Prognostic role of survivin in renal cell carcinoma: A system review and meta-analysis

Abstract

BackgroundSurvivin plays an important role in cancer pathogenesis, which has been suggested to be related to poor prognosis in renal cell carcinoma (RCC). We performed a meta-analysis to quantify the prognostic value of survivin in renal cell carcinoma (RCC) patients. Patients and methodsRelevant articles exploring the relationship between survivin expression and survival of RCC patients published up to 10 November 2015 were retrieved in PubMed, Web of science and Cochrane databases. The summary hazard ratio (HR) and 95% confidence interval (CI) were calculated by a random-effects model. ResultsA total of 1583 patients from 10 studies were included. The high expression of survivin was associated with poor Overall Survival (OS) in two studies (Pooled HRs=2.77, 95%CI: 1.46–5.26, I2=0.0%, P=0.329). Further, meta-analysis of seven studies showed that elevated survivin expression predicted shorter cancer-specific survival (CSS) of RCC (HR=2.85, 95% CI: 2.25–3.61, I2=17.6%, P=0.295). Additionally, subgroup analysis showed that survivin over-expression was associated significantly with worse CSS regardless of different source of survivin, sample size, follow-up duration, race and detection method. ConclusionsA higher survivin expression seems to represent an unfavorable and robust prognostic factor for clinical outcomes in RCC patients.