title: Prognostic role of survivin in renal cell carcinoma: A system review and meta-analysis.
abstract: BACKGROUND
  Survivin plays an important role in cancer pathogenesis, which has been suggested to be related to poor prognosis in renal cell carcinoma (RCC). We performed a meta-analysis to quantify the prognostic value of survivin in renal cell carcinoma (RCC) patients.
  
  
  METHODS
  Relevant articles exploring the relationship between survivin expression and survival of RCC patients published up to 10 November 2015 were retrieved in PubMed, Web of science and Cochrane databases. The summary hazard ratio (HR) and 95% confidence interval (CI) were calculated by a random-effects model.
  
  
  RESULTS
  A total of 1583 patients from 10 studies were included. The high expression of survivin was associated with poor Overall Survival (OS) in two studies (Pooled HRs=2.77, 95%CI: 1.46-5.26, I(2)=0.0%, P=0.329). Further, meta-analysis of seven studies showed that elevated survivin expression predicted shorter cancer-specific survival (CSS) of RCC (HR=2.85, 95% CI: 2.25-3.61, I(2)=17.6%, P=0.295). Additionally, subgroup analysis showed that survivin over-expression was associated significantly with worse CSS regardless of different source of survivin, sample size, follow-up duration, race and detection method.
  
  
  CONCLUSIONS
  A higher survivin expression seems to represent an unfavorable and robust prognostic factor for clinical outcomes in RCC patients.
authors.affiliation: Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.
authors.forename: Chaohui
authors.initials: C
authors.lastname: Xiong
authors.affiliation: Anhui Provience Children's Hospital, Hefei 230022, China.
authors.forename: Haipeng
authors.initials: H
authors.lastname: Liu
authors.affiliation: Department of Clinical Epidemiology & Biostatistics, The Second Affiliated Hospital, School of Medicine, Zhejiang University, China.
authors.forename: Zexin
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China.
authors.forename: Yunxian
authors.initials: Y
authors.lastname: Yu
authors.affiliation: Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China. Electronic address: chaozhao@163.com.
authors.forename: Chaozhao
authors.initials: C
authors.lastname: Liang
mesh_terms: D014408:Biomarkers, Tumor / Q000378:metabolism; D002292:Carcinoma, Renal Cell / Q000503:physiopathology*; D018572:Disease-Free Survival; D006801:Humans; D051034:Inhibitor of Apoptosis Proteins / Q000378:metabolism*; D007680:Kidney Neoplasms / Q000503:physiopathology*; D011379:Prognosis; D000077022:Survivin
chemical_list: C107489:BIRC5 protein, human; D014408:Biomarkers, Tumor; D051034:Inhibitor of Apoptosis Proteins; D000077022:Survivin
keywords: Meta-analysis; Renal cell carcinoma; Survivin