Prognostic significance of vascular endothelial growth factor immunohistochemical expression in gastric cancer: a meta-analysis

Abstract

Vascular endothelial growth factor (VEGF) is considered as a prime mediator of angiogenesis, and has been implicated in carcinogenesis and metastasis. Various studies examined the relationship between VEGF protein overexpression with the clinical outcome in patients with gastric cancer, but yielded conflicting results. The prognostic significance of VEGF overexpression in gastric cancer remains controversial. Electronic databases updated to July 2011 were searched to find relevant studies. A meta-analysis was conducted with eligible studies which quantitatively evaluated the relationship between VEGF overexpression and survival of patients with gastric cancer. Survival data were aggregated and quantitatively analyzed. We performed a meta-analysis of 30 studies (n = 3,999 patients) that evaluated the correlation between VEGF overexpression detected by immunohistochemistry and survival in patients with gastric cancer. Combined hazard ratios suggested that VEGF-A overexpression had an unfavorable impact on overall survival (OS) (HR [hazard ratio] = 1.49, 95 % CI [confidence interval]: 1.22-1.77) and disease free survival (DFS) (HR = 1.85, 95 % CI: 1.38-2.32) in patients with gastric cancer. However, VEGF-C overexpression did not significantly correlate with OS (HR = 1.24, 95 % CI: 0.92-1.56) or DFS (HR = 1.15, 95 % CI: 0.78-1.52). VEGF-D is an unfavorable indicator of OS (HR = 1.68, 95 % CI: 1.02-2.34) and DFS (HR = 1.88, 95 % CI: 1.07-2.70) in patients with gastric cancer. VEGF-A and VEGF-D overexpression indicated a poor prognosis for patients with gastric cancer. VEGF-C overexpression was not associated with poor prognosis in patients with gastric cancer. The prognostic value of VEGF on survival still needs further larger prospective trials to be confirmed.

VEGF expression in pancreatic cancer and other malignancies: a review of the literature

“…Moreover, VEGF-C overexpression indicates a poor prognosis for overall survival at patients with gastric cancer [55]. VEGF-A andVEGF-D are also unfavorable indicators of overall survival and disease free survivalin patients with gastric cancer [56,57].…”

Associations between the expression of MTA1 and VEGF-C in esophageal squamous cell carcinoma with lymph angiogenesis and lymph node metastasis

“…In particular, Asian patients with ESCC and positive VEGF-C expression exhibited a poorer prognosis when compared with those patients with negative VEGF-C expression level (23). VEGF-C was an effective indicator of the prognosis of ESCC; however, prospective studies are required for further confirmation (24). In the present study, among the 63 patients with ESSC and lymph node metastasis, 43 exhibited a high protein expression level of VEGF-C, and among the 44 ESSC patients without lymph node metastasis, 20 had high protein expression levels of VEGF-C, a difference that was statistically significant (P<0.05).…”

“…Peng et al (24) retrieved the VEGF-associated literature in PubMed and Embase databases and performed a meta-analysis of 19 studies that met the final conditions (including 1,453 patient cases), and concluded that the overexpression of VEGF-C was positively associated with the poor prognosis of ESCC. In particular, Asian patients with ESCC and positive VEGF-C expression exhibited a poorer prognosis when compared with those patients with negative VEGF-C expression level (23).…”

Can vascular endothelial growth factor C expression be of use in predicting surgical stage or prognosis in vulvar cancer ?

“…According to literature, SCCs in many different organs express VEGF-C, i.e., tumors of oral cavity [20], oesophageal cancer [21] and cervical cancer [22]. The positive expression has been associated with poorer prognosis and higher risk of lymphatic metastasis.…”