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ABSTRACT
Objectives
This work aimed to measure serum vascular endothelial growth factor (VEGF) levels before and after Conventional transarterial chemoembolization (cTACE) versus drug-eluting beads (DEB)-TACE and evaluate its efficacy in predicting response to therapy and tumor recurrence.
Methods
114 patients with unresectable hepatocellular carcinoma complicating hepatitis C virus-related cirrhosis were included. They underwent cTACE (58) or DEB-TACE (56). VEGF serum levels were measured before and on days 1 and 30 after TACE. Patients with complete response (CR) after TACE were followed-up for one year. Statistical analysis was done.
Results
VEGF level was higher than baseline after cTACE (P < 0.001), and DEB-TACE (P = 0.004). It was also significantly higher in patients with progressive disease (P < 0.001). VEGF level at cut off values of 97.3, 149.8, and 104.1 pg/ml could discriminate disease progression from treatment success with area under ROC curves of 0.806, 0.775, and 0.771, respectively. The sensitivity was 88.9%, 88.9%, and 77.8% and specificity was 62.5%, 64.6 and 66.7%, respectively. However, no relation to tumor recurrence in CR group could be detected after one year.
Conclusion
VEGF serum levels may predict response to therapy in patients treated by DEB-TACE or cTACE but it has no relation to tumor recurrence.
Author contributions
K Farid, H El Alfy, and M Elbendary were involved in the conception and design. T Amer, A El-Morsy, A Abd Elkhalek, and A Elmokadem performed the TACE procedure and diagnose all radiological images. T Besheer, W Shabana, S Abed, and M Elegezy supervised patients’ treatment and follow up. S Abo El-khair, A Negm, and A Z. Elsamanoudy performed the laboratory tests. H El Alfy and H Elgamal collected patient data. B Eldeek performed statistical analysis. M Elegezy, S Abed, and H Elgamal were included in the drafting of the paper. K Farid, H El Alfy, T Besheer, and M Elbendary were included in revising the manuscript and the final approval of the version to be published. All authors agree to be accountable for all aspects of the work.
Declaration of interest
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
Reviewer disclosures
Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.