Comparison of neoadjuvant chemotherapy followed by surgery vs. surgery alone for locally advanced gastric cancer: a meta-analysis
Abstract. Background:. The neoadjuvant chemotherapy is increasingly used in advanced gastric cancer, but the effects on safety and survival are still controversial. The objective of this meta-analysis was to compare the overall survival and short-term surgical outcomes between neoadjuvant chemothera...
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doaj-af441c1091e443b69b19fed77400f54c2021-08-25T06:50:05ZengWolters KluwerChinese Medical Journal0366-69992542-56412021-07-01134141669168010.1097/CM9.0000000000001603202107200-00005Comparison of neoadjuvant chemotherapy followed by surgery vs. surgery alone for locally advanced gastric cancer: a meta-analysisJian-Hong YuZao-Zao WangYing-Chong FanMao-Xing LiuKai XuNan ZhangZhen-Dan YaoHong YangCheng-Hai ZhangJia-Di XingMing CuiXiang-Qian SuJing NiAbstract. Background:. The neoadjuvant chemotherapy is increasingly used in advanced gastric cancer, but the effects on safety and survival are still controversial. The objective of this meta-analysis was to compare the overall survival and short-term surgical outcomes between neoadjuvant chemotherapy followed by surgery (NACS) and surgery alone (SA) for locally advanced gastric cancer. Methods:. Databases (PubMed, Embase, Web of Science, Cochrane Library, and Google Scholar) were explored for relative studies from January 2000 to January 2021. The quality of randomized controlled trials and cohort studies was evaluated using the modified Jadad scoring system and the Newcastle-Ottawa scale, respectively. The Review Manager software (version 5.3) was used to perform this meta-analysis. The overall survival was evaluated as the primary outcome, while perioperative indicators and post-operative complications were evaluated as the secondary outcomes. Results:. Twenty studies, including 1420 NACS cases and 1942 SA cases, were enrolled. The results showed that there were no significant differences in overall survival (P = 0.240), harvested lymph nodes (P = 0.200), total complications (P = 0.080), and 30-day post-operative mortality (P = 0.490) between the NACS and SA groups. However, the NACS group was associated with a longer operation time (P < 0.0001), a higher R0 resection rate (P = 0.003), less reoperation (P = 0.030), and less anastomotic leakage (P = 0.007) compared with SA group. Conclusions:. Compared with SA, NACS was considered safe and feasible for improved R0 resection rate as well as decreased reoperation and anastomotic leakage. While unbenefited overall survival indicated a less important effect of NACS on long-term oncological outcomes.http://journals.lww.com/10.1097/CM9.0000000000001603 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jian-Hong Yu Zao-Zao Wang Ying-Chong Fan Mao-Xing Liu Kai Xu Nan Zhang Zhen-Dan Yao Hong Yang Cheng-Hai Zhang Jia-Di Xing Ming Cui Xiang-Qian Su Jing Ni |
spellingShingle |
Jian-Hong Yu Zao-Zao Wang Ying-Chong Fan Mao-Xing Liu Kai Xu Nan Zhang Zhen-Dan Yao Hong Yang Cheng-Hai Zhang Jia-Di Xing Ming Cui Xiang-Qian Su Jing Ni Comparison of neoadjuvant chemotherapy followed by surgery vs. surgery alone for locally advanced gastric cancer: a meta-analysis Chinese Medical Journal |
author_facet |
Jian-Hong Yu Zao-Zao Wang Ying-Chong Fan Mao-Xing Liu Kai Xu Nan Zhang Zhen-Dan Yao Hong Yang Cheng-Hai Zhang Jia-Di Xing Ming Cui Xiang-Qian Su Jing Ni |
author_sort |
Jian-Hong Yu |
title |
Comparison of neoadjuvant chemotherapy followed by surgery vs. surgery alone for locally advanced gastric cancer: a meta-analysis |
title_short |
Comparison of neoadjuvant chemotherapy followed by surgery vs. surgery alone for locally advanced gastric cancer: a meta-analysis |
title_full |
Comparison of neoadjuvant chemotherapy followed by surgery vs. surgery alone for locally advanced gastric cancer: a meta-analysis |
title_fullStr |
Comparison of neoadjuvant chemotherapy followed by surgery vs. surgery alone for locally advanced gastric cancer: a meta-analysis |
title_full_unstemmed |
Comparison of neoadjuvant chemotherapy followed by surgery vs. surgery alone for locally advanced gastric cancer: a meta-analysis |
title_sort |
comparison of neoadjuvant chemotherapy followed by surgery vs. surgery alone for locally advanced gastric cancer: a meta-analysis |
publisher |
Wolters Kluwer |
series |
Chinese Medical Journal |
issn |
0366-6999 2542-5641 |
publishDate |
2021-07-01 |
description |
Abstract. Background:. The neoadjuvant chemotherapy is increasingly used in advanced gastric cancer, but the effects on safety and survival are still controversial. The objective of this meta-analysis was to compare the overall survival and short-term surgical outcomes between neoadjuvant chemotherapy followed by surgery (NACS) and surgery alone (SA) for locally advanced gastric cancer.
Methods:. Databases (PubMed, Embase, Web of Science, Cochrane Library, and Google Scholar) were explored for relative studies from January 2000 to January 2021. The quality of randomized controlled trials and cohort studies was evaluated using the modified Jadad scoring system and the Newcastle-Ottawa scale, respectively. The Review Manager software (version 5.3) was used to perform this meta-analysis. The overall survival was evaluated as the primary outcome, while perioperative indicators and post-operative complications were evaluated as the secondary outcomes.
Results:. Twenty studies, including 1420 NACS cases and 1942 SA cases, were enrolled. The results showed that there were no significant differences in overall survival (P = 0.240), harvested lymph nodes (P = 0.200), total complications (P = 0.080), and 30-day post-operative mortality (P = 0.490) between the NACS and SA groups. However, the NACS group was associated with a longer operation time (P < 0.0001), a higher R0 resection rate (P = 0.003), less reoperation (P = 0.030), and less anastomotic leakage (P = 0.007) compared with SA group.
Conclusions:. Compared with SA, NACS was considered safe and feasible for improved R0 resection rate as well as decreased reoperation and anastomotic leakage. While unbenefited overall survival indicated a less important effect of NACS on long-term oncological outcomes. |
url |
http://journals.lww.com/10.1097/CM9.0000000000001603 |
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