Neoadjuvant Chemotherapy for Nonmetastatic Esophago-Gastric Adenocarcinomas: A Systematic Review and Meta-Analysis. (1st July 2013)

• Record Type: Journal Article
• Authors: Zhang, Chun-Dong; Zeng, Yong-Ji; Li, Hong-Wu; Zhao, Zhe-Ming; Zhang, Jia-Kui; Dai, Dong-Qiu
• Is Part Of: Cancer investigation. Volume 31:Number 6(2013)
• Page Start: 421
• Page End: 431
• Publication Date: 2013-07-01
• Subjects: Cancer -- Periodicals; Oncology -- Periodicals; Medical Oncology -- Periodicals; Neoplasms -- Periodicals; 616.994
• DOI: 10.3109/07357907.2013.802801
• Languages: English
• ISSNs: 0735-7907

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <p> <italic>Objective</italic>: A systematic review and meta-analysis was performed to investigate the efficacy of neoadjuvant chemotherapy for nonmetastatic esophago-gastric adenocarcinomas. <italic>Methods</italic>: Electronic databases were searched systematically from January 1980 to July 2012 and a total of 2, 587 patients from 17 randomized controlled trials were subjected to meta-analysis. The odds ratios (ORs) for overall survival (OS) and progression-free survival (PFS) were calculated. <italic>Results</italic>: Seventeen randomized controlled trials were obtained and various comparisons of treatment approaches were performed.</p> <p> <italic>Randomized controlled trials detected no differences in these comparisons</italic>:</p> <p>R0 resection for neoadjuvant chemotherapy versus none;</p> <p>Preoperative chemotherapy versus surgery alone: 3-year OS, 5-year OS, 5-year OS in Europe, 3-year PFS;</p> <p>Preoperative chemotherapy plus postoperative chemotherapy versus postoperative chemotherapy: 1-year OS, 5-year OS;</p> <p>Preoperative chemotherapy versus preoperative chemoradiotherapy: 3-year OS.</p> <p> <italic>Randomized controlled trials detected significant differences in these comparisons</italic>:</p> <p>Preoperative chemotherapy plus postoperative chemotherapy versus surgery alone: 3-year and 5-year PFS, 5-year OS;</p> <p>Subgroup analysis examining preoperative chemotherapy versus surgery alone: 5-year OS in Asia;</p> <p>Preoperative chemotherapy versus postoperative chemotherapy: 1-year OS.</p> <p> <italic>Conclusion</italic>: The current limited evidence suggests that preoperative chemotherapy can be applied to patients with nonmetastatic esophago-gastric adenocarcinomas (specifically, advanced esophago-gastric cancer). However, the results should be interpreted with caution because of the statistically low power and the heterogeneity among study designs; therefore, our results need validations in future studies.</p> </abstract>