Objectives: Renal cell carcinoma (RCC) is a vascularised neoplasm. The importance of the angiogenic process in its growth and metastatic spreading is widely recognised. We assessed serum levels of endogenous endostatin and vascular endothelial growth factor (VEGF) in RCC patients and healthy volunteers, and evaluated the factors' prognostic role for patients' survival, distinguishing histologic subtypes with respect to correlation with tumour stage, grade, and size.
Methods: We considered 146 consecutive patients with RCC and 110 healthy volunteers. Serum samples from all subjects were analysed for endostatin and VEGF by using competitive enzyme immunoassays. RCC samples were compared with serum from the control group and with clinicopathologic factors and clinical outcome.
Results: Mean age was 63 years (range: 37-85 years) in RCC patients and 62 years (range: 23-88 years) in the control group. VEGF levels (median: 3.6 ng/ml+/-6.97; range: 0-48.4 ng/mL) were significantly higher in RCC patients, compared with controls (p=0.001). Endostatin levels did not differ significantly between the two groups (p=0.9) without correlation between endostatin and VEGF levels (p=0.09). No significant difference was found in the endostatin levels among the histologic subtypes (p=0.973) and VEGF (p=0.232). The median follow-up was 27 months (range: 1-57 months).
Conclusions: Serum VEGF levels are elevated in RCC patients, compared with controls, and do not correlate significantly with circulating endostatin levels. No difference in preoperative serum VEGF and endostatin levels among the different histologic subtypes was found. In multivariate analysis VEGF and endostatin failed to be prognostic; only tumour stage and grade remained independent predictors of survival.