Meta-Analysis and Systematic Review
Neoadjuvant chemotherapy for gastric cancer: A meta-analysis of randomized, controlled trials
Version of Record online: 25 APR 2013
© 2013 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd
Journal of Gastroenterology and Hepatology
Volume 28, Issue 5, pages 777–782, May 2013
How to Cite
Liao, Y., Yang, Z.-l., Peng, J.-s., Xiang, J. and Wang, J.-p. (2013), Neoadjuvant chemotherapy for gastric cancer: A meta-analysis of randomized, controlled trials. Journal of Gastroenterology and Hepatology, 28: 777–782. doi: 10.1111/jgh.12152
Conflicts of interest: The authors disclose no conflicts.
- Issue online: 25 APR 2013
- Version of Record online: 25 APR 2013
- Accepted manuscript online: 21 FEB 2013 02:41AM EST
- Manuscript Accepted: 11 JAN 2013
- Sixth Affiliated Hospital of Sun Yat-sen University
- gastric cancer;
- neoadjuvant chemotherapy;
- randomized controlled trial
Background and Aim
Although the effect of neoadjuvant chemotherapy in gastric cancer has been extensively studied, the data of survival benefit are still controversial. The purpose of this work was to assess the effectiveness of neoadjuvant chemotherapy followed by surgery in patients with gastric cancer.
We searched systematically electronic through the databases of PUBMED, EMBASE, China Biological Medicine, and China National Knowledge Infrastructure Whole Article for studies published from 1975. Two reviewers independently evaluated the relevant reports and searched manually reference from these reports for additional trials. Outcomes assessed by meta-analysis included overall survival rate, progression-free survival rate, R0 resection rate, downstaging effect, postoperative complications, and perioperative mortality.
Six randomized, controlled trials with 781 patients were included in the meta-analysis. Odds ratio (95% confidence interval; P-value), expressed as neoadjuvant chemotherapy and surgery versus surgery alone, was 1.16 (0.85–1.58; P = 0.36) for overall survival, 1.24 (0.78–1.96; P = 0.36) for R0 resection, 1.25 (0.75–2.09; P = 0.39) for postoperative complications, and 3.60 (0.59–22.45; P = 0.17) for perioperative mortality.
Compared with surgery alone, neoadjuvant chemotherapy followed by surgery was not associated with a higher rate of overall survival or complete resection (R0 resection). It does not increase treatment-related morbidity and mortality. This meta-analysis did not demonstrate a survival benefit for the combination of neoadjuvant chemotherapy and surgery.