Comparison of Vascular Endothelial Growth Factor-C Expression with Lymph Node Metastasis Status and Survival in Gastric Cancer.

Introduction: Lymph node metastasis is crucial in determining prognosis and treatment for gastric cancer. Vascular Endothelial Growth Factor-C (VEGF-C), known for its role in lymphangiogenesis, has been linked to metastasis in various cancers. This study investigates the correlation between VEGF-C expression, lymph node metastasis, and overall survival in gastric cancer patients.

Methods: This retrospective cohort study included 109 patients who underwent gastrectomy and D2 lymphadenectomy for gastric adenocarcinoma between 2011 and 2019. VEGF-C expression was evaluated via immunohistochemistry. Clinical data, including demographics, tumor characteristics, lymph node involvement, and survival outcomes, were analyzed. Cox regression identified factors affecting mortality.

Results: VEGF-C expression was categorized as absent, low, or high. Although no significant association was found between VEGF-C expression and lymphatic metastasis, lymphatic invasion was more frequent (87.9%) in patients with high VEGF-C expression. VEGF-C was significantly associated with perineural invasion and the development of distant metastasis during follow-up, highlighting its potential role in tumor progression beyond lymphatic dissemination. Cox regression identified T3/T4 tumors, metastasis during follow-up, and lack of adjuvant radiotherapy as independent prognostic factors for overall survival.

Conclusion: While VEGF-C was not directly linked to lymph node metastasis, its strong association with perineural invasion and subsequent metastasis highlights its potential prognostic value in identifying aggressive tumor behavior. Further studies are needed to clarify its prognostic significance in gastric cancer.