The changes of tumour vascular endothelial growth factor expression after neoadjuvant chemoradiation in patients with rectal adenocarcinoma

Abstract

Aim of the studyThe aim was to examine the effects of neoadjuvant chemoradiotherapy on VEGF expression in patients with locally advanced rectal cancer.Materials and methodsA total of 53 patients with locally advanced rectal cancer were retrospectively studied. Neoadjuvant treatment comprised external beam radiation (50.4 Gy/28 fractions) with continuous infusion of 5-fluorouracil. Four to 6 weeks after the chemoradiotherapy, the patients underwent surgical resection. Immunohistochemistry was performed to assess VEGF expression in the pretreatment biopsies and in resected specimens.ResultsResection with microscopic residual tumour (R1) was performed in two patients while in the remaining 51 patients radical resection with microscopically negative margins (R0) was possible. Downstaging after preoperative chemoradiotherapy was observed in 34 patients (64%). After chemoradiotherapy 24 patients (45%) had decreased VEGF expression, in 20 patients (38%) there was no change, and in two patients it was not possible to assess the dynamics of VEGF expression due to pathologic complete response after chemoradiotherapy. The five-year overall survival (OS) rate was 56% (95% CI: 43–70%). Although the median OS was 2.5 times shorter in patients who experienced decreased VEGF expression during therapy, this difference did not reach statistical significance. VEGF expression was not significant in Cox regression analysis or log-rank test. VEGF expression decreased after neoadjuvant chemoradiotherapy in most patients with rectal adenocarcinoma examined. This decrease was associated with a trend of inferior prognosis.ConclusionsVEGF expression decreased after neoadjuvant chemoradiotherapy in most patients examined. This decrease was associated with a trend of inferior prognosis.

CEA, EpCAM, αvβ6 and uPAR Expression in Rectal Cancer Patients with a Pathological Complete Response after Neoadjuvant Therapy

“…This improved sensitivity demonstrates the possible value of fluorescence endoscopy for a better identification of residual tumor, decreasing understaging and local regrowth. Furthermore, the expression of CEA and EpCAM, in contrast to VEGF expression, is not influenced by neoadjuvant therapy, possibly making these markers even more suitable for response evaluation [ 44 ].…”

The expression of GLUT-1 and VEGF-A mRNA in the rectal cancer patients with neoadjuvant chemoradiation

“…We did not find any significant association statistically, nevertheless based on the amount of patients we find a tendency that patients with poor prognosis have to elevate VEGF-A mRNA expression. Based on Buka et al 19 study, elevating VEGF expression is correlated with poor prognosis and a high incidence of liver metastases. Vascular endhotelial growth factor-A expression increase in 50 percent of patients of colorectal cancer and associate with cancer cell metastases to lymph nodes and others organ.…”