Vascular endothelial growth factor (
VEGF) is considered as a prime mediator of angiogenesis, and has been implicated in
carcinogenesis and
metastasis. Various studies examined the relationship between
VEGF protein overexpression with the clinical outcome in patients with
gastric cancer, but yielded conflicting results. The prognostic significance of
VEGF overexpression in
gastric cancer remains controversial. Electronic databases updated to July 2011 were searched to find relevant studies. A meta-analysis was conducted with eligible studies which quantitatively evaluated the relationship between
VEGF overexpression and survival of patients with
gastric cancer. Survival data were aggregated and quantitatively analyzed. We performed a meta-analysis of 30 studies (n = 3,999 patients) that evaluated the correlation between
VEGF overexpression detected by immunohistochemistry and survival in patients with
gastric cancer. Combined hazard ratios suggested that
VEGF-A overexpression had an unfavorable impact on overall survival (OS) (HR [hazard ratio] = 1.49, 95 % CI [confidence interval]: 1.22-1.77) and disease free survival (DFS) (HR = 1.85, 95 % CI: 1.38-2.32) in patients with
gastric cancer. However,
VEGF-C overexpression did not significantly correlate with OS (HR = 1.24, 95 % CI: 0.92-1.56) or DFS (HR = 1.15, 95 % CI: 0.78-1.52).
VEGF-D is an unfavorable
indicator of OS (HR = 1.68, 95 % CI: 1.02-2.34) and DFS (HR = 1.88, 95 % CI: 1.07-2.70) in patients with
gastric cancer.
VEGF-A and
VEGF-D overexpression indicated a poor prognosis for patients with
gastric cancer.
VEGF-C overexpression was not associated with poor prognosis in patients with
gastric cancer. The prognostic value of
VEGF on survival still needs further larger prospective trials to be confirmed.