515
Views
7
CrossRef citations to date
0
Altmetric
REVIEW

Neoadjuvant Chemotherapy for Nonmetastatic Esophago-Gastric Adenocarcinomas: A Systematic Review and Meta-Analysis

, , , , &
Pages 421-431 | Received 17 Oct 2012, Accepted 24 Apr 2013, Published online: 11 Jun 2013
 

Abstract

Objective: A systematic review and meta-analysis was performed to investigate the efficacy of neoadjuvant chemotherapy for nonmetastatic esophago-gastric adenocarcinomas. Methods: 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. Results: Seventeen randomized controlled trials were obtained and various comparisons of treatment approaches were performed.

Randomized controlled trials detected no differences in these comparisons:

R0 resection for neoadjuvant chemotherapy versus none;

Preoperative chemotherapy versus surgery alone: 3-year OS, 5-year OS, 5-year OS in Europe, 3-year PFS;

Preoperative chemotherapy plus postoperative chemotherapy versus postoperative chemotherapy: 1-year OS, 5-year OS;

Preoperative chemotherapy versus preoperative chemoradiotherapy: 3-year OS.

Randomized controlled trials detected significant differences in these comparisons:

Preoperative chemotherapy plus postoperative chemotherapy versus surgery alone: 3-year and 5-year PFS, 5-year OS;

Subgroup analysis examining preoperative chemotherapy versus surgery alone: 5-year OS in Asia;

Preoperative chemotherapy versus postoperative chemotherapy: 1-year OS.

Conclusion: 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.

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.