Prognostic role of vascular endothelial growth factor in hepatocellular carcinoma: systematic review and meta-analysis

• Published in: British journal of cancer Vol. 100; no. 9; pp. 1385 - 1392
• Main Authors: Schoenleber, S J, Kurtz, D M, Talwalkar, J A, Roberts, L R, Gores, G J
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 05.05.2009; Nature Publishing Group
• Subjects: Biological and medical sciences; Biomedical and Life Sciences; Biomedicine; Cancer Research; Carcinoma, Hepatocellular - blood; Carcinoma, Hepatocellular - diagnosis; Carcinoma, Hepatocellular - drug therapy; Carcinoma, Hepatocellular - mortality; Clinical Study; Disease; Disease-Free Survival; Drug Resistance; Epidemiology; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Liver cancer; Liver Neoplasms - blood; Liver Neoplasms - diagnosis; Liver Neoplasms - drug therapy; Liver Neoplasms - mortality; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Medical prognosis; Medical research; Medical schools; Medical sciences; Medicine; Meta-analysis; Molecular Medicine; Oncology; Predictive Value of Tests; Prognosis; Survival Analysis; Systematic review; Tumors; Vascular endothelial growth factor; Vascular Endothelial Growth Factor A - blood; United States > US; prognosis; vascular endothelial growth factor; hepatocellular carcinoma; survival; Prognosis; Hepatic disease; Hepatocellular carcinoma; Malignant tumor; Survival; Metaanalysis; Liver cancer; Cancerology; Vascular endothelium growth factor; Digestive diseases; Bibliographic review; Cancer
• ISSN: 0007-0920; 1532-1827
• DOI: 10.1038/sj.bjc.6605017

Hepatocellular carcinoma (HCC) is a highly vascular tumour that expresses vascular endothelial growth factor (VEGF). Various studies have evaluated the prognostic value of VEGF levels in HCC. Its overall test performance remains unclear, however. The aim was to perform a systematic review and meta-analysis of prognostic cohort studies evaluating the use of VEGF as a predictor of survival in patients with treated HCC. Eligible studies were identified through multiple search strategies. Studies were assessed for quality using the Newcastle–Ottawa Tool. Data were collected comparing disease-free and overall survival in patients with high VEGF levels as compared to those with low levels. Studies were pooled and summary hazard ratios were calculated. A total of 16 studies were included for meta-analysis (8 for tissue and 8 for serum). Methodological analysis indicated a trend for higher study quality with serum studies as compared to tissue-based investigations. Four distinct groups were pooled for analysis: tissue overall survival ( n =251), tissue disease-free survival ( n =413), serum overall survival ( n =579), and serum disease-free survival ( n =439). High tissue VEGF levels predicted poor overall (HR=2.15, 95% CI: 1.26–3.68) and disease-free (HR=1.69, 95% CI: 1.23–2.33) survival. Similarly, high serum VEGF levels predicted poor overall (HR=2.35, 95% CI: 1.80–3.07) and disease-free (HR=2.36, 95% CI 1.76–3.16) survival. A high degree of inter-study consistency was present in three of four groups analysed. Tissue and serum VEGF levels appear to have significant predictive ability for estimating overall survival in HCC and may be useful for defining prognosis in HCC.