The role of vascular endothelial growth factor as a prognostic and clinicopathological marker in osteosarcoma: a systematic review and meta-analysis

J Orthop Surg Res. 2021 Dec 28;16(1):738. doi: 10.1186/s13018-021-02888-3.

Abstract

Background: In recent years, numerous investigations have been conducted to determine the clinical significance and critical functions of vascular endothelial growth factor (VEGF) in various malignant cancers. The purpose of this meta-analysis was to comprehensively evaluate the prognostic and clinicopathological value of VEGF in patients with osteosarcoma.

Methods: We performed a systematic literature retrieval of available databases. Odds ratios (ORs) or standard mean difference (SMD) for clinicopathological parameters, hazard ratios (HRs) for overall survival and disease-free survival were calculated to assess the correlation between VEGF expression and prognosis in patients with osteosarcoma.

Results: A total of 22 studies with 1144 patients were included in our study. Pooled analyses showed that VEGF overexpression predicted worse overall survival (HR, 2.42; 95% CI, 1.87-3.11, p < 0.001) and disease-free survival (HR, 2.604; 95% CI, 1.698-3.995, p < 0.001), respectively. Furthermore, investigation regarding osteosarcoma clinicopathologic characteristics suggested that high VEGF expression was significantly associated with metastasis (OR, 4.39; 95% CI, 2.77-6.95; p < 0.001), clinical stage (OR, 0.73; 95% CI, 0.62-0.87; p < 0.001), and microvessel density (SMD, 3.33, 95% CI,1.57-5.10, p < 0.001), but not associated with tumor location, gender, age, local recurrence, and chemotherapy response.

Conclusion: Our meta-analysis findings suggest that elevated VEGF expression may be a predictive biomarker for poor prognosis and adverse clinicopathological characteristics in patients with osteosarcoma.

Keywords: Meta-analysis; Osteosarcoma; Prognosis; Vascular endothelial growth factor.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Biomarkers, Tumor / analysis
  • Biomarkers, Tumor / metabolism*
  • Bone Neoplasms / diagnosis
  • Bone Neoplasms / metabolism
  • Bone Neoplasms / mortality*
  • Endothelial Growth Factors / analysis*
  • Humans
  • Osteosarcoma / blood
  • Osteosarcoma / metabolism
  • Osteosarcoma / mortality*
  • Prognosis
  • Vascular Endothelial Growth Factor A / metabolism*
  • Vascular Endothelial Growth Factors

Substances

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