METHODS: Serum
VEGF levels in patients with
colorectal cancer (median, 492 pg/mL; interquartile range, 281 to 737 pg/mL) were higher (P <.0001) than in control subjects (median, 186 pg/mL; interquartile range, 100 to 273 pg/mL). There was a significant association between serum
VEGF levels and disease stage, invasion depth of the
tumor, the presence of lymph node and distant
metastases, and the degree of differentiation. Curative but not palliative resection of the primary
tumor resulted in a significant decrease of preoperative serum
VEGF levels but normalized in only 72% of patients. Failure of a return of
VEGF to normal after resection for cure was associated with an increased although not statistically significant risk of
metastasis during follow-up. Univariate analysis showed a lower survival rate for patients with increased preoperative serum
VEGF levels (P <.002). Multivariate regression analysis showed that the prognostic value of serum
VEGF level was not independent of
tumor stage.
CONCLUSIONS: These findings suggest that
VEGF plays an important role in
tumor progression and the formation of distant
metastases in
colorectal cancer. It is at present unclear whether serial estimation of serum
VEGF is clinically useful in the prediction of
tumor relapse.