title: Prognostic value of vascular endothelial growth factor expression in resected gastric cancer.
abstract: OBJECTIVE
  Vascular endothelial growth factor (VEGF) is a potential prognostic biomarker for patients with resected gastric cancer. However, its role remains controversial. The objective of this study was to conduct a systematic review and meta-analysis of published literature.
  
  
  METHODS
  Relevant literature was identified using 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 the correlation of VEGF overexpression with survival and recurrence in patients with gastric cancer.
  
  
  RESULTS
  Our meta-analysis included 44 published studies with 4,794 resected patients. VEGF subtype for the prediction of overall survival (OS) included tissue VEGF (HR=2.13, 95% CI 1.71-2.65), circulating VEGF (HR=4.22, 95% CI 2.47-7.18), tissue VEGF-C (HR=2.21, 95% CI 1.58-3.09), tissue VEGF-D (HR=1.73, 95% CI 1.25-2.40). Subgroup analysis 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) in non-Asians and Asians, respectively. The meta-analysis was also conducted for disease free survival (DFS) and disease specific survival (DSS).
  
  
  CONCLUSIONS
  Positive expression of tissue VEGF, circulating VEGF, VEGF-C and VEGF-D were all associated with poor prognosis in resected gastric cancer. However, VEGF demonstrated no significant prognostic value for non-Asian populations. Circulating VEGF may be better than tissue VEGF in predicting prognosis.
authors.affiliation: State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, Chengdu, China. liuleihx@gmail.com
authors.forename: Lei
authors.initials: L
authors.lastname: Liu
authors.forename: Xue-Lei
authors.initials: XL
authors.lastname: Ma
authors.forename: Zhi-Lan
authors.initials: ZL
authors.lastname: Xiao
authors.forename: Mei
authors.initials: M
authors.lastname: Li
authors.forename: Si-Hang
authors.initials: SH
authors.lastname: Cheng
authors.forename: Yu-Quan
authors.initials: YQ
authors.lastname: Wei
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000096:biosynthesis* / Q000097:blood; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000378:metabolism / Q000473:pathology; D011379:Prognosis; D013274:Stomach Neoplasms / Q000097:blood / Q000378:metabolism* / Q000473:pathology* / Q000601:surgery; D042461:Vascular Endothelial Growth Factor A / Q000096:biosynthesis* / Q000097:blood
chemical_list: D014408:Biomarkers, Tumor; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A