Association between increment of serum VEGF level and prognosis after transcatheter arterial chemoembolization in hepatocellular carcinoma patients

Ju Hyun Shim, Joong Won Park, Ji Hoon Kim, Min An, Sun Young Kong, Byung Ho Nam, Joon Il Choi, Hyun Beom Kim, Woo Jin Lee, Chang Min Kim

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138 Citations (Scopus)

Abstract

We prospectively investigated the association between a change of serum vascular endothelial growth factor (VEGF) level after transcatheter arterial chemoembolization (TACE) and hepatocellular carcinoma (HCC) patient prognosis. The study involved 147 patients with unresectable HCC treated at the National Cancer Center, Korea, between July and December 2005. Serum samples were collected from each patient before TACE, and 1-2 days and 1 month after TACE. Serum VEGF concentrations were measured using an enzyme-linked immunosorbent assay (ELISA). The log e (VEGF/ platelets) increased transiently 1-2 days after TACE and declined thereafter. Frequency of previous TACE did not correlate with log e (VEGF/platelets). This study found that log e (VEGF/platelets) 1-2 days after TACE, but not log e (VEGF/platelets) at baseline, was strongly correlated with vascular or nodal invasion and AJCC (American Joint Committee on Cancer)/UICC (International Union Against Cancer) stage, and was significantly greater in men. Relative changes in serum VEGF/ platelet levels 1-2 days after TACE (ΔVEGF) > 0.5 were directly correlated with tumor size, vascular invasion and modified UICC and AJCC/ UICC stage (P < 0.05 for each). Additionally, ΔVEGF> 0.5 was significantly correlated with newly developed extrahepatic metastases one and six months after TACE (P = 0.005 and 0.003, respectively). Progression free survival of patients with ΔVEGF > 0.5 was significantly worse (P < 0.001) and ΔVEGF > 0.5 was an independent prognostic factor for PFS (hazard ratio, 3.111; P < 0.001). This study showed that a high increment in serum VEGF level 1-2 days after TACE in HCC patients was associated with distant metastasis and unfavorable outcomes.

Original languageEnglish
Pages (from-to)2037-2044
Number of pages8
JournalCancer Science
Volume99
Issue number10
DOIs
Publication statusPublished - 2008 Nov 3
Externally publishedYes

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Vascular Endothelial Growth Factor A
Hepatocellular Carcinoma
Serum
Blood Platelets
Blood Vessels
Neoplasms
Neoplasm Metastasis
Korea
Disease-Free Survival
Enzyme-Linked Immunosorbent Assay

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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Association between increment of serum VEGF level and prognosis after transcatheter arterial chemoembolization in hepatocellular carcinoma patients. / Shim, Ju Hyun; Park, Joong Won; Kim, Ji Hoon; An, Min; Kong, Sun Young; Nam, Byung Ho; Choi, Joon Il; Kim, Hyun Beom; Lee, Woo Jin; Kim, Chang Min.

In: Cancer Science, Vol. 99, No. 10, 03.11.2008, p. 2037-2044.

Research output: Contribution to journalArticle

Shim, Ju Hyun ; Park, Joong Won ; Kim, Ji Hoon ; An, Min ; Kong, Sun Young ; Nam, Byung Ho ; Choi, Joon Il ; Kim, Hyun Beom ; Lee, Woo Jin ; Kim, Chang Min. / Association between increment of serum VEGF level and prognosis after transcatheter arterial chemoembolization in hepatocellular carcinoma patients. In: Cancer Science. 2008 ; Vol. 99, No. 10. pp. 2037-2044.
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AU - Park, Joong Won

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AU - Kong, Sun Young

AU - Nam, Byung Ho

AU - Choi, Joon Il

AU - Kim, Hyun Beom

AU - Lee, Woo Jin

AU - Kim, Chang Min

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AB - We prospectively investigated the association between a change of serum vascular endothelial growth factor (VEGF) level after transcatheter arterial chemoembolization (TACE) and hepatocellular carcinoma (HCC) patient prognosis. The study involved 147 patients with unresectable HCC treated at the National Cancer Center, Korea, between July and December 2005. Serum samples were collected from each patient before TACE, and 1-2 days and 1 month after TACE. Serum VEGF concentrations were measured using an enzyme-linked immunosorbent assay (ELISA). The log e (VEGF/ platelets) increased transiently 1-2 days after TACE and declined thereafter. Frequency of previous TACE did not correlate with log e (VEGF/platelets). This study found that log e (VEGF/platelets) 1-2 days after TACE, but not log e (VEGF/platelets) at baseline, was strongly correlated with vascular or nodal invasion and AJCC (American Joint Committee on Cancer)/UICC (International Union Against Cancer) stage, and was significantly greater in men. Relative changes in serum VEGF/ platelet levels 1-2 days after TACE (ΔVEGF) > 0.5 were directly correlated with tumor size, vascular invasion and modified UICC and AJCC/ UICC stage (P < 0.05 for each). Additionally, ΔVEGF> 0.5 was significantly correlated with newly developed extrahepatic metastases one and six months after TACE (P = 0.005 and 0.003, respectively). Progression free survival of patients with ΔVEGF > 0.5 was significantly worse (P < 0.001) and ΔVEGF > 0.5 was an independent prognostic factor for PFS (hazard ratio, 3.111; P < 0.001). This study showed that a high increment in serum VEGF level 1-2 days after TACE in HCC patients was associated with distant metastasis and unfavorable outcomes.

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