Reducing peritoneal vascular endothelial growth factor concentration and inhibiting cancer scattering in a mouse model of laparoscopy

Objective: The objective of the study was to investigate the efficacy of early intraperitoneal (IP) paclitaxel administration in reducing vascular endothelial growth factor (VEGF) concentration in peritoneal fluid and preventing intraoperative cancer scattering during laparoscopy. Study Design: Nude mice were given IP ovarian cancer SKOV-3 xenografts to simulate intraoperative cancer dissemination and were assigned into concurrent- (day 0) and salvage-giving (day 5) treatment groups and nontreatment and nonxenografted groups. Results: The xenografted nontreatment group showed markedly increased peritoneal VEGF concentrations, whereas the paclitaxel (no-tumor) control group showed significantly reduced concentrations. In mice with cancer xenografts, both concurrent- and salvage-giving treatment groups showed significantly decreased peritoneal VEGF concentrations (P < .05), and the concurrent-giving group had significantly fewer implanted cancer nodules (P < .05), whereas the salvage-giving group had decreased total tumor weights (P < .05) compared with nontreatment. Total tumor weights were found closely correlated to peritoneal VEGF concentrations in a positive exponential relationship (P = .003, R² = 0.581). Conclusion: Early treatment with IP paclitaxel significantly decreased the VEGF concentration in peritoneal fluid, which was associated with reduced implantation and growth of disseminated cancer cells after laparoscopy. These encouraging results suggest a useful strategy for future clinical applications.