Impact of vascular endothelial growth factor expression on overall survival in patients with osteosarcoma: a meta-analysis

Osteosarcoma is the most common primary malignant bone tumor of childhood. Vascular endothelial growth factor (VEGF) expression has been implicated in tumor development and progression of osteosarcoma, but previous studies investigating the impact of VEGF expression on overall survival in patients with osteosarcoma report conflicting findings. A meta-analysis of published studies was performed. The pooled hazard ratio (HR) with its 95 % confidence interval (95 % CI) was used to assess the impact of VEGF expression on overall survival in patients with osteosarcoma. Nine studies with a total of 432 osteosarcoma patients were included into this meta-analysis. There was no between-study heterogeneity among those nine studies (I (2) = 0.0 %). Overall, high VEGF expression was obviously associated with poorer overall survival (HR = 1.68, 95 % CI 1.33-2.12, P < 0.001). Sensitivity analysis performed by excluding single study in turns showed the pooled estimate was stable. Egger's test also did not suggest evidence for publication bias (P = 0.216). Therefore, this meta-analysis suggests that VEGF expression has an important impact on overall survival in patients with osteosarcoma and high VEGF expression is associated with poorer overall survival.