Tumor Biol. DOI 10.1007/s13277-014-2024-8
RESEARCH COMMENTARY
Comment on Xu XW et al.: prognostic significance of VEGF expression in osteosarcoma: a meta-analysis Shaozhong He & Zhenyu Xiao & Longhua Chen & Shizhong Xiong
Received: 13 April 2014 / Accepted: 27 April 2014 # International Society of Oncology and BioMarkers (ISOBM) 2014
Dear Editor, We read with great interests on the recent paper by Xu XW et al., “Prognostic significance of VEGF expression in osteosarcoma: a meta-analysis” published online in Tumor Biology [1]. The investigators performed a meta-analysis of eight studies to evaluate the correlation between vascular endothelial growth factor (VEGF) overexpression and survival of patients with osteosarcoma. It is a very interesting study. Nevertheless, we have several queries which we would like to communicate with the investigators. 1. The investigators included 13 studies [2–14] in the metaanalysis, while five studies [10–14] did not provide any data on overall survival of patients in VEGF overexpression. In our opinion, the five studies should be excluded from the meta-analysis. 2. In the methods section, the investigators clarified that “The data extraction and quality assessment were reported in previous meta-analysis”. However, we cannot find any issues about the quality assessment in the meta-analysis. We hope that the investigators could provide us the issues about the quality assessment. 3. The investigators just evaluate the effect of VEGF overexpression on the overall survival of the patients with osteosarcoma. However, they did not evaluate the effect of VEGF overexpression on clinical stage and the
S. He : Z. Xiao : S. Xiong (*) Department of Oncology, Ganzhou People’s Hospital, Ganzhou 341000, Jiangxi Province, People’s Republic of China e-mail: [email protected] S. He : L. Chen Department of Oncology, Nanfang Hospital of Southern Medical University, Guangzhou 510515, Guangdong Province, People’s Republic of China
neoplasm metastasis. To make the meta-analysis better, these correlations should be added in the results section. 4. The investigators did not follow the meta-analysis of observational studies in epidemiology (MOOSE). As a minor suggestion, adding some MOOSE checklist summary could make this manuscript better. Thanks go to the authors for their contribution for supplying us with an assessment of the correlation between VEGF overexpression and survival of patients with osteosarcoma. However, well-designed prospective studies with better standardized assessment of prognostic markers should help to explore the relation between VEGF overexpression and survival of osteosarcoma.
References 1. Yu XW, Wu TY, Yi X, Ren WP, Zhou ZB, Sun YQ, et al. Prognostic significance of VEGF expression in osteosarcoma: a meta-analysis. Tumor Biol. 2014;35(1):155–60. 2. Lee YH, Tokunaga T, Oshika Y, et al. Cell-retained isoforms of vascular endothelial growth factor (VEGF) are correlated with poor prognosis in osteosarcoma. Eur J Cancer. 1999;35(7):1089–93. 3. Kaya M, Wada T, Akatsuka T, et al. Vascular endothelial growth factor expression in untreated osteosarcoma is predictive of pulmonary metastasis and poor prognosis. Clin Cancer Res. 2000;6(2):572–7. 4. Jung ST, Moon ES, Seo HY, Kim JS, Kim GJ, Kim YK. Expression and significance of TGF-beta isoform and VEGF in osteosar-coma. Orthopedics. 2005;28(8):755–60. 5. Charity RM, Foukas AF, Deshmukh NS, Grimer RJ. Vascular endothelial growth factor expression in osteosarcoma. Clin Orthop Relat Res. 2006;448:193–8. 6. Oda Y, Yamamoto H, Tamiya S, et al. CXCR4 and VEGF expression in the primary site and the metastatic site of human osteosarcoma: analysis within a group of patients, all of whom developed lung metastasis. Mod Pathol. 2006;19(5):738–45. 7. Kaya M, Wada T, Nagoya S, Sasaki M, Matsumura T, Yamashita T. The level of vascular endothelial growth factor as a predictor of a
Tumor Biol. poor prognosis in osteosarcoma. J Bone Joint Surg Br. 2009;91(6): 784–8. 8. Ługowska I, Woźniak W, Klepacka T, Michalak E, Szamotulska K. A prognostic evaluation of vascular endothelial growth factor in children and young adults with osteosarcoma. Pediatr Blood Cancer. 2011;57(1):63–8. 9. Chen Y, Wang CM, Shi YQ, Yang Y. Expression of hypoxiainducible factor 1α in osteosarcoma and its value in predicting chemosensitivity [in Chinese]. Chin J Oncol. 2012;34(12):899–904. 10. Boulytcheva IV, Soloviev YN, Kushlinskii NE, Mahson AN. Expression of molecular markers in the tumor and survival prognosis in osteosarcoma. Bull Exp Biol Med. 2010;150(2):237–42.
11. Handa A, Tokunaga T, Tsuchida T, et al. Neuropilin-2 expression affects the increased vascularization and is a prognostic factor in osteosarcoma. Int J Oncol. 2000;17(2):291–5. 12. Ek ET, Ojaimi J, Kitagawa Y, Choong PF. Does the degree of intratumoural microvessel density and VEGF expression have prognostic significance in osteosarcoma. Oncol Rep. 2006;16(1):17–23. 13. Abdeen A, Chou AJ, Healey JH, et al. Correlation between clinical outcome and growth factor pathway expression in osteogenic sarcoma. Cancer. 2009;115(22):5243–50. 14. Zhou Q, Zhu Y, Deng Z, Long H, Zhang S, Chen X. VEGF and EMMPRIN expression correlates with survival of patients with osteosarcoma. Surg Oncol. 2011;20(1):13–9.
