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Research continues to highlight the importance of vascular endothelial growth factor (VEGF) in colorectal cancer and to generate new hypotheses about its role in angiogenesis throughout development of this disease. VEGF expression is observed early in the progression from premalignant adenoma to invasive and metastatic disease. Additionally, VEGF expression has been correlated with increased microvessel count in colon tumors, and both VEGF and microvessel count have been associated with poor outcomes, as measured by tumor progression, metastasis, and patient survival. As noted by Takahashi and colleagues, "these findings support the hypothesis that VEGF is an important angiogenic factor in primary and metastatic human colorectal cancer."2 Large prospective studies are necessary to better define the relationship of prognosis to angiogenesis and VEGF.
