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Prognostic Significance of Vascular Endothelial Growth Factor Expression and Microvessel Density in Esophageal Squamous Cell Carcinoma: Comparison With Positron Emission Tomography

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Abstract

Background

This study investigated whether the expression of vascular endothelial growth factor (VEGF) in a primary tumor and the intratumoral microvessel density (MVD) were independent prognostic factors in patients with an esophageal squamous cell carcinoma (SCC) in comparison with positron emission tomography (PET) by using 18F-fluorodeoxyglucose (FDG) and stage.

Methods

Fifty-one patients with a newly diagnosed esophageal SCC who underwent preoperative FDG-PET and esophagectomy with intent to cure were enrolled in this study. The VEGF expression level, the intratumoral MVD, and the Ki-67 labeling index were evaluated by using immunohistochemical staining. Only significant variables in the univariate survival analysis were examined by multivariate survival analysis with the Cox proportional hazards model.

Result

Cancer-related deaths occurred in 17 of 51 patients during the follow-up. Univariate survival analysis showed that the pathologic stage, pNM, maximum standardized uptake value of the primary tumor, tumor length on PET, number of PET-positive lymph nodes, PET stage, Ki-67 labeling index, intratumoral MVD, and the presence of VEGF expression were significant prognostic predictors for the overall survival. Multivariate analysis revealed that the pathologic stage, number of PET-positive nodes (0, 1, 2, or ≥3), intratumoral MVD (cutoff, 60/mm2), and presence of VEGF expression were independent significant prognostic predictors for overall survival.

Conclusion

In addition to the pathologic stage, the intratumoral MVD, the presence of VEGF expression, and the number of FDG-PET–positive nodes were independent prognostic predictors in patients with an esophageal SCC undergoing curative surgery.

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Acknowledgments

This study was supported by a grant of the Korea Health 21 R&D Project, Ministry of Health & Welfare, Republic of Korea (02-PJ3-PG6-EV06-0002).

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Authors and Affiliations

  1. Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-ku, Seoul, 135-710, Korea

    Joon Young Choi MD, Kyung-Han Lee MD, Yong Choi PhD, Yearn Seong Choe PhD & Byung-Tae Kim MD

  2. Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-ku, Seoul, 135-710, Korea

    Kee-Taek Jang MD & Geunghwan Ahn MD

  3. Department of Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-ku, Seoul, 135-710, Korea

    Young Mog Shim MD & Kwhanmien Kim MD

Authors
  1. Joon Young Choi MD
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  2. Kee-Taek Jang MD
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  3. Young Mog Shim MD
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  4. Kwhanmien Kim MD
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  5. Geunghwan Ahn MD
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  6. Kyung-Han Lee MD
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  7. Yong Choi PhD
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  9. Byung-Tae Kim MD
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Correspondence to Byung-Tae Kim MD.

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Choi, J.Y., Jang, KT., Shim, Y.M. et al. Prognostic Significance of Vascular Endothelial Growth Factor Expression and Microvessel Density in Esophageal Squamous Cell Carcinoma: Comparison With Positron Emission Tomography. Ann Surg Oncol 13, 1054–1062 (2006). https://doi.org/10.1245/ASO.2006.08.012

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  • DOI: https://doi.org/10.1245/ASO.2006.08.012

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