Survival Benefit of Neoadjuvant Chemotherapy for Resectable Cancer of the Gastric and Gastroesophageal Junction. Issue 5 (May 2015)

• Record Type: Journal Article
• Authors: Jiang, Lei; Yang, Ke-hu; Guan, Quan-lin; Chen, Yan; Zhao, Peng; Tian, Jin-hui
• Is Part Of: Journal of clinical gastroenterology. Volume 49:Issue 5(2015)
• Publication Date: 2015-05
• Subjects: Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; Gastroenterology -- Periodicals; Digestive organs -- Diseases; Gastroenterology; Periodicals; Periodicals; 616.33005
• DOI: 10.1097/MCG.0000000000000212
• Languages: English
• ISSNs: 0192-0790

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Background:</title> <p>The objective of the present meta-analysis was to estimate the magnitude of survival benefits of neoadjuvant chemotherapy (NAT) in resectable cancer of the gastric and gastroesophageal junction.</p> </sec> <sec> <title>Materials and Methods:</title> <p>We searched PubMed, Embase, the Cochrane Library, ISI Web of Knowledge, Chinese biomedical literature database, Chinese Scientific Journals full-text database of retrieved articles from their inception to 2013. Two reviewers independently retrieved study and data extraction of included studies. Results regarding the overall survival and progression-free survival in the meta-analysis were expressed as hazard ratios (HRs) with 95% confidence intervals (CI).</p> </sec> <sec> <title>Results:</title> <p>Twelve randomized control trials (n=1755) were eligible for final meta-analysis. NAT was associated with a statistically significant benefit in terms of overall survival (HR=0.72; 95% CI, 0.56-0.93, <italic>P</italic>=0.01), progression-free survival (HR=0.73; 95% CI, 0.62-0.87, <italic>P</italic>=0.0003), 5-year survival rate [relative risk (RR)=1.36; 95% CI, 1.10-1.67, <italic>P</italic>=0.0004], and curative resection rate (RR=1.11; 95% CI, 1.03-1.20, <italic>P</italic>=0.009). Five-year survival rate increased from 30% to 42% with NAT. No significant difference with regards to overall postoperative complications rate (RR=1.08; 95% CI, 0.92-1.27, <italic>P</italic>=0.28) was found between 2 groups.</p> </sec> <sec> <title>Conclusion:</title> <p>There is convincing evidence for a survival benefit of NAT over surgery alone in patient with cancer of the gastric and gastroesophageal junction.</p> </sec> </abstract>