Clinical significance of urinary vascular endothelial growth factor in patients with superficial bladder tumors.

Vascular endothelial growth factor (VEGF) is an important mediator of tumor angiogenesis and has been shown to be excreted in the urine of bladder cancer patient. The goal of this study was to evaluate urinary VEGF levels of patients with superficial bladder transitional cell carcinoma (TCC) and to determine its predictive value for recurrence. Pre-operative urinary VEGF levels were determined in 31 patients with superficial bladder TCC and 10 control patients. A quantitative enzyme immunoassay was used to measure urinary VEGF levels and the urine VEGF concentration was corrected by the creatinine concentration in a 24-h urine specimen. The corrected urinary VEGF levels were higher in patients than controls (p=0.003). Ten of 31 patients had TCC recurrences during this study. Corrected urinary VEGF levels were significantly higher in recurrent vs. non-recurrent patients (p=0.001). A cut-off value of 0.32 (corrected urinary VEGF levels) was valuable for predicting recurrences in this prospective study. However, there was no statistical correlation between VEGF levels and tumor stage (Ta or T1), tumor size or tumor grade. Pre-operative urinary VEGF levels are associated with a risk of recurrence in patient with superficial bladder TCC. Quantification of urinary VEGF may prove to be a valuable, non-invasive indicator of carcinoma recurrence in patients with superficial bladder TCC. Urinary VEGF may be a therapeutic target for intravesical therapy. However, because of the small number of cases, further studies with larger number of patients will be needed to clarify this issue.