662P - Increased VEGF-C serum levels are predictive of a poor outcome in patients with resectable gastric cancer

Date 29 September 2014
Event ESMO 2014
Session Poster Display session
Topics Gastric Cancer
Translational Research
Presenter Maria Maddalena Laterza
Authors M.M. Laterza, M. Orditura, A. Fabozzi, J. Ventriglia, B. Savastano, A. Petrillo, G. Giordano, E. Martinelli, V. Gambardella, F. Ciardiello, F. De Vita
  • Medical Oncology, Second University of Naples, 80131 - Naples/IT

Abstract

Aim

Vascular endothelial growth factor C (VEGF-C), also known as vascular endothelial growth factor-related protein (VRP) is a VEGF growth factor family member playing a key-role in lymphangiogenesis. It is overexpressed in 30-60% of gastric cancer patients, showing a strong correlation with an advanced stage and a poor survival. Based on this background we investigated the meaning of serum levels of VEGF-C in gastric cancer patients suitable for surgery.

Methods

Preoperative VEGF-C serum levels were determined by enzyme-linked immunoadsorbent assay (ELISA) in 183 patients with gastric carcinoma and 51 healthy subjects (control group) observed at our department from January 2008 until December 2012.

Results

Patients characteristics were the following: median age was 64 years (range 22 - 91), the male/female ratio was 115/68. The stage at diagnosis was 1A: 2.2%, 1B: 10.9%, 2A: 13.1%, 2B: 11.5%, 3A: 25.1%, 3B: 15.3%, 4: 21.9%. 29% of patients showed a proximal primary site of tumor, 32.2% a middle and 38.8% a distal primary site localization.

Preoperative VEGF-C serum levels were significantly higher in gastric cancer patients (mean, 295 pg/mL; range, 55–865 pg/mL) if compared with the control group (mean, 30 pg/mL; range, 11.8– 60,2 pg/mL; P< 0.001). High VEGF-C serum levels correlated with nodal diffusion: in fact, node-positive patients showed significantly higher levels (mean, 339 pg/mL – 95% C.I, 307.4 – 370.6; P< 0.001) when compared with node-negative ones (mean 93 pg/mL – 95%C.I, 72 – 114; P<0.001). Moreover, preoperative VEGF-C serum levels were significantly lower in patients who underwent curative surgery (248.7 pg/mL, range: 54.9 – 865.2 pg/mL) compared with patients who underwent palliative surgery (mean 461.1 pg/mL, range: 120.5 - 805.8; P < 0.001).

Pearson correlation analysis demonstrated a significant negative correlation between preoperative VEGF-C serum levels and OS (Pearson correlation -0.281; Sig.2 tails 0.001). Finally in multivariate analysis elevated serum VEGF-C levels were an independent prognostic factor in our population.

Conclusions

Our data obtained in this setting suggest that increased serum VEGF-levels appear as a poor prognostic factor correlating with a wide nodal involvement, palliative surgery, and worse overall survival.