Perioperative chemotherapy more of a benefit for overall survival than adjuvant chemotherapy for operable gastric cancer: an updated Meta-analysis

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dc.contributor.authorYang, Y.
dc.contributor.authorYin, X.
dc.contributor.authorSheng, L.
dc.contributor.authorXu, S.
dc.contributor.authorDong, L.
dc.contributor.authorLiu, L.
dc.date.issued2015
dc.description.abstractTo clarify the effect of neoadjuvant chemotherapy (NAC) on the survival outcomes of operable gastric cancers, we searched PubMed, Embase, and Cochrane Library for randomized clinical trials published until June 2014 that compared NAC-containing strategies with NAC-free strategies in patients with adenocarcinoma of the stomach or the esophagogastric junction, who had undergone potentially curative resection. The adjusted pooled hazard ratio (HR) for overall survival (OS) was insignificant when comparing the NAC-containing arm with the NAC-free arm. Subgroup analysis showed that the OS of the treatment arm that involved both adjuvant chemotherapy (AC) and NAC was significantly improved over the control arm (AC only) (HR = 0.48, 95% CI: 0.35-0.67; P < 0.001). While NAC alone plus surgery did not show any survival benefit over surgery alone. Perioperative chemotherapy (PC) also showed a significant increase in PFS and a significant reduction in distant metastasis compared to surgery alone. Therefore, in patients with resectable gastric cancer, NAC alone is not enough and AC alone is not good enough to definitely improve their OS. Collectively, PC combined with surgery could maximize the survival benefit for patients with resectable gastric cancer.
dc.description.statementofresponsibilityYa'nan Yang, Xue Yin, Lei Sheng, Shan Xu, Lingling Dong, Lian Liu
dc.identifier.citationScientific Reports, 2015; 5(1):12850-1-12850-12
dc.identifier.doi10.1038/srep12850
dc.identifier.issn2045-2322
dc.identifier.issn2045-2322
dc.identifier.urihttp://hdl.handle.net/2440/95990
dc.language.isoen
dc.publisherNature Publishing Group
dc.rightsThis work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/
dc.source.urihttps://doi.org/10.1038/srep12850
dc.subjectHumans
dc.subjectAdenocarcinoma
dc.subjectStomach Neoplasms
dc.subjectNeoplasm Recurrence, Local
dc.subjectDisease-Free Survival
dc.subjectChemotherapy, Adjuvant
dc.subjectNeoadjuvant Therapy
dc.subjectProportional Hazards Models
dc.subjectRandomized Controlled Trials as Topic
dc.subjectKaplan-Meier Estimate
dc.subjectPerioperative Period
dc.titlePerioperative chemotherapy more of a benefit for overall survival than adjuvant chemotherapy for operable gastric cancer: an updated Meta-analysis
dc.typeJournal article
pubs.publication-statusPublished

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