RESEARCH COMMENTARY
Comment on Xu XW et al.: prognostic significance of VEGF expression in osteosarcoma: a meta-analysis Shaozhong He & Zhenyu Xiao & Longhua Chen & Shizhong Xiong
Received: 13 April 2014 / Accepted: 27 April 2014 # International Society of Oncology and BioMarkers (ISOBM) 2014
Dear Editor, We read with great interests on the recent paper by Xu XW et al., “Prognostic significance of VEGF expression in osteosarcoma: a meta-analysis” published online in Tumor Biology [1]. The investigators performed a meta-analysis of eight studies to evaluate the correlation between vascular endothelial growth factor (VEGF) overexpression and survival of patients with osteosarcoma. It is a very interesting study. Nevertheless, we have several queries which we would like to communicate with the investigators. 1. The investigators included 13 studies [2–14] in the metaanalysis, while five studies [10–14] did not provide any data on overall survival of patients in VEGF overexpression. In our opinion, the five studies should be excluded from the meta-analysis. 2. In the methods section, the investigators clarified that “The data extraction and quality assessment were reported in previous meta-analysis”. However, we cannot find any issues about the quality assessment in the meta-analysis. We hope that the investigators could provide us the issues about the quality assessment. 3. The investigators just evaluate the effect of VEGF overexpression on the overall survival of the patients with osteosarcoma. However, they did not evaluate the effect of VEGF overexpression on clinical stage and the
S. He : Z. Xiao : S. Xiong (*) Department of Oncology, Ganzhou People’s Hospital, Ganzhou 341000, Jiangxi Province, People’s Republic of China e-mail: [email protected] S. He : L. Chen Department of Oncology, Nanfang Hospital of Southern Medical University, Guangzhou 510515, Guangdong Province, People’s Republic of China
neoplasm metastasis. To make the meta-analysis better, these correlations should be added in the results section. 4. The investigators did not follow the meta-analysis of observational studies in epidemiology (MOOSE). As a minor suggestion, adding some MOOSE checklist summary could make this manuscript better. Thanks go to the authors for their contribution for supplying us with an assessment of the correlation between VEGF overexpression and survival of patients with osteosarcoma. However, well-designed prospective studies with better standardized assessment of prognostic markers should help to explore the relation between VEGF overexpression and survival of osteosarcoma.
References 1. Yu XW, Wu TY, Yi X, Ren WP, Zhou ZB, Sun YQ, et al. Prognostic significance of VEGF expression in osteosarcoma: a meta-analysis. Tumor Biol. 2014;35(1):155–60. 2. Lee YH, Tokunaga T, Oshika Y, et al. Cell-retained isoforms of vascular endothelial growth factor (VEGF) are correlated with poor prognosis in osteosarcoma. Eur J Cancer. 1999;35(7):1089–93. 3. Kaya M, Wada T, Akatsuka T, et al. Vascular endothelial growth factor expression in untreated osteosarcoma is predictive of pulmonary metastasis and poor prognosis. Clin Cancer Res. 2000;6(2):572–7. 4. Jung ST, Moon ES, Seo HY, Kim JS, Kim GJ, Kim YK. Expression and significance of TGF-beta isoform and VEGF in osteosar-coma. Orthopedics. 2005;28(8):755–60. 5. Charity RM, Foukas AF, Deshmukh NS, Grimer RJ. Vascular endothelial growth factor expression in osteosarcoma. Clin Orthop Relat Res. 2006;448:193–8. 6. Oda Y, Yamamoto H, Tamiya S, et al. CXCR4 and VEGF expression in the primary site and the metastatic site of human osteosarcoma: analysis within a group of patients, all of whom developed lung metastasis. Mod Pathol. 2006;19(5):738–45. 7. Kaya M, Wada T, Nagoya S, Sasaki M, Matsumura T, Yamashita T. The level of vascular endothelial growth factor as a predictor of a
Tumor Biol. poor prognosis in osteosarcoma. J Bone Joint Surg Br. 2009;91(6): 784–8. 8. Ługowska I, Woźniak W, Klepacka T, Michalak E, Szamotulska K. A prognostic evaluation of vascular endothelial growth factor in children and young adults with osteosarcoma. Pediatr Blood Cancer. 2011;57(1):63–8. 9. Chen Y, Wang CM, Shi YQ, Yang Y. Expression of hypoxiainducible factor 1α in osteosarcoma and its value in predicting chemosensitivity [in Chinese]. Chin J Oncol. 2012;34(12):899–904. 10. Boulytcheva IV, Soloviev YN, Kushlinskii NE, Mahson AN. Expression of molecular markers in the tumor and survival prognosis in osteosarcoma. Bull Exp Biol Med. 2010;150(2):237–42.
11. Handa A, Tokunaga T, Tsuchida T, et al. Neuropilin-2 expression affects the increased vascularization and is a prognostic factor in osteosarcoma. Int J Oncol. 2000;17(2):291–5. 12. Ek ET, Ojaimi J, Kitagawa Y, Choong PF. Does the degree of intratumoural microvessel density and VEGF expression have prognostic significance in osteosarcoma. Oncol Rep. 2006;16(1):17–23. 13. Abdeen A, Chou AJ, Healey JH, et al. Correlation between clinical outcome and growth factor pathway expression in osteogenic sarcoma. Cancer. 2009;115(22):5243–50. 14. Zhou Q, Zhu Y, Deng Z, Long H, Zhang S, Chen X. VEGF and EMMPRIN expression correlates with survival of patients with osteosarcoma. Surg Oncol. 2011;20(1):13–9.
