laboratory andanimal investigations Vascular Endothelial GrowthFactor Increased byPulmonary Surgery Accelerates theGrowthof Micrometastases inMetastatic Lung

Background: Theuse ofsurgery formetastatic lung cancer hasbeenestablished recently andthe indications havebeenextended tomultiple andbilateral lung metastases. However, insome patients, secondary lung metastasis appears soon after thefirst pulmonary surgery, making curative treatmentverydifficult. Postoperative weakness oftumorangiogenesis suppression mechanisms seems toplay an important role intherecurrence oflung metastases. Toverify this hypothesis, we performed a clinical andan experimental study. Results andconclusion: Theclinical study revealed that serum vascular endothelial growth factor (VEGF), alsoknownas vascular permeability factor, increased after pulmonary surgery. The experimental study showed that VEGFplayed an important role intherapid growth ofdormant micrometastases ofthelung. Theseresults suggested that thepostoperative increase ofVEGF disrupted angiogenesis suppression andinduced thegrowth ofdormant micrometastases early in thepostoperative period. Itwas also demonstrated that this effect ofVEGF on micrometastases was abolished byAGM-1470, an angiogenesis inhibitor. Inconclusion, postoperative treatment withAGM-1470might inhibit theearly recurrence ofmalignant tumors. (CHEST 1998; 114:1668-1675)