Clinicalpathological and prognostic significance of survivin expression in renal cell carcinoma: a meta-analysis.
BACKGROUND
In recent years, survivin expression had been investigated as a prognostic biomarker for renal cell carcinoma (RCC), however, the results were conflicting. This study was aimed to explore the association between survivin expression and clinicalpathological features and the prognostic value for cancer-specific survival (CSS) and overall survival (OS) in RCC.


RESULTS
Eleven studies with 1,697 subjects were included in this meta-analysis. The results showed that survivin expression was associated with higher tumor grade (OR=4.25, 95%CI: 3.04-5.95, p<0.001), advanced tumor stage (OR=3.83, 95%CI: 2.01-7.3, p<0.001) and lymph node metastasis (OR=4.19, 95%CI: 2.34-7.52, p<0.001), but had no association with age, gender or distant metastasis. In addition, survivin expression was also correlated with poor CSS (HR=2.08, 95%CI: 1.07-4.05, p=0.032) and poor OS (HR=2.28, 95%CI: 1.57-3.33, p<0.001).


METHODS
Literature was searched by PubMed, Embase and Web of Science. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were extracted from eligible studies. Fixed or random effects model were used to calculate pooled HRs and 95%CIs according to heterogeneity.


CONCLUSIONS
This study demonstrated that survivin expression was associated with more aggressive clinical features and predicted poor CSS and OS in patients with RCC.
State Key Laboratory of Natural Medicines, Key Laboratory of Drug Metabolism and Pharmacokinetics, China Pharmaceutical University, Nanjing 210009, China.
Zhichen
Z
Pu
Department of Urology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, China.
Qifei
Q
Wang
Department of Clinical Pharmacy, Yijishan Hospital of Wannan Medical College, Anhui Provincial Center for Drug Clinical Evaluation, Wuhu, Anhui 241002, China.
Haitang
H
Xie
State Key Laboratory of Natural Medicines, Key Laboratory of Drug Metabolism and Pharmacokinetics, China Pharmaceutical University, Nanjing 210009, China.
Guangji
G
Wang
State Key Laboratory of Natural Medicines, Key Laboratory of Drug Metabolism and Pharmacokinetics, China Pharmaceutical University, Nanjing 210009, China.
Haiping
H
Hao
D014408:Biomarkers, Tumor / Q000235:genetics / Q000378:metabolism; D002292:Carcinoma, Renal Cell / Q000235:genetics* / Q000378:metabolism / Q000473:pathology; D018572:Disease-Free Survival; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D051034:Inhibitor of Apoptosis Proteins / Q000235:genetics* / Q000378:metabolism; D007680:Kidney Neoplasms / Q000235:genetics* / Q000378:metabolism / Q000473:pathology; D008207:Lymphatic Metastasis; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011379:Prognosis; D000077022:Survivin
C107489:BIRC5 protein, human; D014408:Biomarkers, Tumor; D051034:Inhibitor of Apoptosis Proteins; D000077022:Survivin
meta-analysis; prognosis; renal cell carcinoma; survivin