Serum VEGF Levels As a Predictor of Recurrence in Patients with Advanced‑stage Esophageal Squamous Cell Carcinoma Following Curative Esophagectomy Followed by Chemotherapy or Concurrent Radiotherapy

Overview

Journal Mol Clin Oncol

Specialty Oncology

Date 2023 Oct 9

PMID 37809347

Authors

Heng Xu

Haixia Cao

Junying Zhang

Changwen Jing

Zhuo Wang

Jianzhong Wu

Mengjie Du

Xuyun Xu

Rong Ma

Affiliations

Soon will be listed here.

Abstract

The present study evaluated serum levels of vascular endothelial growth factor (VEGF) as a predictor of recurrence in patients with advanced-stage esophageal squamous cell carcinoma (ESCC) following curative esophagectomy followed by chemotherapy or concurrent radiotherapy. Patients with locally advanced resectable ESCC underwent R0 esophagectomy followed by chemotherapy or concurrent radiotherapy as an adjuvant. Serum VEGF levels in 173 patients, including 57 patients with recurrent disease, and 183 healthy controls were determined using a Luminex assay. The results demonstrated that the serum VEGF levels were significantly higher in 57 patients with locally advanced resectable ESCC at recurrence compared with the levels at pre-treatment (P<0.001). The patients with recurrence exhibited significantly higher serum VEGF levels during chemotherapy or concurrent radiotherapy than patients with no recurrence (P<0.05). Patients with low serum VEGF levels had a significantly longer survival time than those with high serum VEGF levels prior to treatment (P<0.01). The median survival times were 70 and 25 months in patients with locally advanced resectable ESCC with serum VEGF levels <161.75 and ≥161.75 pg/ml following treatment, respectively (P<0.01). Compared with patients with VEGF levels <147 pg/ml following treatment, patients with locally advanced resectable ESCC with VEGF levels ≥147 pg/ml had a significantly higher risk of recurrence (P<0.01). Patients with low serum VEGF levels (<147 pg/ml) had significantly higher recurrence-free survival rates than those with high serum VEGF levels (≥147 pg/ml) following treatment (P<0.01). The findings of the present study demonstrate that serum VEGF levels are a potential predictor of recurrence and of the treatment outcomes of chemotherapy or concurrent radiotherapy in patients with locally advanced resectable ESCC.

References

Wang Y, Wang L, Yang Q, Li J, He M, Yao J . [Patterns of recurrence in patients with stage pT3N0M0 thoracic esophageal squamous cell carcinoma after two-field esophagectomy]. Zhonghua Zhong Liu Za Zhi. 2016; 38(1):48-54. DOI: 10.3760/cma.j.issn.0253-3766.2016.01.010. View

Smyth E, Lagergren J, Fitzgerald R, Lordick F, Shah M, Lagergren P . Oesophageal cancer. Nat Rev Dis Primers. 2017; 3:17048. PMC: 6168059. DOI: 10.1038/nrdp.2017.48. View

Wang L, Chow K, Chi K, Liu C, Li W, Chiu J . Prognosis of esophageal squamous cell carcinoma: analysis of clinicopathological and biological factors. Am J Gastroenterol. 1999; 94(7):1933-40. DOI: 10.1111/j.1572-0241.1999.01233.x. View

Lordick F, Mariette C, Haustermans K, Obermannova R, Arnold D . Oesophageal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2016; 27(suppl 5):v50-v57. DOI: 10.1093/annonc/mdw329. View

Ma R, Xu H, Wu J, Sharma A, Bai S, Dun B . Identification of serum proteins and multivariate models for diagnosis and therapeutic monitoring of lung cancer. Oncotarget. 2017; 8(12):18901-18913. PMC: 5386656. DOI: 10.18632/oncotarget.14782. View

Shen W, Gao H, Zhu S, Li Y, Li S, Xu J . Analysis of the causes of failure after radical surgery in patients with TNM thoracic esophageal squamous cell carcinoma and consideration of postoperative radiotherapy. World J Surg Oncol. 2017; 15(1):192. PMC: 5657067. DOI: 10.1186/s12957-017-1259-4. View

