title: Clinicopathological and prognostic significance of survivin expression in renal cancer patients: a meta-analysis.
abstract: BACKGROUND
  Survivin has been reported to play a role in the diagnosis and prognosis of renal cell carcinoma (RCC); however, published data on this subject are conflicting.
  
  
  OBJECTIVE
  To conduct a meta-analysis to evaluate the impact of survivin as a prognostic marker and its association with clinicopathological variables in patients with RCC.
  
  
  METHODS
  Comprehensive searches of electronic databases (PubMed, ISI Web of Knowledge Embase, Google Scholar Web and the Cochrane Library) were updated to June 2016 to retrieve eligible studies. The association strength was measured with relative risks (RRs) and pooled HRs with 95% CIs, which were extracted and pooled to determine the association between survivin expression and patient survival and clinicopathological features.
  
  
  RESULTS
  Ten studies with 1063 cases of RCC were included. Positive survivin expression in RCC was associated with the TNM stage (pooled RR 1.49; 95% CI 1.07 to 2.07) or Fuhrman grade (pooled RR 1.63; 95% CI 1.15 to 2.32) in patients. The correlation between survivin expression and gender was not significant (pooled RR 0.97; 95% CI 0.83 to 1.15). In addition, a considerable association was found between survivin expression and overall survival for patients with RCC (pooled HR 1.94; 95% CI 1.24 to 3.05 (multivariate model) and 5.41; 95% CI 4.08 to 7.17 (univariate model)).
  
  
  CONCLUSIONS
  Our results indicate that survivin is of prognostic signiﬁcance in patients with RCC.
authors.affiliation: Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China.
authors.forename: Chengquan
authors.initials: C
authors.lastname: Ma
authors.affiliation: Department of Urology, Tianjin Nankai hospital, Tianjin, China.
authors.forename: Bingxin
authors.initials: B
authors.lastname: Lu
authors.affiliation: Tianjin institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China.
authors.forename: Erlin
authors.initials: E
authors.lastname: Sun
mesh_terms: D014408:Biomarkers, Tumor / Q000378:metabolism; D061945:Caspase Inhibitors / Q000378:metabolism*; D005260:Female; D006801:Humans; D051034:Inhibitor of Apoptosis Proteins / Q000378:metabolism*; D007680:Kidney Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology*; D008297:Male; D009363:Neoplasm Proteins / Q000378:metabolism; D011237:Predictive Value of Tests; D011379:Prognosis; D000077022:Survivin
chemical_list: C107489:BIRC5 protein, human; D014408:Biomarkers, Tumor; D061945:Caspase Inhibitors; D051034:Inhibitor of Apoptosis Proteins; D009363:Neoplasm Proteins; D000077022:Survivin
keywords: Clinicopathological variables; Meta-analysis; Prognosis; Renal cell carcinomas; Survivin