Prognostic Value of Vascular Endothelial Growth Factor Expression in Resected Gastric Cancer

Abstract

Background and Aims: Vascular endothelial growth factor (VEGF) is a potential prognostic biomarker forpatients with resected gastric cancer. However, its role remains controversial. The objective of this study was toconduct a systematic review and meta-analysis of published literature. <br/><b>Methods</b>: Relevant literature was identifiedusing Medline and survival data from published studies were collected following a methodological assessment.Quality assessment of eligible studies and meta-analysis of hazard ratio (HR) were performed to review thecorrelation of VEGF overexpression with survival and recurrence in patients with gastric cancer. <br/><b>Results</b>: Ourmeta-analysis included 44 published studies with 4,794 resected patients. VEGF subtype for the prediction ofoverall survival (OS) included tissue VEGF (HR=2.13, 95% CI 1.71–2.65), circulating VEGF (HR=4.22, 95% CI2.47–7.18), tissue VEGF-C (HR=2.21, 95% CI 1.58–3.09), tissue VEGF-D (HR=1.73, 95% CI 1.25–2.40). Subgroupanalysis showed that HRs of tissue VEGF for OS were, 1.78 (95% CI 0.90-3.51) and 2.31 (95% CI 1.82-2.93) innon-Asians and Asians, respectively. The meta-analysis was also conducted for disease free survival (DFS) anddisease specific survival (DSS). <br/><b>Conclusion</b>: Positive expression of tissue VEGF, circulating VEGF, VEGF-C andVEGF-D were all associated with poor prognosis in resected gastric cancer. However, VEGF demonstrated nosignificant prognostic value for non-Asian populations. Circulating VEGF may be better than tissue VEGF inpredicting prognosis.