Meta-analysis:prognostic value of survivin in patients with pancreatic cancer

Objective:The aim of the study was to conduct a systematic review of the literature evaluating survivin expres-sion in pancreatic carcinoma as a prognostic indicator. Methods:The relevant literatures were searched using PubMed, EMBASE, and Chinese Biomedicine Databases. A meta-analysis of the association between survivin expression and overal survival in patients with pancreatic cancer was performed. Studies were pooled and summary hazard ratios (HRs) were calcu-lated. Subgroup analysis according to the location of survivin expression was also performed. Results:Seven eligible studies with a total of 448 patients were included in this study. Combined HR suggested that survivin expression had an unfavorable impact on survival of pancreatic cancer patients (HR=1.65, 95%CI:1.02-2.68). When stratified according to the location of survivin expression, the combined HR showed that expression in the cytoplasm was significantly associated with poor prog-nosis of pancreatic cancer patients (HR=2.09, 95%CI:1.29-3.40). In contrast, survivin expression in the nucleus was not significantly associated with poor prognosis (HR=0.83, 95%CI:0.24-2.81), and the heterogeneity was highly significant (I2=87.2%, P=0.005). Conclusion:Survivin expression was associated with a poor prognosis in patients with pancreatic cancer. Cytoplasmic expression of survivin may be a prognostic factor for pancreatic cancer patients. Based on the current obtained data, there was no evidence that survivin expression in the nucleus had a significant impact on patients’ overal survival.