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Vessel counts and expression of vascular endothelial growth factor as prognostic factors in node-negative colon
Y Takahashi1, S L Tucker, Y Kitadai
1Department of Surgical Oncology, University of Texas M. D. Anderson Cancer Center, Houston, USA.
Background:
The value of these prognostic factors was compared with that of other clinicopathologic factors such as tumor grade, tumor stage, mucin production, vascular invasion, perineural invasion, and lymphatic invasion.
Objective:
To determine whether the development of distant recurrence in patients with node-negative colon cancer could be predicted using vessel count and vascular endothelial growth factor (VEGF) expression.
Design:
Paraffin-embedded colon cancers were immunostained for factor VIII, VEGF, basic fibroblast growth factor, and proliferating cell nuclear antigen; slides were reviewed for differentiation, mucin production, and the presence of vascular, lymphatic, and/or perineural invasion.
Setting:
A large academic cancer referral center where 27 patients with node-negative colon cancer were operated on during 1988 and 1989.
Main Outcome Measure:
The development of and interval to recurrence.
Results:
Eight patients developed liver, lung, or lymph node metastases at a median of 24 months. The median follow-up for patients without cancer recurrence was 60 months. The mean tumor vessel count for those patients who remained disease-free was significantly fewer than for those patients who suffered a recurrence (20 vs 33, respectively). By univariate analysis, 3 factors- perineural invasion, vessel count, and VEGF expression- were correlated with time to recurrence. By multivariate analysis, only vessel count was significantly related to differences in time to recurrence. Expression of VEGF correlated with vessel count.
Conclusion:
Vessel count and expression of VEGF may be useful for predicting distant recurrence in patients with node-negative colon cancer.