Abstract
Background: Vascular endothelial growth factor (VEGF) has been reported to serve as a promising prognostic marker in several cancers. This meta-analysis aims to assess the prognostic significance of VEGF in nasopharyngeal cancer (NPC).Methods: We conducted a systematic literature search of PubMed, Embase, and the Cochrane Library for observational studies published until June, 2018 to identify observational studies on the prognostic effect of tissue VEGF expression or serum VEGF level on the survival of NPC. The primary outcome measure assessed was overall survival (OS). The secondary outcomes included disease-free survival (DFS) or progression-free survival (PFS). Summary hazard ratio (HR) and its 95% confidence interval (95% CI) were derived using a random-effects model.Results: Out of 840 retrieved citations, 16 studies inclusive of 1,345 patients were included in the analysis of tissue VEGF expression and cancer survival. The pooled HRs for OS and DFS in patients with high VEGF expression were 2.07 (95% CI: 1.32–3.25) and 5.99 (95% CI: 2.66–13.48), respectively, with significant heterogeneity between studies (I2 = 79.1% for OS and 50.2% for DFS). Tissue high VEGF expression was not significantly associated with short RFS, PFS, or MFS. Five studies also investigated the prognostic effect between serum VEGF level and patient survival and found that high serum VEGF level was significantly associated with short OS for patients with NPC (HR 2.47, 95% CI 1.16–5.28), but not with short PFS (HR 1.47, 95% CI 0.92–2.35).Conclusions: Determination of tissue VEGF expression and serum VEGF level have the potential to serve as biomarkers and add prognostic information in NPC. Prospective analyses of associated data on VEGF expression and serum VEGF level in large NPC cohorts could be further conducted to advance our understanding of the relationship between VEGF and NPC outcomes.
Highlights
Nasopharyngeal cancer (NPC), a rare cancer with unbalanced distribution, has a high prevalence rate in southern China, with 85,000 estimated new cases and 50,000 estimated deaths worldwide in 2012 [1]
We conducted a systematic literature search of PubMed, Embase, and the Cochrane Library for observational studies published until June, 2018 to investigate the prognostic effect of tissue vascular endothelial growth factor (VEGF) expression or serum VEGF level on the survival of NPC using the strategy shown in Supplementary Material
16 studies had reported the prognostic value of tissue VEGF expression in NPC and 5 studies had evaluated serum VEGF level in NPC [53,54,55,56,57]
Summary
Nasopharyngeal cancer (NPC), a rare cancer with unbalanced distribution, has a high prevalence rate in southern China, with 85,000 estimated new cases and 50,000 estimated deaths worldwide in 2012 [1]. Recent advancement achieved in the field of NPC is that it involves several associated signaling pathways contributing to the biological and clinical behavior of NPC, one of which was JAK2/STAT3 signaling pathway [6]. This pathway has been reported to be involved in multiple cellular functions such as differentiation, survival, proliferation, and apoptosis [7, 8]. Vascular endothelial growth factor (VEGF) has been reported to serve as a promising prognostic marker in several cancers This meta-analysis aims to assess the prognostic significance of VEGF in nasopharyngeal cancer (NPC)
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