Abstract
Objective: To evaluate the association between pretreatment levels of serum vascular endothelial growth factor (VEGF) and long-term treatment outcomes in patients with locally advanced cervical cancer (LACC). Methods: Thirty-nine patients diagnosed with LACC (stage IIB-IVA) and obtaining blood for serum VEGF were identified. All patients received complete treatment as radical radiotherapy with or without concurrent chemotherapy. Surveillance for all patients was every 3 months during the first 2 years, and every 6 months later. Results: Mean age of 39 patients was 52.3 ± 10.8 years old. Twenty-three patients (59.0%) had stage IIB, and 16 patients (41.0%) had stage IIIB. Histological cell type was mostly squamous cell carcinoma (89.7%). The median and 75th percentile level of serum VEGF were 610.2 pg/ml (0.0 - 4067.2 pg/ml) and 825.6 pg/ml, respectively. At median follow-up of 37.0 months (range, 26.8 - 46.3 months), the 3-year OS rate was 78.6%. Clinical stage (p = 0.04) and 75th percentile of VEGF level (p = 0.04) were impacted on OS in univariable analysis. The 3-year OS of patients in stage IIB with serum VEGF of ≤825.6 pg/ml and of > 825.6 pg/ml was slightly different, 94.4% and 80.0% respectively (p = 0.34), whereas there were many differences in stage IIIB, 71.4% and 25.0% in patients with serum VEGF of ≤825.6 pg/ml and of >825.6 pg/ml respectively (p = 0.05). Conclusion: High pretreatment serum VEGF level has an influence on OS for LACC. It is potentially used as a predictive factor, especially in patients stage IIIB, in order to provide efficient treatment and improve survival outcomes in the future.
Highlights
Screening program is well known for prevention in cervical cancer, the incident rate of this cancer is still high
In 2011, we reported a prospective study which focused on the association of pretreatment serum Vascular Endothelial Growth Factor (VEGF) with clinicopathology and response of treatment by radical radiotherapy with or without concurrent chemotherapy in stage IIB-IVA cervical cancer patients
We found that serum VEGF at pretreatment time in locally advanced cervical cancer has some correlations with survival outcomes
Summary
Screening program is well known for prevention in cervical cancer, the incident rate of this cancer is still high. In developing countries including Thailand, cervical cancer is the second most common cancer in women [1]. For locally advanced stage (IIB-IVA), concurrent chemoradiation (CCRT) is the standard treatment. The treatment outcome is fair, which is just 60% - 65% in terms of 5-year overall survival [2]. An important meta-analysis study found that CCRT had less influence on advanced stages, while distant failure was
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