Vascular endothelial growth factor as an age-dependent prognostic factor in gastric cancer patients

Background: We investigated whether vascular endothelial growth factor (VEGF) plays an important role in maintaining constant tumor growth in wasted elderly patients, in whom oxygen and glucose supply are often unable to meet the demands of the body. Methods: Tissue concentrations of VEGF in 70 gastric carcinomas and 70 normal mucosas were determined. The expression of VEGF was evaluated immunohistochemically. Results The net balance between the concentration of VEGF in the cancer and normal mucosa (VEGF Ca/N ratio: the cancer tissue VEGF concentration divided by normal mucosa VEGF concentration) increased with age and was associated with disease progression only in elderly patients. VEGF Ca/N ratio increased in response to systemic hypo-oxygenation and nutritional depletion only in elderly patients. Conclusions The systemic-local regulating mechanism of VEGF production may play an important role in the constant growth of tumor cells, especially in elderly gastric cancer patients.