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Kwon, Jo, and Lee: Serum Levels of Vascular Endothelial Growth Factor (VEGF) as a Prognostic Factor in Renal Cell Carcinoma
Original Article
Korean Journal of Urology

Korean Journal of Urology 2007; 48(12): 1219-1223.

Published online: 31 December 2007

DOI: https://doi.org/10.4111/kju.2007.48.12.1219

Serum Levels of Vascular Endothelial Growth Factor (VEGF) as a Prognostic Factor in Renal Cell Carcinoma

Nam Sung Kwon, Moon Ki Jo, Hyun Moo Lee1

Department of Urology, Korea Cancer Center Hospital, Seoul, Korea.

1Department of Urology, College of Medicine, Sungkyunkwan University, Seoul, Korea.

Corresponding author (andrea@kcch.re.kr)

Received 1 August 2007       Accepted 1 October 2007

Copyright © 2007 The Korean Urological Association

Abstract

Purpose

Vascular endothelial growth factor (VEGF) is recognized as a potent constituent of the vascularization and growth of solid tumors. We assessed the serum levels of VEGF and we evaluated its correlation to the clinicopathologic findings and clinical outcome of patients with renal cell carcinoma (RCC).

Materials and Methods

Serum samples were collected before surgery from patients with RCC. The levels of serum VEGF were assessed by using quantitative enzyme immunoassay. Comparison of the serum VEGF level with the tumor stage, grade, cell type and clinical outcome was performed, and the survival rate between the RCC patients above and below the mean VEGF level was evaluated.

Results

The mean follow-up was 5.1 years. The serum VEGF level was significantly higher in the patients with RCC (mean: 497pg/ml) than that in the controls (mean: 211pg/ml) (p<0.001). The serum VEGF level was correlated with the tumor size, the pathologic T stage and the clinical stage and histologic nuclear grade, but not with the histologic subtype. Patients with a lower VEGF level (<497pg/ml) showed longer survival (p=0.0207 on univariate analysis, p=0.04 on multivariate analysis).

Conclusions

Our study indicated that the serum VEGF level was significantly correlated with the clinical or pathologic stage, the nuclear grade and adverse survival. These results suggest that the serum VEGF level could be a comparable prognostic factor to the tumor stage and grade.

Keywords: Renal cell carcinoma, Vascular endothelial growth factor, Prognosis

Figures and Tables

kju-48-1219-g001
Fig. 1
Comparing the survival rate of the group with a serum vascular endothelial growth factor (s. VEGF) level>497pg/ml-renal cell carcinoma (RCC) with the group having a s. VEGF level <497pg/ml-RCC by the Kaplan-Meier curves and the log rank test (p=0.0207, log rank 5.35).

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Table 1
Clinical characteristics of the patients
kju-48-1219-i001

RCC: renal cell carcinoma, s. VEGF: serum vascular endothelial growth factor, SD: standard deviation, *: Student's t-test

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Table 2
Correlation analysis of serum VEGF with age and tumor size by Pearson's correlation coefficient analysis
kju-48-1219-i002

s. VEGF: serum vascular endothelial growth factor, *: Pearson's correlation coefficient

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Table 3
Comparison of the serum VEGF level according to the pathologic T stage by one way ANOVA and the Post Hoc Tukey test
kju-48-1219-i003

s. VEGF: serum vascular endothelial growth factor, pT: pathologic T stage, *: Post Hoc Tukey test, †: F cumulative probability of one-way ANOVA

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Table 4
Comparison of the serum VEGF level according to pathologic T stage by one way ANOVA and the Post Hoc Tukey test
kju-48-1219-i004

s. VEGF: serum vascular endothelial growth factor, *: Post Hoc Tukey test, †: F cumulative probability of one-way ANOVA

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Table 5
Comparison of the serum VEGF level according to the clinical stage by one way ANOVA and the Post Hoc Tukey test
kju-48-1219-i005

s. VEGF: serum vascular endothelial growth factor, *: Post Hoc Tukey test, †: F cumulative probability of one-way ANOVA

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Table 6
Multivariate analysis of the survival rate according to the prognostic factors by the Cox hazard regression model
kju-48-1219-i006

s. VEGF: serum vascular endothelial growth factor, pT: pathologic T stage, RR (95% CI): relative risk (95% confidence interval)

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Table 7
Comparison of the serum VEGF level according to the histologic subtypes by the Kruskal-Wallis test
kju-48-1219-i007

s. VEGF: serum vascular endothelial growth factor, *: unclear or unclassified subtypes (No.=20) were excluded, †: chi-square of Kruskal-Wallis test

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