• Vol. 40 No. 7, 319–324
  • 15 July 2011

Vascular Endothelial Growth Factor C as a Predictor of Early Recurrence and Poor Prognosis of Resected Stage I Non-small Cell Lung Cancer

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ABSTRACT

Introduction: Stage I non-small cell lung cancer (NSCLC) is potentially curable after completely resection, but early recurrence may influence prognosis. This study hypothesises that vascular endothelial growth factor C (VEGF-C) plays a key role in predicting early recurrence and poor survival of patients with stage I NSCLC.

Materials and Methods: : The expression of VEGF-C was immuno-histochemically (IHC) analysed in tumour samples of primary stage I NSCLC and correlated to early recurrence (< 36 months), disease-free survival, and overall survival in all 49 patients.

Results:Early recurrence was identified in 16 patients (33%), and the early recurrence rate in strong and weak VEGF-C activity was significantly different (P = 0.016). VEGF-C was also an independent risk factor in predicting early recurrence (HR = 3.98, P = 0.02). Patients with strong VEGF-C staining also had poor 3-year disease-free survival (P = 0.008) and overall survival (P = 0.007).

Conclusion: Strong VEGF-C IHC staining could be a biomarker for predicting early recurrence and poor prognosis of resected stage I NSCLC, if the results of the present study are confirmed in a larger study. A more aggressive adjuvant therapy should be used in this group of patients.


Non-small-cell lung cancer (NSCLC) is the leading cause of cancer-related deaths worldwide, with a 5-year survival of around 15%. Approximately 20% of patients present with stage I disease (T1N0M0 or T2N0M0) and undergo potentially curative surgical resection. However, approximately 30% to 40% of patients with stage I NSCLC after completely resection relapse and ultimately die of recurrent disease. Early postoperative recurrence, often defined as relapse within 36 months after surgery, occur with high variety in resected stage I disease. Although adjuvant chemotherapy clearly improves disease-free survival in Stage IB patients, an absolute overall survival benefit has not yet been conclusively established.

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