Huang F, Yu S . Esophageal cancer: Risk factors, genetic association, and treatment. Asian J Surg. 2016; 41(3):210-215. DOI: 10.1016/j.asjsur.2016.10.005. View

Siegel R, Miller K, Jemal A . Cancer Statistics, 2017. CA Cancer J Clin. 2017; 67(1):7-30. DOI: 10.3322/caac.21387. View

Liu Q, Cai X, Wu B, Zhu Z, Chen H, Fu X . Patterns of failure after radical surgery among patients with thoracic esophageal squamous cell carcinoma: implications for the clinical target volume design of postoperative radiotherapy. PLoS One. 2014; 9(5):e97225. PMC: 4018255. DOI: 10.1371/journal.pone.0097225. View

10.

Liu Y, Xiong Z, Beasley A, DAmico T, Chen X . Personalized and targeted therapy of esophageal squamous cell carcinoma: an update. Ann N Y Acad Sci. 2016; 1381(1):66-73. PMC: 5083215. DOI: 10.1111/nyas.13144. View

11.

Butkiewicz D, Gdowicz-Klosok A, Krzesniak M, Rutkowski T, Krzywon A, Cortez A . Association of Genetic Variants in ANGPT/TEK and VEGF/VEGFR with Progression and Survival in Head and Neck Squamous Cell Carcinoma Treated with Radiotherapy or Radiochemotherapy. Cancers (Basel). 2020; 12(6). PMC: 7352333. DOI: 10.3390/cancers12061506. View

12.

Li B, Liu Y, Peng J, Sun C, Rang W . Trends of Esophageal Cancer Incidence and Mortality and Its Influencing Factors in China. Risk Manag Healthc Policy. 2021; 14:4809-4821. PMC: 8643221. DOI: 10.2147/RMHP.S312790. View

13.

Araki K, Ohno S, Egashira A, Saeki H, Kawaguchi H, Sugimachi K . Pathologic features of superficial esophageal squamous cell carcinoma with lymph node and distal metastasis. Cancer. 2002; 94(2):570-5. DOI: 10.1002/cncr.10190. View

14.

Aggarwal S, Devaraja K, Sharma S, Das S . Expression of vascular endothelial growth factor (VEGF) in patients with oral squamous cell carcinoma and its clinical significance. Clin Chim Acta. 2014; 436:35-40. DOI: 10.1016/j.cca.2014.04.027. View

15.

. Integrated genomic characterization of oesophageal carcinoma. Nature. 2017; 541(7636):169-175. PMC: 5651175. DOI: 10.1038/nature20805. View

16.

Fujita N, Okegawa T, Terado Y, Tambo M, Higashihara E, Nutahara K . Serum level and immunohistochemical expression of vascular endothelial growth factor for the prediction of postoperative recurrence in renal cell carcinoma. BMC Res Notes. 2014; 7:369. PMC: 4072492. DOI: 10.1186/1756-0500-7-369. View

17.

Wang S, Chen X, Fan J, Lu L . Prognostic Significance of Lymphovascular Invasion for Thoracic Esophageal Squamous Cell Carcinoma. Ann Surg Oncol. 2016; 23(12):4101-4109. DOI: 10.1245/s10434-016-5416-8. View

18.

Huang Q, Luo K, Chen C, Wang G, Jin J, Kong M . Identification and Validation of Lymphovascular Invasion as a Prognostic and Staging Factor in Node-Negative Esophageal Squamous Cell Carcinoma. J Thorac Oncol. 2016; 11(4):583-92. DOI: 10.1016/j.jtho.2015.12.109. View

19.

Li C, Zhang F, Wang Y, Han C, Sun G, Liu Q . Characteristics of recurrence after radical esophagectomy with two-field lymph node dissection for thoracic esophageal cancer. Oncol Lett. 2012; 5(1):355-359. PMC: 3525472. DOI: 10.3892/ol.2012.946. View

20.

Lai Y, Wang X, Zeng T, Xing S, Dai S, Wang J . Serum VEGF levels in the early diagnosis and severity assessment of non-small cell lung cancer. J Cancer. 2018; 9(9):1538-1547. PMC: 5950582. DOI: 10.7150/jca.23973. View