The prognostic value of vascular endothelial growth factor in endometrial cancer: A protocol for systematic review and meta-analysis.

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A large number of studies have shown that high expression of vascular endothelial growth factor (VEGF) in cancer tissues is associated with poor prognosis of various cancers. However, this finding in endometrial cancer is controversial. Therefore, this meta-analysis aimed to explore the effects of VEGF on survival in patients with endometrial cancer. Four databases of PubMed, Medline, Web of Science, and China National Knowledge Infrastructure were searched to collect literature that met the inclusion criteria. The association between high VEGF expression and survival outcomes and clinicopathological features of patients with cancer was evaluated by calculating the combined hazard ratio (HR), odds ratio (OR), and 95% confidence interval (CI). The Begg test was used to assess publication bias. A total of 11 studies were included, involving 1251 patients. The results showed that compared with low VEGF expression, high VEGF expression was significantly associated with shorter overall survival (HR = 2.44, 95% CI = 1.15-5.16, I2 = 80%, P = .02) and disease-specific survival (HR = 7.87, 95% CI = 1.70-36.44, I2 = 64%, P = .008) but not with disease-free survival (HR = 1.45, 95% CI = 0.70-3.02, I2 = 68%, P = .32). In addition, VEGF expression is higher in patients with advanced stage (OR = 3.70, 95% CI = 2.22-6.19, P < .001), lower histological differentiation (OR = 2.08, 95% CI = 1.22-3.55, P = .007), and lymph node metastasis (OR = 5.42, 95% CI = 2.35-5.11, P < .001). High VEGF expression can predict poor prognosis and poor clinicopathological features in patients with endometrial cancer, and it may be a valuable new indicator to evaluate the prognosis of patients with endometrial cancer.