title: Prognostic Value of VEGF in Hepatocellular Carcinoma Patients Treated with Sorafenib: A Meta-Analysis.
abstract: BACKGROUND
  Hepatocellular carcinoma (HCC) is characterized by rich vascularization in the tumor, and vascular endothelial growth factor (VEGF) plays important roles in vascularization. The results of the roles of VEGF in predicting efficacy of sorafenib in HCC are conflicting. In this meta-analysis, we aimed to investigate the prognostic and predictive value of VEGF in HCC patients receiving sorafenib.
  
  
  METHODS
  PubMed, Embase, and Cochrane library electronic databases were systematically searched for eligible studies. The baseline characteristics were recorded and overall qualities of the eligible studies were assessed by 2 reviewers independently. VEGF levels and data relevant to efficacy of sorafenib were extracted and used for meta-analysis.
  
  
  RESULTS
  The comprehensive search yielded 9 studies that evaluated the relationship between VEGF level and clinical outcome in advanced HCC patients treated with sorafenib. Pooled estimates suggested that high level of VEGF was associated with poor overall survival (HR=1.85; 95% CI: 1.24-2.77; P=0.003) and poor progression-free survival (HR=2.09; 95% CI: 1.43-3.05; P<0.01) in HCC. Mutation of VEGF had a favorable effect on hand-foot skin reaction in HCC patients treated with sorafenib (P<0.05).
  
  
  CONCLUSIONS
  High level of VEGF is associated with poor outcomes in HCC patients treated with sorafenib, indicating that VEGF could be used as an indicator of clinical efficacy in patients with HCC. However, more well-designed studies are needed to strengthen our findings.
authors.affiliation: Department of Pharmacy, Women's and Children's Hospital, Linyi, Shandong, China (mainland).
authors.forename: Guangchao
authors.initials: G
authors.lastname: Cao
authors.affiliation: Department of Obstetrics, Women's and Children's Hospital, Linyi, Shandong, China (mainland).
authors.forename: Xiaoyun
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Emergency Medicine, Capital Medical University Tongren Hospital, Beijing, China (mainland).
authors.forename: Chao
authors.initials: C
authors.lastname: Qin
authors.affiliation: Department of Pharmacy, First People's Hospital, Jining, Shandong, China (mainland).
authors.forename: Jie
authors.initials: J
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000188:drug therapy / Q000378:metabolism*; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009154:Mutation; D009536:Niacinamide / Q000031:analogs & derivatives* / Q000627:therapeutic use; D064887:Observational Studies as Topic; D010671:Phenylurea Compounds / Q000627:therapeutic use*; D011110:Polymorphism, Genetic; D011379:Prognosis; D000077157:Sorafenib; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism*; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D010671:Phenylurea Compounds; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D009536:Niacinamide; D000077157:Sorafenib