Dynamic changes of serum vascular endothelial growth factor after surgical resection of hepatocellular carcinoma and its application in recurrence monitoring.

Abstract

Background: Hepatocellular carcinoma (HCC) recurs frequently after resection. Vascular endothelial growth factor (VEGF) mediates tumor angiogenesis, but its post-operative behavior is poorly described. We compared serum VEGF and alpha-fetoprotein (AFP) trajectories over the first post-operative year.

Methodology: In this single-center prospective pilot study, 21 patients undergoing curative resection were assessed and 19 analyzed (8 recurrence, 11 non-recurrence). Both markers were measured before surgery and at 3, 6 and 12 months. Trajectories were compared using mixed-effects models with a group × time interaction (time categorical) and a random intercept; VEGF was modeled on the native scale, AFP on the log₁₀ scale. All analyses are exploratory.

Results: Eight of 19 patients (42.1%) recurred, at a median of 177.5 days. VEGF trajectories differed between groups (interaction p = 0.041). In the recurrence group, estimated mean VEGF fell from 188.4 to 82.5 pg/mL by 3 months, rose to 103.9 at 6 months and fell to 67.9 at 12 months. Reductions from baseline were significant in the recurrence group only (all p ≤ 0.003). The 6-month rise was not itself significant (+21.2 pg/mL; p = 0.552). Observed VEGF never differed between groups; AFP was higher in the recurrence group at 12 months (15.61 versus 2.04 IU/mL; p = 0.016).

Conclusion: Serum VEGF declines markedly after resection, most steeply in patients who recur, and the groups follow different trajectories. The transient six-month rise coincided with the median time to recurrence but was not significant. Given the small, stage-imbalanced cohort, these findings are hypothesis-generating.