Abstract
BackgroundThe prediction of response to treatment would be valuable for managing cervical carcinoma with neoadjuvant chemotherapy.MethodsTo this end, the expression of VEGF was analyzed by immunohistochemistry using paraffin-embedded pre-treatment cervical biopsy tissues. This study included 29 patients with bulky IB to IIA cervical squamous cell carcinoma treated with neoadjuvant chemotherapy.ResultsFifteen (51.7%) of 29 patients were scored as VEGF-positive. Response to chemotherapy (complete response or residual tumor with less than 3 mm stromal invasion) was observed in eight patients (27.6%), and it was negatively associated with VEGF expression (P = 0.009). With logistic regression analysis, VEGF positivity continued to be an independent predictor for poor response (P = 0.032). In addition, the progression-free survival rate was significantly lower in patients with VEGF-positive tumors (P = 0.033).ConclusionPretreatment assessment of VEGF expression may provide additional information for identification of patients with cervical cancer who had a low likelihood of response to neoadjuvant chemotherapy and an unfavorable prognosis.
Highlights
The prediction of response to treatment would be valuable for managing cervical carcinoma with neoadjuvant chemotherapy
If non-responsive tumors could be identified before neoadjuvant chemotherapy (NAC), using predictive biological factors, these patients could be allocated to concurrent chemoradiation (CCRT)
There are some reports that show that vascular endothelial growth factor (VEGF) plays an important role in patient response to chemotherapeutic agents, [10] there is little information available on its predictive value for treatment response in patients receiving NAC for cervical carcinoma
Summary
The prediction of response to treatment would be valuable for managing cervical carcinoma with neoadjuvant chemotherapy. If non-responsive tumors could be identified before NAC, using predictive biological factors, these patients could be allocated to CCRT. The correlation between VEGF expression and prognosis in patient with cervical cancer has been inconsistent; this may be because of the marked heterogeneity of patient disease stages and treatment modalities in reported studies [7,8,9]. There are some reports that show that VEGF plays an important role in patient response to chemotherapeutic agents, [10] there is little information available on its predictive value for treatment response in patients receiving NAC for cervical carcinoma. We evaluated whether VEGF may have predictive value for patient response to NAC in cases with bulky cervical carcinoma
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