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

View Article: PubMed Central - PubMed

ABSTRACT

Aim of the study: The aim was to examine the effects of neoadjuvant chemoradiotherapy on VEGF expression in patients with locally advanced rectal cancer.

Materials and methods: A 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.

Results: Resection 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.

Conclusions: VEGF expression decreased after neoadjuvant chemoradiotherapy in most patients examined. This decrease was associated with a trend of inferior prognosis.

No MeSH data available.


Kaplan-Meier overall survival curve in days (solid line) with median overall survival (dotted line)
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f0002: Kaplan-Meier overall survival curve in days (solid line) with median overall survival (dotted line)

Mentions: The median follow-up was 109 months (9.1 years). During the follow-up 24 patients had recurrence and 30 patients died. At the time of this analysis, 22 patients were alive with no recurrence and one patient was alive with recurrence. Five-year OS rate was 56% (95% CI: 43–70%) with median OS of 8.6 years (Fig. 2). Median OS was 2.5 times shorter in patients who experienced decreased VEGF expression during therapy, but this difference did not reach statistical significance (Fig. 3). VEGF expression was not significant in Cox regression analysis or log-rank test. The coefficient of determination (R2) in Cox regression analysis was 0.0267. R2 in analysis of deviance was not significant (p = 0.502). Similarly, decrease in VEGF expression after neoadjuvant treatment was not predictive for treatment response and tumour downstaging (p = 0.61).


The changes of tumour vascular endothelial growth factor expression after neoadjuvant chemoradiation in patients with rectal adenocarcinoma
Kaplan-Meier overall survival curve in days (solid line) with median overall survival (dotted line)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5385478&req=5

f0002: Kaplan-Meier overall survival curve in days (solid line) with median overall survival (dotted line)
Mentions: The median follow-up was 109 months (9.1 years). During the follow-up 24 patients had recurrence and 30 patients died. At the time of this analysis, 22 patients were alive with no recurrence and one patient was alive with recurrence. Five-year OS rate was 56% (95% CI: 43–70%) with median OS of 8.6 years (Fig. 2). Median OS was 2.5 times shorter in patients who experienced decreased VEGF expression during therapy, but this difference did not reach statistical significance (Fig. 3). VEGF expression was not significant in Cox regression analysis or log-rank test. The coefficient of determination (R2) in Cox regression analysis was 0.0267. R2 in analysis of deviance was not significant (p = 0.502). Similarly, decrease in VEGF expression after neoadjuvant treatment was not predictive for treatment response and tumour downstaging (p = 0.61).

View Article: PubMed Central - PubMed

ABSTRACT

Aim of the study: The aim was to examine the effects of neoadjuvant chemoradiotherapy on VEGF expression in patients with locally advanced rectal cancer.

Materials and methods: A 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.

Results: Resection 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.

Conclusions: VEGF expression decreased after neoadjuvant chemoradiotherapy in most patients examined. This decrease was associated with a trend of inferior prognosis.

No MeSH data available.