Prognostic value of tissue vascular endothelial growth factor expression in bladder cancer: a meta-analysis

Asian Pac J Cancer Prev. 2013;14(2):645-9. doi: 10.7314/apjcp.2013.14.2.645.


Objective: The prognostic role of vascular endothelial growth factor (VEGF) in bladder cancer remains controversial. 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 and outcome of bladder cancer patients. Study quality was assessed using the Newcastle-Ottawa Scale. After careful review, survival data were extracted from eligible studies. A meta-analysis was performed to generate combined hazard 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 tissue VEGF 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, there was 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 to be associated with a poor prognosis in patients with bladder cancer.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Biomarkers, Tumor / biosynthesis
  • Biomarkers, Tumor / metabolism*
  • Disease-Free Survival
  • Gene Expression
  • Humans
  • Middle Aged
  • Neovascularization, Pathologic
  • Survival
  • Treatment Outcome
  • Urinary Bladder Neoplasms / metabolism*
  • Urinary Bladder Neoplasms / mortality*
  • Vascular Endothelial Growth Factor A / biosynthesis
  • Vascular Endothelial Growth Factor A / metabolism*


  • Biomarkers, Tumor
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A