Prospective validation of the prognostic value of elevated serum vascular endothelial growth factor in patients with nasopharyngeal carcinoma: more distant metastases and shorter overall survival after treatment.

Background: The purpose of this prospective study was to investigate the prognostic value of serum vascular endothelial growth factor (sVEGF) in patients with nasopharyngeal carcinoma (NPC).

Methods: sVEGF was prospectively detected in 306 patients with NPC with enzyme-linked immunosorbent assay before treatment. The correlations between sVEGF and the survival of these patients were evaluated.

Results: Patients were followed for at least 36 months. The mean sVEGF was 387.0 ng/L. sVEGF showed no difference in sex, age, and local recurrence. However, sVEGF was positively associated with histology, TNM classification, distant metastasis, and overall survival (OS; p < .05). The 4-year OS and distant metastasis-free survival (DMFS) of the high-sVEGF versus low-sVEGF groups were 68% versus 86% and 70% versus 89%, respectively (p < .05). Stratified analysis showed that patients with stage IV(a,b) , T(4) , N(1) , or N(positive) disease with high VEGF levels had worse 4-year OS and 4-year DMFS than those with low VEGF levels (p < .05). Multifactorial Cox regression confirmed sVEGF was among the independent prognostic factors.

Conclusion: Elevation of sVEGF in patients with NPC predicts more posttreatment distant metastases and shorter OS and can be used as an independent poor prognostic indicator.