Chen M et al. – In this meta-analysis, elevated VEGF expression was associated with poor survival in patients with esophageal cancer, but not esophageal sdenocarcinoma. Impact:These results support further investigation of VEGF expression for predicting poor survival in patients with esophageal carcinoma, and may have implications for treatments directed at inhibiting VEGF-mediated angiogenesis.Methods
- Searches were applied to PubMed and EMBASE until December 31, 2011, without language restrictions.
- Studies were assessed for quality using REMARK (Reporting recommendations for tumor MARKer prognostic studies).
- Data were collected comparing overall survival in patients with high VEGF level as compared to those with low level.
- We conducted a systematic review of 31 studies (n=2387 patients) and completed a meta-analysis of 30 studies (n=2345 patients) that correlated VEGF levels with overall survival.
- Data were synthesized with hazard ratios.
- The estimated risk of death was 1.82-fold greater in patients with high VEGF expression (95% confidence interval, 1.58-2.08).
- The heterogeneity was not significant (P=0.130) between studies. High VEGF expression was associated with worse survival in esophageal squamous cell carcinoma (hazard ratio, 1.81; 95% confidence interval, 1.57-2.10) and there was no significance in between-study heterogeneity (P=0.185).
- Data collected were not sufficient to determine the prognostic value of VEGF in patients with esophageal adenocarcinoma.