Yuanwei Huang1, Haidong Wang2, Ganfeng Luo3, Yanting Zhang4, Li Wang5, Ke Li6. 1. Department of Public Health, Shantou University Medical College, No.22 Xinling Road, Shantou, Guangdong, 515041, China. Electronic address: hywwell@126.com. 2. School of Public Health, Tianjin Medical University, Tianjin, China. Electronic address: whd575545@126.com. 3. Department of Public Health, Shantou University Medical College, No.22 Xinling Road, Shantou, Guangdong, 515041, China. Electronic address: luoganfeng1991@126.com. 4. Department of Public Health, Shantou University Medical College, No.22 Xinling Road, Shantou, Guangdong, 515041, China. Electronic address: zhangyanting1992@126.com. 5. Department of Public Health, Shantou University Medical College, No.22 Xinling Road, Shantou, Guangdong, 515041, China. Electronic address: wangli3740@126.com. 6. Department of Public Health, Shantou University Medical College, No.22 Xinling Road, Shantou, Guangdong, 515041, China. Electronic address: keli1122@126.com.
Abstract
BACKGROUND: The role of neoadjuvant therapy combined with surgery for treating esophageal squamous cell carcinoma (ESCC) remains controversial. We performed a network meta-analysis to synthesize direct and indirect evidence to identify the optimal therapeutic method for ESCC. METHODS: We identified 15 randomized controlled trials that compared any of the following 4 therapeutic measures: surgery alone (S), preoperative chemotherapy followed by surgery (CTS), preoperative radiotherapy followed by surgery (RTS), and preoperative chemoradiotherapy followed by surgery (CRTS). The main outcomes were 5-year survival, rate of radical resection, operative mortality and postoperative complications. RESULTS: Network meta-analysis showed that CRTS was associated with improved survival as compared with S (OR = 1.50 [95% CI 1.21 to 1.97]) and decreased occurrence of complications as compared with RTS (OR = 0.50 [95% CI 0.22 to 0.99]). Direct evidence revealed CRTS associated with improved survival (OR = 1.61 [95% CI 1.01 to 2.57]) and radical resection (OR = 4.01 [95% CI 1.66 to 9.69]) as compared with S. In terms of radical resection, CTS was more effective than S (OR = 1.73 [95% CI 1.09 to 2.76]). Findings for CTS and RTS did not differ for 5-year survival, operative mortality and postoperative complications. CONCLUSIONS: Overall, CRTS might be the best choice for resectable ESCC because it could increase the radical resection rate and lower the occurrence of complications, thereby prolonging survival time.
BACKGROUND: The role of neoadjuvant therapy combined with surgery for treating esophageal squamous cell carcinoma (ESCC) remains controversial. We performed a network meta-analysis to synthesize direct and indirect evidence to identify the optimal therapeutic method for ESCC. METHODS: We identified 15 randomized controlled trials that compared any of the following 4 therapeutic measures: surgery alone (S), preoperative chemotherapy followed by surgery (CTS), preoperative radiotherapy followed by surgery (RTS), and preoperative chemoradiotherapy followed by surgery (CRTS). The main outcomes were 5-year survival, rate of radical resection, operative mortality and postoperative complications. RESULTS: Network meta-analysis showed that CRTS was associated with improved survival as compared with S (OR = 1.50 [95% CI 1.21 to 1.97]) and decreased occurrence of complications as compared with RTS (OR = 0.50 [95% CI 0.22 to 0.99]). Direct evidence revealed CRTS associated with improved survival (OR = 1.61 [95% CI 1.01 to 2.57]) and radical resection (OR = 4.01 [95% CI 1.66 to 9.69]) as compared with S. In terms of radical resection, CTS was more effective than S (OR = 1.73 [95% CI 1.09 to 2.76]). Findings for CTS and RTS did not differ for 5-year survival, operative mortality and postoperative complications. CONCLUSIONS: Overall, CRTS might be the best choice for resectable ESCC because it could increase the radical resection rate and lower the occurrence of complications, thereby prolonging survival time.
Authors: Yichun Wang; Li Zhang; Dongmei Ye; Wanli Xia; Jun Jiang; Xiumei Wang; Mingxia Zhang; Fan Wang Journal: Oncol Lett Date: 2018-01-16 Impact factor: 2.967
Authors: Wei Feng; Zhan Qi; Rong Qiu; Zhen-Sheng Li; Shi-Lei Dong; Yue-Kao Li; Yuan-Ping Hu; Ming He; Yu-Xiang Wang Journal: J Int Med Res Date: 2020-12 Impact factor: 1.671