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Prognostic Role of Survivin in Bladder Cancer: A Systematic Review and Meta-Analysis

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  • Chanhoo Jeon
  • Myong Kim
  • Cheol Kwak
  • Hyeon Hoe Kim
  • Ja Hyeon Ku

Abstract

Purpose: The objective of the present study was to conduct a systematic review and meta-analysis of published literature investigating the survivin expression and its effects on bladder cancer prognosis. Materials and Methods: We carefully searched online Pubmed, Cochrane Library and SCOPUS database from August 1997 to May 2013. Results: A total of 14 articles met the eligibility criteria for this systematic review. The eligible studies included a total of 2,165 patients with a median number of 155 patients per study (range: 17–726). Of the 14 studies, nine evaluated immunohistochemistry in formalin-fixed paraffin-embedded tissue blocks. In non-muscle invasive bladder tumor, the pooled hazard ratio (HR) was statistically significant for recurrence-free survival (pooled HR, 1.81; 95% confidence interval [CI], 1.30–2.52), progression-free survival (pooled HR, 2.12; 95% CI, 1.60–2.82), cancer-specific survival (pooled HR, 2.01; 95% CI, 1.32–3.06), and overall survival (pooled HR, 1.53; 95% CI, 1.02–2.29). The overall HRs by survivin status were robust across advanced stages. When only adjusted survival data were included, statistically significant differences were identified for all survival subgroup analyses. There was no between-study heterogeneity in the effect of survivin status on the majority of meta-analyses. There was no clear evidence of publication bias in this meta-analysis. Conclusions: Survivin expression indicates worse prognosis in patients with bladder cancer but the results should be interpreted with caution. It is necessary that better-designed studies with standardized assays need to provide a better conclusion about the relationship between survivin expression and the outcome of patients with bladder cancer.

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  • Chanhoo Jeon & Myong Kim & Cheol Kwak & Hyeon Hoe Kim & Ja Hyeon Ku, 2013. "Prognostic Role of Survivin in Bladder Cancer: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 8(10), pages 1-10, October.
    • Handle: RePEc:plo:pone00:0076719
    DOI: 10.1371/journal.pone.0076719
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    1. Luc Duchateau & Laurence Collette & Richard Sylvester & Jean-Pierre Pignon, 2000. "Estimating Number of Events from the Kaplan–Meier Curve for Incorporation in a Literature-Based Meta-Analysis: What You Don't See You Can't Get!," Biometrics, The International Biometric Society, vol. 56(3), pages 886-892, September.
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    Cited by:

    1. Shang Xie & Hui Xu & Xiaofeng Shan & Baozhong Liu & Kan Wang & Zhigang Cai, 2015. "Clinicopathological and Prognostic Significance of Survivin Expression in Patients with Oral Squamous Cell Carcinoma: Evidence from a Meta-Analysis," PLOS ONE, Public Library of Science, vol. 10(2), pages 1-16, February.

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