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VEGF and progression in urothelial carcinoma

VEGF as a prognosticator of tumor stage

A number of studies have validated the importance of vascular endothelial growth factor (VEGF) as a marker for progression in urothelial carcinoma of the bladder. The relationship was ascertained by Yang et al, who determined that VEGF was significantly correlated with tumor stage (P<0.05), and by Shariat et al, who reported an association between VEGF and established clinicopathologic features of aggressive urothelial carcinoma. These findings are consistent with those of Bernardini et al, who observed a significant relationship between high serum VEGF (sVEGF) levels (median 247.9 pg/mL) and urothelial carcinoma stage (P<0.0001), grade (P<0.02), vascular invasion (P<0.001), and carcinoma in situ (P<0.01). High median sVEGF levels (582 pg/mL) were also associated with metastases (P<0.0001) as well as with disease-free survival (when >400 pg/mL, P<0.0001).^1-3

VEGF and survival

High VEGF levels portend poor prognosis not only with regard to tumor stage, but also to overall survival. Results from one study indicated that bladder cancer patients with higher VEGF-A mRNA levels had a significantly shorter survival without progression, compared with those with lower levels. The study involved a group of 37 patients and included both noninvasive and stroma-invasive urothelial tumors and muscle-invasive carcinomas. Expression levels of 3 different VEGF-A isoforms were analyzed in the study to decipher their prognostic significance.⁴ In a separate analysis of locally advanced bladder tumor samples derived from 64 patients, high VEGF expression was correlated with a much poorer survival (P<0.001).⁵

References:

1.

Yang S, Wu X, Luo C, et al. World J Urol. 2010;28:473-478.

2.

Shariat SF, Youssef RF, Gupta A, et al. J Urol. 2010;183:1744-1750.

3.

Bernardini S, Fauconnet S, Chabannes E, et al. J Urol. 2001;166:1275-1279.

4.

Fauconnet S, Bernardini S, Lascombe I, et al. Oncol Rep. 2009;21:1495-1504.

5.

Slaton JW, Millikan R, Inoue K, et al. J Urol. 2004 Feb;171:570-574.