High serum vascular endothelial growth factor C predicts better relapse-free survival in early clinically node-negative breast cancer

// Jose Maanon 1, * , Diego Perez 2, * , Alejandro Rhode 3 , Gonzalo Callejon 4 , Francisco Rivas-Ruiz 5 , Elisabeth Perez-Ruiz 2 , Isabel Rodrigo 6 , Belen Ramos 7 , Francisco Medina 8 , Rosa Villatoro 2 , Maximino Redondo 9 and Antonio Rueda 2 1 Obstetrics and Gynecology Unit, Breast Cancer Unit, Hospital Costa de Sol, Malaga University, Malaga, Spain 2 Medical Oncology Unit, Breast Cancer Unit, Hospital Costa de Sol, (REDISSEC), Marbella, Malaga, Spain 3 Obstetrics and Gynecology Unit, Breast Cancer Unit, Hospital Costa de Sol, Marbella, Malaga, Spain 4 Clinical Analysis Laboratory Unit, Hospital Costa de Sol, Marbella, Malaga, Spain 5 Support for Research Unit, Hospital Costa de Sol, (REDISSEC), Marbella, Malaga, Spain 6 Pathology Unit, Breast Cancer Unit, Hospital Costa de Sol, Marbella, Malaga, Spain 7 Radiology Unit, Breast Cancer Unit, Hospital Costa de Sol, Marbella, Malaga, Spain 8 General and Digestive Surgery Unit, Breast Cancer Unit, Hospital Costa de Sol, (REDISSEC), Marbella, Malaga, Spain 9 Hospital Tumor Registry, Hospital Costa de Sol, (REDISSEC), Marbella, Malaga, Spain * These authors contributed equally to this work Correspondence to: Antonio Rueda, email: arueda@hcs.es Jose Maanon, email: jcm@hcs.es Keywords: breast cancer; sentinel lymph node biopsy; clinically node negative; VEGF-C; relapse-free survival Received: October 07, 2017      Accepted: May 19, 2018      Published: June 15, 2018 ABSTRACT A recent meta-analysis indicated that higher tumoral expression of vascular endothelial growth factor C (VEGF-C) was related to poorer relapse-free and overall survival in breast cancer patients. However, a retrospective study found that higher circulating VEGF-C levels were associated with better survival in breast cancer patients. In 2009, we initiated a prospective study to determine the utility of preoperative serum VEGF-C levels for predicting the risk of sentinel lymph node involvement in early breast cancer and to assess serum VEGF-C levels as a prognostic factor for relapse-free and overall survival. We analyzed serum samples from 174 patients with early breast cancer who underwent sentinel lymph node biopsies. VEGF-C levels were determined using an ELISA. Serum VEGF-C levels were normally distributed, with a median value of 6561.5 pg/mL, and did not correlate with any other clinical or pathological variables. During a median follow-up period of 58 months, the five-year relapse-free survival rate was higher in patients with VEGF-C levels above the median than in patients with lower levels (95.3% vs. 85.9%, p < 0.04). No association was found between VEGF-C levels and overall survival. Our study demonstrates that the prognosis was better for early breast cancer patients with high serum VEGF-C levels.