Abstract
BackgroundThe long-term survival benefit of concurrent neoadjuvant chemoradiotherapy in patients with resectable esophageal cancer remains controversial. In the present study, we conducted a meta-analysis to assess these effectiveness.MethodsWe searched for most relevant studies published up to the end of August 2016, using Pubmed and web of knowledge. And additional articles were identified from previous meta-analysis. The hazard ratio (HR, for overall survival and progression free survival) or risk ratio (RR, for R0 resection) with its corresponding 95 % confidence interval (CI) were used to assess the pooled effect.ResultsTwelve articles including 1756 patients were included in the meta-analysis. Concurrent neoadjuvant chemoradiotherapy followed by surgery was associated with significantly improved overall survival (HR=0.76 , 95% CI= 0.68-0.86), progression survival (HR =0.69, 95% CI= 0.59-0.81), and R0 resection rate(RR =1.17, 95% CI= 1.03-1.33). Subgroup analysis suggested that concurrent neoadjuvant chemoradiotherapy could improve overall survival outcome for squamous cell carcinoma (HR=0.73, 95%CI=0.61-0.88) but not those for adenocarcinoma (HR=0.72, 95%CI=0.48-1.04).ConclusionOur findings suggested that concurrent neoadjuvant chemoradiotherapy was associated with a significant survival benefit in patients with esophageal cancer.
Highlights
Our findings suggested that concurrent neoadjuvant chemoradiotherapy was associated with a significant survival benefit in patients with esophageal cancer
[5] This, along with the evident difficulties of administering radiotherapy and chemotherapy after resection for esophageal cancer, makes recent trials focus on the role of neoadjuvant treatment, especially the concurrent neoadjuvant chemoradiotherapy (NCRT)
Of these 12 studies, twelve studies reported the outcome of overall survival, six studies reported the R0 resection rate, and four studies reported the progression-free survival
Summary
With more than 456,000 newly diagnosed cases and 400,000 related deaths annually, esophageal cancer is the tenth most common cancer and the eighth leading cause of cancer-related deaths worldwide. [1, 2] Since most esophageal cancer patients are diagnosed at the advanced stages, the 5-year survival rate is less than 20%. [3] Despite surgical care and improvements in preoperative staging, surgery alone leads to relatively few long-term survivors. [4] A great number of patients who underwent esophagectomy continue to die as a result of tumor recurrence. [5]Adjuvant therapies, with either radiotherapy or chemotherapy, have not shown survival any benefits. [5] This, along with the evident difficulties of administering radiotherapy and chemotherapy after resection for esophageal cancer, makes recent trials focus on the role of neoadjuvant treatment, especially the concurrent neoadjuvant chemoradiotherapy (NCRT). [1, 2] Since most esophageal cancer patients are diagnosed at the advanced stages, the 5-year survival rate is less than 20%. [3] Despite surgical care and improvements in preoperative staging, surgery alone leads to relatively few long-term survivors. With either radiotherapy or chemotherapy, have not shown survival any benefits. [5] This, along with the evident difficulties of administering radiotherapy and chemotherapy after resection for esophageal cancer, makes recent trials focus on the role of neoadjuvant treatment, especially the concurrent neoadjuvant chemoradiotherapy (NCRT). A recent metaanalysis showed that concurrent NCRT was associated with improved 1-, 3- and 5-year survival rate. The long-term survival benefit of concurrent neoadjuvant chemoradiotherapy in patients with resectable esophageal cancer remains controversial. We conducted a meta-analysis to assess these effectiveness
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
