Levels of vascular endothelial growth factor in serum and pleural fluid are independent predictors of survival in advanced non-small cell lung cancer: results of a prospective study.

AIM

To further evaluate the prognostic significance of pre-treatment serum and pleural fluid levels of vascular endothelial growth factor VEGF in patients with non-small cell lung cancer (NSCLC) presenting with malignant pleural effusion (MPE).

PATIENTS AND METHODS

Forty consecutive newly-diagnosed patients with NSCLC with MPE at presentation but without distant metastases were prospectively enrolled. The prognostic value of serum and pleural fluid VEGF levels for overall survival (OS) and progression-free survival (PFS) was assessed by Cox regression analysis.

RESULTS

The median serum VEGF level was significantly higher in patients compared to healthy controls (p<0.001). Serum VEGF higher than 375 pg/ml, pleural fluid VEGF greater than the median value and the presence of progressive disease were all significantly associated with reduced OS and PFS, both in univariate and multivariate analyses.

CONCLUSION

The results of our study suggest that increased pre-treatment serum and pleural fluid levels of VEGF may be independent predictors of a worse survival in patients with advanced-stage NSCLC.