Dynamic changes of serum vascular endothelial growth factor after surgical resection of hepatocellular carcinoma and its application in recurrence monitoring

Background Hepatocellular carcinoma (HCC) recurs frequently after resection. Vascular endothelial growth factor (VEGF) mediates tumor angiogenesis, but its post-operative behavior is poorly described. We compared serum VEGF and alpha-fetoprotein (AFP) trajectories over the first post-operative year. Methodology In this single-center prospective pilot study, 21 patients undergoing curative resection were assessed and 19 analyzed (8 recurrence, 11 non-recurrence). Both markers were measured before surgery and at 3, 6 and 12 months. Trajectories were compared using mixed-effects models with a group × time interaction (time categorical) and a random intercept; VEGF was modeled on the native scale, AFP on the log 10 scale. All analyses are exploratory. Results Eight of 19 patients (42.1%) recurred, at a median of 177.5 days. VEGF trajectories differed between groups (interaction p = 0.041). In the recurrence group, estimated mean VEGF fell from 188.4 to 82.5 pg/mL by 3 months, rose to 103.9 at 6 months and fell to 67.9 at 12 months. Reductions from baseline were significant in the recurrence group only (all p ≤ 0.003). The 6-month rise was not itself significant (+21.2 pg/mL; p = 0.552). Observed VEGF never differed between groups; AFP was higher in the recurrence group at 12 months (15.61 versus 2.04 IU/mL; p = 0.016). Conclusion Serum VEGF declines markedly after resection, most steeply in patients who recur, and the groups follow different trajectories. The transient six-month rise coincided with the median time to recurrence but was not significant. Given the small, stage-imbalanced cohort, these findings are hypothesis-generating.