRC) tissues.

METHODS: VEGF-A expression was investigated by immunohistochemistry in 89 cases with CRC.  Some demographic and histopathologic variables were compared with VEGF-A expression to determine the prognostic significance in CRC.

RESULTS:  VEGF-A (-) was found in 24 cases; (+), (++) and (+++) stainings were detected in 24, 35 and 6 cases, respectively.  VEGF-A (-) was found in 20 of 58 cases with left colon cancer, while only 4 of 31 cases with right colon cancer were VEGF-A (-)(P = 0.024).  There was a trend for lower tumor grade and lesser serosal invasion in cases with VEGF-A (-) samples (P = 0.07 and P = 0.079, respectively).  Although the correlation was not statistically significant, there was a trend for lower death rate in cases with VEGF-A (-) tumor (P = 0.087).  The longest survival was found in cases with VEGF-A (-) tumor and the shortest survival was found in cases with VEGF-A (+++) tumor.  Median survival for patients with VEGF-A (-), (+), (++) and (+++) tumors was 59, 47, 35 and 11 months, respectively (P = 0.02).  The Cox proportional hazards model identified stage IV disease and VEGF-A (+++) tumor as having the most important influences upon overall survival (odds ratio: 5.1, 95% confidence interval: 2.0-13.0 and odds ratio: 3.6, 95% confidence interval: 1.0-12.7, respectively), followed by serosal invasion (odds ratio: 2.4, 95% confidence interval: 1.0-5.9).

CONCLUSION: This study shows that VEGF-A is a poor prognostic factor in cases with CRC but the relatively small size of the study group precluded the correlation with all the known prognostic indicators.

 Received 7/20/06; Revised 8/11/06; Accepted 8/11/06.

¹Correspondence: Dr. Semra Paydas, Department of Medical Oncology, Faculty of Medicine, Cukurova University, Adana, Balcali 01330, Turkey. Fax: 90-322-338 6153. E-mail: sepay@cu.edu.tr

²Abbreviations: VEGF, vascular endothelial growth factor; CRC, colorectal cancer; LVI, lymphovascular invasion; SI, serosal invasion.