Research Papers:

VEGF-C expression attributes the risk for lymphatic metastases to ovarian cancer patients

Sascha Kuerti, Leticia Oliveira-Ferrer, Karin Milde-Langosch, Barbara Schmalfeldt, Karen Legler, Linn Woelber, Katharina Prieske, Sven Mahner and Fabian Trillsch _

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Oncotarget. 2017; 8:43218-43227. https://doi.org/10.18632/oncotarget.17978

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Sascha Kuerti1,*, Leticia Oliveira-Ferrer1,*, Karin Milde-Langosch1, Barbara Schmalfeldt1, Karen Legler1, Linn Woelber1, Katharina Prieske1, Sven Mahner2 and Fabian Trillsch2

1Department of Gynaecology and Gynaecologic Oncology, University Medical Center Hamburg-Eppendorf, Hamburg 20246, Germany

2Department of Obstetrics and Gynaecology, University of Munich, Munich 81377, Germany

*These authors have contributed equally to this work

Correspondence to:

Fabian Trillsch, email: [email protected]

Keywords: ovarian cancer, (VEGF)-A, -C, -D, mesenchymal phenotype, tumour dissemination, lymph node metastases

Received: February 20, 2017     Accepted: March 31, 2017     Published: May 18, 2017


Background: Peritoneal dissemination and retroperitoneal lymph node involvement are main routes for progression of epithelial ovarian cancer (EOC). Vascular endothelial growth factor (VEGF) mediated angiogenesis has been identified as an important mechanism promoting tumour progression.

Methods: Tumour tissue of 100 patients with EOC was analysed for protein expression of vascular endothelial growth factor (VEGF)-A, -C, -D by Western Blot analysis. Expression patterns in patients with ‘extensive intraperitoneal’ metastases (pT3c pN1 and pT3b-pT3c pN0, n=80) were compared to patients with ‘predominantly retroperitoneal’ metastases (pT1a-pT3b, pN1, n=20). Overall and progression-free survival was analysed by Kaplan-Meier method.

Results: While no significant differences in expression levels among the different modes of metastases were noted for VEGF-A and -D, VEGF-C expression was significantly higher in the group of predominantly retroperitoneal metastases compared to the group with extensive intraperitoneal metastases. Patients with high VEGF-C expression had a significantly worse overall survival compared to patients with low expression levels.

Conclusions: Retroperitoneal tumour progression in EOC patients is associated with high VEGF-C expression. VEGF-C may serve as a molecular marker to identify patients with assumed high risk for lymphatic metastases, who might benefit from specific treatment strategies.

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