Angiogenic Response to Major Lung Resection for Non-Small Cell Lung Cancer with Video-Assisted Thoracic Surgical and Open Access

Abstract EN

Background.

Angiogenic factors following oncological surgery is important in tumor recurrence.

Vascular endothelial growth factor (VEGF), angiopoietin 1 (Ang-1), Ang-2, soluble VEGF-receptor 1 (sVEGFR1) and sVEGFR2 may influence angiogenesis.

This prospective study examined the influence of open and video-assisted thoracic surgery (VATS) lung resections for early stage non-small cell lung cancer (NSCLC) on postoperative circulating angiogenic factors.

Methods.

Forty-three consecutive patients underwent major lung resection through either VATS (n=23) or Open thoracotomy (n=20) over an 8-month period.

Blood samples were collected preoperatively and postoperatively on days (POD) 1 and 3 for enzyme linked immunosorbent assay determination of angiogenic factors.

Results.

Patient demographics were comparable.

For all patients undergoing major lung resection, postoperative Ang-1 and sVEGFR2 levels were significantly decreased, while Ang-2 and sVEGFR1 levels markedly increased.

No significant peri-operative changes in VEGF levels were observed.

Compared with open group, VATS had significantly lower plasma levels of VEGF (VATS 170±93 pg/mL; Open 486±641 pg/mL; P=0.04) and Ang-2 (VATS 2484±1119 pg/mL; Open 3379±1287 pg/mL; P=0.026) on POD3.

Conclusions.

Major lung resection for early stage NSCLC leads to a pro-angiogenic status, with increased Ang-2 and decreased Ang-1 productions.

VATS is associated with an attenuated angiogenic response with lower circulating VEGF and Ang-2 levels compared with open.

Such differences in angiogenic factors may be important in lung cancer biology and recurrence following surgery.