Prognostic significance of vascular endothelial growth factor expression in hepatocellular carcinoma tissue: a meta-analysis

Background: 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 betweenVEGF overexpression with the clinical outcome in patients with hepatocellular carcinoma (HCC), butyielded conflicting results.Methods: Electronic databases updated to June 2013 were searched to find relevant studies. A metaanalysiswas conducted with eligible studies which quantitatively evaluated the relationship between VEGFoverexpression and survival of patients with HCC. Survival data were aggregated and quantitatively analyzed.Results: We performed a meta-analysis of 14 studies that evaluated the correlation between VEGFoverexpression and survival in patients with HCC. Combined hazard ratios suggested that VEGFoverexpression had an unfavorable impact on overall survival (OS) [hazard ratio (HR) =1.42, 95% confidenceinterval (CI): 1.42-1.7], but not disease free survival (DFS) (HR=1.13, 95% CI: 0.89-1.38) in patients withHCC. No significant heterogeneity (P=0.949) was observed among 9 studies for OS, however significantheterogeneity (P=0.008) was observed among 11 studies for DFS.Conclusions: VEGF overexpression indicates a poor prognosis for patients with HCC.