Prognostic relevance of serum vascular endothelial growth factor in ovarian cancer

The vascular endothelial growth factor (VEGF) is the angiogenic growth factor most strongly implicated in tumor angiogenesis. Its special role in the pathophysiology of ovarian cancer emerges from its dual functional capability as an endothelial cell mitogen and a potent stimulator of vascular permeability, leading to the characteristic ascites accumulation in this disease. The aim of our study was to analyze the prognostic value of serum VEGF (sVEGF) as a tumor marker in ovarian cancer.

41 patients with ovarian carcinomas were included in the study. Venous blood was taken from all patients preoperatively. From 15 patients an additional postoperative blood sample was drawn. sVEGF was measured in duplicate using a commercially available ELISA-kit.

The mean sVEGF level for the ovarian cancer patients was 522 +/- 321 pg/ml (SD) (median: 440; range: 55-1263 pg/ml) No statistically significant correlation could be found between sVEGF concentration and age, histologic type or FIGO-stage. sVEGF values four weeks after surgery were significantly lower than those before treatment (p = 0.002). In patients after radical surgery sVEGF values dropped or stayed stable below the cut-off more often than in patients with residual disease. In the univariate analysis, improved overall survival (OS) was found for ovarian cancer patients with a sVEGF below the cut-off value of 440 pg/ml (p = 0.017). sVEGF was also tested in a multivariate analysis together with residual disease and FIGO-stage using the Cox's proportional hazard model. In the final model only residual disease had an independent influence on OS (p = 0.018).

sVEGF levels decrease significantly after cytoreductive therapy and might indicate treatment efficiency. According to our study, sVEGF is not an independent prognosticator of survival for ovarian cancer.