7 ± 5.9%. Follow up was available for 87 patients and ranged from 1 to 165 months (median 64 months). Survival time was calculated from the date of surgery to the date of death or of the last follow up. The expression of HIF-1α, VEGF-A and VEGF-C in carcinoma cells was compared to tumor variables that represent prognostic factors in CRCC: nuclear grade,

Gefitinib clinical trial tumor size, Ki67 proliferative index and pathologic stage (Table 2). Table 2 Relation of HIF-1α, VEGF-A and VEGF-C to clinicopathologic parameters     Nuclear grade1 P value Tumor size (cm)1 p value Ki67 (%)1,2 P value Pathologic stage1 P value     1,2 3,4   < 7 ≥ 7   low high   1 2,3,4,   HIF-1α nHIF-1α 49.5 39 0.006 48.6 43.6 0.057 43.9 48.1 0.134 48.1 44.5 0.165 (%)   (16.3–82.3) (19.2–72.6)   (27.9–73.9) (16.3–82.3)   (16.3–72.4) (21.2–82.3)   (27.9–73.9) (16.3–82.3)     cHIF-1α 11.4 18.7 0.006 11.3 Selleck LY2157299 17.5 0.009 14.6 11.6 0.246 11.4 16.6 0.023     (1.4–75) (5.2–59.5)   (1.4–59.5) (2.9–75)   (4.3–75) (1.4–46.5)   (1.4–42.6) (2.9–75)   VEGF-A pVEGF-A 15 12.5 0.307 15 7.5 0.173 12.5 12.7 0.658 12.1 17.5 0.682 (%)

  (0.00–94) (0–75)   (0–94) (0–75)   (0–94) (0–75)   (0–94) (0–75)     dVEGF-A 6.7 30 <0.001 6.7 16.7 0.015 10.6 10 0.652 6.3 11.7 0.027     (0–92.5) (0–90)   (0–67.5) (0–92.5)   (0–92.5) (0–83.3)   (0–76.7) (0–92.5)   VEGF-C pVEGF-C 65 14 <0.001 64.2 27.9 0.007 45 55 0.913 61.3 33.3 0.042 (%)   (0–100) (0–92.5)   (0–100) (0–100)   (0–100) (0–100)   (0–100) (0–100)     dVEGF-C 18.5 37 0.004 18 37.1 0.007 25

26.3 0.516 20 30 0.109     (0–100) (0–100)   (0–100) (0–100)   (0–100) (0–100)   (0–100) (0–100)   1Mann-Whitney U-test; median (range);2cut-off is mean Nuclear HIF-1α and pVEGF-C expression was associated with lower nuclear grade and smaller tumor size indicating better prognosis, while cHIF-1α together with dVEGF-A and -C was associated with worse prognostic factors, i.e. higher nuclear grade, larger tumor size and higher tumor stage. There was no association of Ki67 index with either protein analyzed. Association of HIF-1α, VEGF-A and -C with patient survival The association of immunohistochemical cAMP positivity for HIF-1α, VEGF-A and VEGF-C and cumulative proportion of patients surviving during the follow up are shown in Figure 2. Figure 2 Kaplan-Meier cumulative survival analysis according to staining for nuclear and cytoplasmic HIF-1α, VEGF-A and VEGF-C. The log-rank test showed significantly shorter overall survival in patients with tumors showing low nHIF-1α (p = 0.005) (A) and low pVEGF-C (p = 0.008) (D). The 5-year survival rate was 32% for patients whose tumors showed low nHIF-1α vs. 65% for patients whose tumors showed high nHIF-1α (A); and 40% for patients whose tumors showed low pVEGF-C vs. 61% for patients whose tumors showed high pVEGF-C (D). The log-rank test showed significantly shorter overall survival in patients with tumors showing high cHIF-1α (p = 0.018) (B) and high dVEGF-A (p = 0.024) (C).