Prognostic value of vascular endothelial growth factor in Stage IB carcinoma of the uterine cervix

Purpose: To clarify the role of vascular endothelial growth factor (VEGF) expression as an independent prognostic factor in Stage IB cervical cancer. Methods and Materials: A total of 117 patients with Stage IB cervical cancer who had undergone radical hysterectomy and pelvic lymph node dissection with complete histopathologic examination were included. Eighty-eight (75.2%) patients received postoperative radiotherapy and/or chemotherapy. VEGF expression was examined using immunohistochemistry. Results: Of 117 patients, 35 (29.9%) showed high-intensity VEGF expression and 69 (59%) had a high score for area of VEGF expression. Strong correlations were found between high VEGF intensity and both deep stromal invasion ( p = 0.01) and positive pelvic lymph nodes ( p = 0.03). The area of VEGF expression was significantly associated with tumor size ( p = 0.02). In a multivariate analysis, high VEGF intensity ( p = 0.009) and tumor size ( p = 0.01) were significant prognostic factors for overall survival and disease-free survival ( p = 0.001 and p = 0.003, respectively). However, the area of VEGF expression was not a prognostic factor for overall survival or disease-free survival. Conclusion: Our findings on the correlation between VEGF expression and prognosis were conflicting. Functional and quantitative tools to assess tumor angiogenesis in addition to the expression of VEGF need to be developed and would be helpful to support the finding that tumor angiogenesis correlates significantly with prognosis in early-stage cervical cancer.