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J Thorac Cardiovasc Surg 2004;128:517-522
© 2004 The American Association for Thoracic Surgery

General thoracic surgery

Vascular endothelial growth factor expression in metastatic pulmonary tumor from colorectal carcinoma: Utility as a prognostic factor

^a Department of General and Cardiothoracic Surgery, Kanazawa University School of Medicine, Kanazawa, Japan

Received for publication October 2, 2003; revisions received February 16, 2004; accepted for publication March 1, 2004.

^* Address for reprints: Masaya Tamura, MD, Department of General and Cardiothoracic Surgery, Kanazawa University School of Medicine, Takara-machi 13-1, Kanazawa 920-8640, Japan
m-tamura{at}sf.m.kanazawa-u.ac.jp

OBJECTIVE: To define the most reliable prognostic factor, we studied the 5-year survival of patients after resection of pulmonary metastases from colorectal cancer in relation to various prognostic factors, including vascular endothelial growth factor expression in primary and metastatic tumors.

METHODS: A retrospective study was undertaken in 49 patients who had undergone complete resection of pulmonary metastasis from colorectal carcinoma. All patients were retrospectively analyzed for sex, age, location and stage of primary tumor, number of pulmonary metastases, type of pulmonary resection, size of metastatic tumor, lymph node metastasis, and prethoracotomy carcinoembryonic antigen level. Furthermore, vascular endothelial growth factor expression of both primary and metastatic tumors was investigated.

RESULTS: Overall 5-year survival was 34.3%. In the univariate analysis the number of pulmonary metastases (P = .007) and vascular endothelial growth factor expression in metastatic tumors (P = .008) and primary colorectal tumors (P = .011) were significantly associated with poor survival. In the multivariate analysis the number of pulmonary metastases (P = .0031), vascular endothelial growth factor expression in metastatic tumors (P = .0057), and stage of primary tumor (P = .0321) were characteristics that retained a significant independent prognostic effect on overall survival. A statistically significant difference was not found in the 5-year survival of patients with solitary and negative vascular endothelial growth factor expression in metastatic tumors (59.1%) versus those with multiple and positive vascular endothelial growth factor expression in metastatic tumors (10.0%; P .0001).

CONCLUSIONS: Vascular endothelial growth factor expression in metastatic pulmonary tumors is an important prognostic marker for patients with pulmonary metastasis from colorectal carcinoma. Our results suggested that patients with multiple and positive vascular endothelial growth factor expression in the metastatic tumor will not receive benefit from metastasectomy.

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