Institute for Cancer Care, Mercy Medical Center, 227 St. Paul Place, Baltimore, MD 21202-2001, USA.
Eur J Surg Oncol. 2013 Dec;39(12):1415-22. doi: 10.1016/j.ejso.2013.08.032. Epub 2013 Sep 12.
Vascular endothelial growth factor (VEGF) is a prognostic factor and target treatment for metastatic colorectal and ovarian cancer. Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) has improved survival on peritoneal carcinomatosis (PC) from appendiceal cancer. We hypothesize that tumoral high expression of VEGF receptor 2 (VEGFR-2) is a negative prognostic factor for survival in patients with PC from appendiceal cancer.
A retrospective study of a prospective database revealed 89 patients with PC from appendiceal cancer who underwent 127 CRS/HIPECs. Surgical specimens from 59 patients were tested to identify high vs. low VEGFR-2 expression. Patient outcomes and survival were analyzed.
There were 26 males and 33 females. Mean age was 51 years. Forty-seven VEGFR-2 high expressers and 15 low expressers were identified. Mean follow-up of high and low expressers was 25.1 and 26.6 months, respectively (p = 0.806). At follow-up, 33 (70%) high expressers were alive and 14 (30%) deceased, while 11 (92%) low expressers were alive and 1 (8%) deceased. Recurrence, use of bevacizumab, CC score, PCI, and LN status showed no differences between high and low expressers. OS for high expressers was 90.5%, 59.8%, and 47.1% at 1-, 3-, and 5-years, respectively, while OS for low expressers remained stable at 91.7% at 1-, 3-, and 5-years (p = 0.133).
There is a trend towards better outcomes and survival in patients with PC from appendiceal cancer who have low expression of VEGFR-2 compared to high expression. More studies are encouraged to confirm this trend.
血管内皮生长因子（VEGF）是转移性结直肠癌和卵巢癌的预后因素和靶向治疗靶点。细胞减灭术（CRS）和腹腔热灌注化疗（HIPEC）已改善了阑尾癌腹膜转移（PC）患者的生存。我们假设肿瘤中 VEGF 受体 2（VEGFR-2）的高表达是阑尾癌 PC 患者生存的负预后因素。
对前瞻性数据库的回顾性研究显示，89 例阑尾癌 PC 患者接受了 127 例 CRS/HIPEC。59 例患者的手术标本用于检测高与低 VEGFR-2 表达。分析患者结局和生存情况。
男性 26 例，女性 33 例。平均年龄为 51 岁。确定了 47 例 VEGFR-2 高表达者和 15 例低表达者。高表达者和低表达者的平均随访时间分别为 25.1 和 26.6 个月（p=0.806）。随访时，33 例（70%）高表达者存活，14 例（30%）死亡，而 11 例（92%）低表达者存活，1 例（8%）死亡。高表达者与低表达者之间在复发、贝伐珠单抗的使用、CC 评分、PCI 和 LN 状态方面无差异。高表达者的 OS 分别为 90.5%、59.8%和 47.1%，1 年、3 年和 5 年时，而低表达者的 OS 分别为 91.7%，1 年、3 年和 5 年时保持稳定（p=0.133）。
与 VEGFR-2 高表达相比，阑尾癌 PC 患者 VEGFR-2 低表达者的预后和生存更好。鼓励进行更多的研究来证实这一趋势。
