Vessel Counts and Expression of Vascular Endothelial Growth Factor as Prognostic Factors in Node-Negative Colon Cancer

BACKGROUND: The value of these prognostic factors was compared with that of other clinicopathologic factors such as tumor grade, tumor stage, mucin production, vascular invasion, perineural invasion, and lymphatic invasion. OBJECTIVE: To determine whether the development of distant recurrence in patients with node-negative colon cancer could be predicted using vessel count and vascular endothelial growth factor (VEGF) expression. DESIGN: Paraffin-embedded colon cancers were immunostained for factor VIII, VEGF, basic fibroblast growth factor, and proliferating cell nuclear antigen; slides were reviewed for differentiation, mucin production, and the presence of vascular, lymphatic, and/or perineural invasion. SETTING: A large academic cancer referral center where 27 patients with node-negative colon cancer were operated on during 1988 and 1989. MAIN OUTCOME MEASURE: The development of and interval to recurrence. RESULTS: Eight patients developed liver, lung, or lymph node metastases at a median of 24 months. The median follow-up for patients without cancer recurrence was 60 months. The mean tumor vessel count for those patients who remained disease-free was significantly fewer than for those patients who suffered a recurrence (20 vs 33, respectively). By univariate analysis, 3 factors- perineural invasion, vessel count, and VEGF expression- were correlated with time to recurrence. By multivariate analysis, only vessel count was significantly related to differences in time to recurrence. Expression of VEGF correlated with vessel count. CONCLUSION: Vessel count and expression of VEGF may be useful for predicting distant recurrence in patients with node-negative colon cancer.