Assessment of circulating VEGF as a predictive biomarker of peritoneal carcinomatosis in gastric cancer

Introduction: Early diagnosis of peritoneal carcinomatosis is difficult in patients with gastric cancer who are at high risk of developing peritoneal metastases. The measurement of serum Vascular Endothelial Growth Factor (VEGF) has proven to be a useful prognostic factor in gastric cancer, but it also could be a predictive factor for peritoneal metastases since the VEGF signalling pathway is directly involved in the development of peritoneal metastases. Methods: This is a retrospective study from 2005 to 2017. We reviewed the peritoneal recurrence pattern of a cohort of 59 gastric cancer patients in whom serum VEGF was measured before surgery and after completion of adjuvant treatment Results: Preoperative serum VEGF (pre-VEGF) level was identified as an independent prognostic factor for developing peritoneal metastases. The optimal cut-off value of pre-VEGF levels was 507 pg/mL, which presented a sensitivity of 66 % and a specificity of 78% to predict the development of peritoneal metastases. Patients with high pre-VEGF levels (>507 pg/mL) were at greater risk of developing peritoneal metastases than patients with low pre-VEGF levels (<507 pg/mL) (p=0.023). Conclusions: VEGF plays a crucial role in the development of peritoneal metastases, and serum VEGF meets the requirements of a potential predictive marker for peritoneal carcinomatosis. Therefore, the measurement of serum VEGF levels could be useful during the follow-up of patients with advanced gastric cancer.