Prognostic value of serum vascular endothelial growth factor receptor 2 response in patients with hepatocellular carcinoma undergoing transarterial chemoembolization

We aimed to elucidate whether serum VEGFR2 concentration before and after transarterial chemoembolization (TACE) can predict survival in patients with unresectable hepatocellular carcinoma (HCC). Serum VEGFR2 concentrations were serially measured in 169 patients with advanced HCC before and after TACE. We defined a decrease in the serum VEGFR2 level >10 % from the pretreatment level as response. Serum VEGFR2 concentrations decreased in 44 (26.0 %) patients at week 4. Patients who had a VEGFR2 response at week 4 had a longer median survival than those who did not have a VEGFR2 decrease (19.0 vs. 9.8 months, p < 0.001). Clinical variables associated with OS in addition to VEGFR2 response also included extrahepatic metastases (p = 0.005) and vascular invasion (p = 0.035). VEGFR2 decrease after TACE (p = 0.012) and presence of extrahepatic metastases (p = 0.02) were independently associated with OS by multivariate analysis. A serum VEGFR2 concentration decrease at 4 weeks after TACE may predict favorable overall survival in patients with advanced HCC.