The aim of the study was to evaluate
VEGF expression in tumour biopsies as a prognostic factor for
radiotherapy outcome in advanced
carcinoma of the cervix. A retrospective study was carried out on 100 patients. Pre-treatment tumour
VEGF expression was examined immunohistochemically in
formalin-fixed,
paraffin-embedded biopsies using a widely available commercial antibody. A semi-quantitative analysis was made using a scoring system of 0, 1, 2, and 3, for increasing intensity of staining. High
VEGF expression was associated with a poor prognosis. A univariate log rank analysis found a significant relationship with overall survival (P = 0.0008) and
metastasis-free survival (P = 0.0062), but not local control (P = 0.23). There was no correlation between
VEGF expression and disease stage, tumour differentiation, patient age, or tumour radiosensitivity (SF2). In a Cox multivariate analysis of survival
VEGF expression was the most significant independent prognostic factor (P = 0.001). After allowing for
VEGF only SF2 was a significant prognostic factor (P = 0.003). In conclusion, immunohistochemical analysis of
VEGF expression is a highly significant and independent prognostic
indicator of overall and
metastasis-free survival for patients treated with
radiotherapy for advanced
carcinoma of the cervix. It is also a rapid and easy method that could be used in the clinical setting, to identify patients at high risk of failure with conventional
radiotherapy who may benefit from novel approaches or
chemoradiotherapy.