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Vascular Endothelial Growth Factor is a Useful Predictor of Postoperative Distant Metastasis and Survival Prognosis in Esophageal Squamous Cell Carcinoma

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The correlation between vascular endothelial growth factor (VEGF) and prognosis for patients with esophageal squamous cell carcinoma (ESCC) is controversial. This study investigated the correlation of VEGF expression with distant metastases and prognosis in resectable ESCC to improve the identification of patients with increased risk of postoperative metastases.

Methods

Data from two centers were used to establish a training cohort (n = 319) and a validation cohort (n = 164). Tissue microarrays were generated for immunohistochemical evaluation. The correlations among VEGF expression, clinicopathologic variables, and prognosis were analyzed. The outcomes generated from the training cohort then were tested using the validation cohort. Multivariate analyses were used to test the independent factors that had an impact on postoperative distant metastases, overall survival (OS), and distant metastasis-free survival (DMFS).

Results

Tumor stages, tumor cell grade, and VEGF expression were prognostic factors independent of ESCC outcome. The data indicated that high levels of VEGF expression were correlated with a high risk of postoperative distant metastases (p = 0.013) in the training cohort. This result was confirmed by the validation cohort (p < 0.01) and logistic regression analyses. A high level of VEGF expression also was correlated with poor DMFS (p = 0.011) and OS (p = 0.033) in the training cohort, which also was confirmed by the validation cohort and Cox regression analyses.

Conclusions

Expression of VEGF is a predictor of distant metastasis, OS, and DMFS in resectable ESCC patients. Using a combination of VEGF expression, tumor stages, and tumor cell grade, identification of patients with increased risk of postoperative metastases may become possible.

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Acknowledgment

We thank Dr. T.-S. Zeng from the Department of Information and Computational Science, School of Mathematical Sciences, South China Normal University for helping us with data processing. This work was supported by the Fundamental Research Funds for the Central Universities in China (11ykpy59, 13ykzd27), the Guangdong Provincial Science and Technology Planning Foundation (2011B031800179, 2012B031800280, 2013B021800147), the Guangzhou Science and Technology Planning Foundation (201300000191), the Guangdong Esophageal Cancer Institute Science and Planning Foundation (M201401), and the State Scholarship Fund of the China Scholarship Council (201306385029).

Disclosure

The authors have no conflict of interest to disclose.

Author information

Authors and Affiliations

  1. Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, People’s Republic of China

    Xue Hou MD

  2. State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, People’s Republic of China

    Xue Hou MD, Jian-Hua Fu MD & Hao-Xian Yang MD, PhD

  3. Collaborative Innovation Center of Cancer Medicine, Guangzhou, Guangdong, People’s Republic of China

    Xue Hou MD, Jian-Hua Fu MD & Hao-Xian Yang MD, PhD

  4. Department of Thoracic Surgery, Linzhou Esophageal Cancer Hospital, Linzhou, Henan, People’s Republic of China

    Jin-Chang Wei MD

  5. Department of Thoracic Surgery, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, People’s Republic of China

    Jian-Hua Fu MD, Xin Wang MD, Lan-Jun Zhang MD, Peng Lin MD & Hao-Xian Yang MD, PhD

  6. Guangdong Esophageal Cancer Institute, Guangzhou, Guangdong, People’s Republic of China

    Jian-Hua Fu MD & Hao-Xian Yang MD, PhD

  7. Department of Pathology, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, People’s Republic of China

    Rong-Zhen Luo MD, PhD & Jie-Hua He MD, PhD

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  1. Xue Hou MD
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  2. Jin-Chang Wei MD
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  3. Jian-Hua Fu MD
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  4. Xin Wang MD
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  5. Rong-Zhen Luo MD, PhD
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  6. Jie-Hua He MD, PhD
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  7. Lan-Jun Zhang MD
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  8. Peng Lin MD
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  9. Hao-Xian Yang MD, PhD
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Correspondence to Hao-Xian Yang MD, PhD.

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Hou, X., Wei, JC., Fu, JH. et al. Vascular Endothelial Growth Factor is a Useful Predictor of Postoperative Distant Metastasis and Survival Prognosis in Esophageal Squamous Cell Carcinoma. Ann Surg Oncol 22, 3666–3673 (2015). https://doi.org/10.1245/s10434-015-4390-x

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  • DOI: https://doi.org/10.1245/s10434-015-4390-x

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