Prognostic significance of VEGF-C immunohistochemical expression in breast cancer: a meta-analysis.

Vascular endothelial growth factor-C (VEGF-C) is considered as a prime mediator of lymphangiogenesis and has been implicated in carcinogenesis and metastasis. Various studies examined the relationship between VEGF-C protein overexpression with the clinical outcome in patients with breast cancer but yielded conflicting results. Electronic databases updated to April 2013 were searched to find relevant studies. A meta-analysis was conducted with eligible studies which quantitatively evaluated the relationship between VEGF-C overexpression and survival of patients with breast cancer. Survival data were aggregated and quantitatively analyzed. We performed a meta-analysis of 11 studies (n = 1,357 patients) that evaluated the correlation between VEGF-C overexpression detected by immunohistochemistry and survival in patients with breast cancer. Combined hazard ratios suggested that VEGF-C overexpression was not associated with poor prognosis of disease-free survival (HR [hazard ratio] = 0.80, 95 % CI [confidence interval]: 0.51-1.09), overall survival (OS) (HR = 1.08, 95 % CI: 0.37-1.78) in patients with breast cancer. In the stratified analysis by patient source, significantly risks were not found among Asians or non-Asians. No significant heterogeneity was observed among all studies. VEGF-C overexpression was not associated with poor disease-free survival or overall survival in breast cancer.