Prognostic Value of Tissue Vascular Endothelial Growth FactorExpression in Bladder Cancer: a Meta-analysis

Objective: The prognostic role of vascular endothelial growth factor (VEGF) in bladder cancer remainscontroversial. This meta-analysis aimed to explore any association between overexpression and survival outcomes.
Methods: We systematically searched for studies investigating the relationships between VEGF expression andoutcome of bladder cancer patients. Study quality was assessed using the Newcastle-Ottawa Scale. After carefulreview, survival data were extracted from eligible studies. A meta-analysis was performed to generate combinedhazard ratios (HRs) for overall survival (OS), disease-free survival (DFS) and disease-specific survival (DSS).
Results: A total of 1,285 patients from 11 studies were included in the analysis. Our results showed that tissueVEGF overexpression in patients with bladder cancer was associated with poor prognosis in terms of OS (HR,1.843; 95% CI, 1.231-2.759; P = 0.003), DFS (HR, 1.498; 95% CI, 1.255-1.787; P = 0.000) and DSS (HR, 1.562;95% CI, 0.996-1.00; P = 0.052), though the difference for DSS was not statistically significant. In addition, therewas no evidence of publication bias as suggested by Begg’s and Egger’s tests except for DFS (Begg’s test, P =0.221; Egger’s test, P = 0.018).
Conclusion: The present meta-analysis indicated elevated VEGF expression tobe associated with a poor prognosis in patients with bladder cancer.