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Intraperitoneal Vascular Endothelial Growth Factor: A Prognostic Factor and the Potential for Intraperitoneal Bevacizumab Use in Peritoneal Surface Malignancies

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Introduction

Intraperitoneal (IP) vascular endothelial growth factor (VEGF) levels have been shown to vary in the peritoneal cavity of patients with peritoneal surface malignancies. Our purpose was to correlate levels of IP VEGF with overall and disease-free survival to identify whether IP VEGF can be used to prognosticate patients and the possible role of IP bevacizumab.

Methods

From February to October 2012, 97 consecutive patients with peritoneal carcinomatosis were treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Intravenous (IV) VEGF levels were taken before surgery, whereas IP VEGF levels were taken at various time points during and after surgery.

Results

Median follow-up was 19.48 months. On univariate analysis, a lower IP VEGF taken just after incision (T1) was associated with improved overall (P = 0.0004) and disease-free survival (P = 0.0006) at 2 years. A lower T1/IV VEGF ratio also was associated with improved overall (P = 0.004) and disease-free survival (P = 0.0051). On multivariate analysis, a lower T1 was associated with improved overall survival, whereas a lower T1/IV VEGF was associated with improved disease-free survival. On subset analysis, these two variables were associated with improved survival in colorectal cancers.

Conclusions

A lower IP VEGF level prior to surgery is associated with improved survival. The use of preoperative intraperitoneal bevacizumab for patients with a heavy disease load should be considered, especially in colorectal cancers.

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Acknowledgment

The authors thank Adeline Roux for her contributions to the statistical analysis.

Disclosures

The authors have no financial disclosures or conflict of interests.

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Authors and Affiliations

  1. Department of Surgical Oncology, National Cancer Centre Singapore, Singapore, Singapore

    Claramae Shulyn Chia MBBS, MMed, FRCS

  2. Department of Oncologic and General Surgery, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud Pierre Bénite, Lyon, France

    Olivier Glehen MD, PhD, François Noël Gilly MD, PhD & Guillaume Passot MD

  3. Department of Gynaecology, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud Pierre Bénite, Lyon, France

    Naoual Bakrin MD

  4. UMR 37-38, Université Lyon 1, Lyon, France

    Olivier Glehen MD, PhD, Naoual Bakrin MD, Benoit You MD, PhD, François Noël Gilly MD, PhD & Guillaume Passot MD

  5. Hospices Civils de Lyon, Pole IMER, Lyon, France

    Evelyne Decullier PhD

  6. Health Information and Clinical Research, Lyon, France

    Evelyne Decullier PhD

  7. Department of Oncology, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud Pierre Bénite, Lyon, France

    Benoit You MD, PhD

Authors
  1. Claramae Shulyn Chia MBBS, MMed, FRCS
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  2. Olivier Glehen MD, PhD
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  3. Naoual Bakrin MD
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  7. Guillaume Passot MD
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Correspondence to Claramae Shulyn Chia MBBS, MMed, FRCS.

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Chia, C.S., Glehen, O., Bakrin, N. et al. Intraperitoneal Vascular Endothelial Growth Factor: A Prognostic Factor and the Potential for Intraperitoneal Bevacizumab Use in Peritoneal Surface Malignancies. Ann Surg Oncol 22 (Suppl 3), 880–887 (2015). https://doi.org/10.1245/s10434-015-4644-7

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  • DOI: https://doi.org/10.1245/s10434-015-4644-7

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