title: Prognostic significance of vascular endothelial growth factor expression in hepatocellular carcinoma tissue: a meta-analysis.
abstract: 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 between VEGF overexpression with the clinical outcome in patients with hepatocellular carcinoma (HCC), but yielded conflicting results.
  
  
  METHODS
  Electronic databases updated to June 2013 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 HCC. Survival data were aggregated and quantitatively analyzed.
  
  
  RESULTS
  We performed a meta-analysis of 14 studies that evaluated the correlation between VEGF overexpression and survival in patients with HCC. Combined hazard ratios suggested that VEGF overexpression had an unfavorable impact on overall survival (OS) [hazard ratio (HR) =1.42, 95% confidence interval (CI): 1.42-1.7], but not disease free survival (DFS) (HR=1.13, 95% CI: 0.89-1.38) in patients with HCC. No significant heterogeneity (P=0.949) was observed among 9 studies for OS, however significant heterogeneity (P=0.008) was observed among 11 studies for DFS.
  
  
  CONCLUSIONS
  VEGF overexpression indicates a poor prognosis for patients with HCC.
authors.affiliation: First Department of Respiratory Medicine, Nanjing Chest Hospital, Nanjing 210029, China; ; The Collaborative Research (CORE) Group, Sydney, Australia.
authors.forename: Ping
authors.initials: P
authors.lastname: Zhan
authors.affiliation: First Department of Respiratory Medicine, Nanjing Chest Hospital, Nanjing 210029, China;
authors.forename: Qian
authors.initials: Q
authors.lastname: Qian
authors.affiliation: First Department of Respiratory Medicine, Nanjing Chest Hospital, Nanjing 210029, China;
authors.forename: Li-Ke
authors.initials: LK
authors.lastname: Yu
keywords: Vascular endothelial growth factor (VEGF); hepatocellular carcinoma (HCC); meta-analysis; prognosis