The aim of the present study was to evaluate serum concentrations of
vascular endothelial growth factor (
VEGF) in patients with
vulvar cancer and healthy female controls with respect to correlation of
VEGF with clinicopathological parameters and impact on the patients' prognosis. Serum concentrations of
VEGF were measured using a commercially available ELISA. Results were correlated to clinical data. Median serum concentrations of
VEGF in patients with
vulvar cancer (n = 41) and healthy female controls (n = 130) were 260 (range, 33-1216) pg/ml and 216 (range, 0-777) pg/ml, respectively (Mann-Whitney U test, P = 0.048). Serum concentrations of
VEGF significantly correlated with
tumor stage (Mann-Whitney U test, P = 0.02) but not with histological grade (Mann-Whitney U test, P = 0.2). In a univariate analysis, elevated pretreatment serum concentrations of
VEGF were significantly correlated with a shortened disease-free and overall survival (Wilcoxon test, P = 0.03; and Wilcoxon test, P = 0.04, respectively). A multivariate Cox regression model considering
tumor stage and serum concentrations of
VEGF revealed, however, that serum concentrations of
VEGF did not confer additional prognostic information to that already obtained by the established prognosticator
tumor stage (multivariate Cox regression model: P = 0.9 and P = 0.8, respectively). Our data indicate that angiogenesis, as reflected by serum concentrations of
VEGF, plays a functional role in vulvar
carcinogenesis.
VEGF seems to be a mediator of vulvar
tumor growth but not of
tumor cell dedifferentiation. Although associated with impaired disease-free and overall survival, pretreatment serum concentrations of
VEGF are not an independent predictor of outcome in patients with
vulvar cancer.