title: Microvessel density as a prognostic factor in bladder cancer: a systematic review of literature and meta-analysis.
abstract: BACKGROUND
  Many studies have shown that microvessel density (MVD) could play a potential value as prognostic biomarkers of tumors. The aim of this systematic review and meta-analysis is to evaluate the association between MVD and survival in patients with bladder cancer.
  
  
  METHODS
  Relevant literature was identified using PubMed and EMBASE. The eligible studies were assessed for quality using REMAPK (REporting recommendations for tumor MARKer prognostic studies (REMARK)). The patients' clinical characteristics and survival outcomes in eligible studies were extracted. And then, data were synthesized to evaluate the prognostic role of the MVD in bladder cancer with hazard ratio (HR), while the heterogeneity among studies was examined using the I<formula>^{2}</formula>.
  
  
  RESULTS
  This meta-analysis included 10 eligible studies conducted between 1998 and 2011 dealing with bladder cancer. The combined HRs and 95% confidence interval [95% CI] for disease-free survival (DFS) was 2.24 [1.20,4.17], for overall survival (OS) was 1.16 [1.02,1.33] and 1.68 [1.15,2.45] for disease-specific survival (DSS).There was evidence heterogeneity between studies, and the disease stage was a key factor for heterogeneity in subgroup analysis.
  
  
  CONCLUSIONS
  Our studies suggested that high MVD was significantly associated with poor survival and MVD could serve as a prognostic biomarker in patients with bladder cancer.
authors.affiliation: Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Juan
authors.initials: J
authors.lastname: Huang
authors.affiliation: Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Xuelei
authors.initials: X
authors.lastname: Ma
authors.affiliation: Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Xiangjun
authors.initials: X
authors.lastname: Chen
authors.affiliation: Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Xiaoxiao
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Binglan
authors.initials: B
authors.lastname: Zhang
authors.affiliation: Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Li
authors.initials: L
authors.lastname: Minmin
authors.affiliation: Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Nie
authors.affiliation: Department of Obstetrics and Gynecology, Chengdu Integrated TCM & Western Medical Hospital, Chengdu, Sichuan, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Liu
mesh_terms: D018572:Disease-Free Survival; D006801:Humans; D055806:Microvessels / Q000473:pathology*; D011379:Prognosis; D001749:Urinary Bladder Neoplasms / Q000473:pathology*
keywords: Bladder cancer; disease-free survival(DFS); disease-specific survival(DSS); microvessel density; overall survival (OS)