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Association of Preoperative Plasma Levels of Vascular Endothelial Growth Factor and Soluble Vascular Cell Adhesion Molecule-1 With Lymph Node Status and Biochemical Progression After Radical Prostatectomy

From the Baylor Prostate Center and the Division of Male Reproductive Medicine and Surgery of the Scott Department of Urology; Department of Pathology and Molecular and Cellular Biology, Baylor College of Medicine; The Methodist Hospital, Houston; and Department of Urology, University of Texas Southwestern Medical School, Dallas, TX.

Address reprint requests to Kevin Mark Slawin, MD, Scott Department of Urology, Baylor College of Medicine, 6560 Fannin St, Ste 2100, Houston, TX 77030; e-mail: kslawin{at}www.urol.bcm.tmc.edu

PURPOSE: Angiogenesis is a critical process for cancer progression. We tested whether elevated circulating levels of the angiogenesis-related markers vascular endothelial growth factor (VEGF) and/or soluble vascular cell adhesion molecule-1 (sVCAM-1) are associated with prostate cancer diagnosis, stage, progression, and metastasis.

PATIENTS AND METHODS: Plasma levels of VEGF and sVCAM-1 were measured on frozen, archival plasma obtained preoperatively from 215 consecutive patients who underwent radical prostatectomy for clinically localized disease, nine men with untreated prostate cancer metastatic to bones, and 40 healthy men without cancer.

RESULTS: Plasma levels of both VEGF and sVCAM-1 were highest in patients with bone metastases (P < .001). VEGF levels were higher in patients with clinically localized disease than in healthy controls (P < .001). VEGF levels were elevated in patients with biopsy and final Gleason sum 7 (P = .036 and P = .020, respectively) and extraprostatic extension (P = .047). Higher preoperative VEGF was independently associated with metastases to lymph nodes (P < .001). Both VEGF and sVCAM-1 were independently associated with biochemical progression after adjustment for the effects of standard preoperative features (P = .014 and P = .039, respectively). VEGF remained independently associated with biochemical progression after adjustment for standard postoperative features (P = .019).

CONCLUSION: Plasma levels of VEGF increased incrementally from healthy controls to patients with clinically localized disease to patients with lymph node and skeletal metastases. Higher preoperative VEGF was independently associated with metastases to lymph nodes and biochemical progression after surgery in both pre- and postoperative models. Plasma sVCAM-1 was elevated in men with bone metastases and was associated with biochemical progression in a preoperative model.

S.F.S. is supported by the Austrian Program for Advanced Research and Technology, and V.A.A. is supported by the American Cancer Society (grant No. IRG 93-034-06).

Drs Shariat and Anwuri contributed equally to this study.

Authors' disclosures of potential conflicts of interest are found at the end of this article.

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