Expression of VEGF-C correlates with a poor prognosis based on analysis of prognostic factors in 73 patients with esophageal squamous cell carcinomas

Abstract

Objective: The purpose of this study was to specifically investigate the clinicopathological role of expression of vascular endothelial growth factor-C (VEGF-C) as well as the correlation with clinical outcomes in esophageal squamous cell carcinomas (ESCCs). Methods: Seventy-three patients with ESCC resected in our institute were included in this study. Formalin-fixed paraffin-embedded specimens were stained for VEGF-C and the correlation between the staining, its clinicopathological parameters and its prognostic power were analyzed statistically. Results: Of the 73 ESCC patients studied, 39 cases (53.4%) were strongly positive for VEGF-C. Six cases (8.2%) were negative and 28 cases (38.4%) revealed unclear weak reactions. All 34 cases were included in the negative group (46.6%). VEGF-C expression correlated with histological grade (P = 0.005), depth of tumor invasion (pT) (P = 0.021), lymph node metastasis (pN) (P = 0.002) and lymphatic invasion (P = 0.008). The median overall survival of 39 patients who had positive staining for tumor cell VEGF-C and 34 patients who had negative staining were 10.4 months (95% CI, 6.9-13.9 months) and 28.5 months (95% CI, 12.6-44.4 months), respectively (P = 0.003). In univariate analysis by log-rank test, histological grade, pN, stage, lymphatic invasion and VEGF-C were significant prognostic factors (P = 0.047, 0.007, 0.018, 0.002 and 0.003, respectively.). In multivariate analysis, high VEGF-C expression (P = 0.0451) maintained its independent prognostic influence on overall survival, as well as pN status (P = 0.0029). Conclusions: Expression of VEGF-C is related to histological grade, pT, pN and lymphatic invasion, and is a prognostic indicator for ESCC. © The Author (2009). Published by Oxford University Press. All rights reserved.