Ioannis Baloyiannis1, Konstantinos Perivoliotis2, Styliani Vederaki3, Georgios Koukoulis3,4, Dimitrios Symeonidis1, George Tzovaras1. 1. Department of Surgery, University Hospital of Larissa, Mezourlo, 41110, Larissa, Greece. 2. Department of Surgery, University Hospital of Larissa, Mezourlo, 41110, Larissa, Greece. kperi19@gmail.com. 3. Faculty of Medicine, University of Thessaly, Mezourlo, 41110, Larissa, Greece. 4. Department of Surgery, Koutlimbaneio and Triantafylleio General Hospital of Larissa, Larissa, Greece.
Abstract
PURPOSE: The aim of this meta-analysis was to investigate the role of adjuvant chemotherapy (AC) in rectal cancer patients with pathologic complete response (pCR) after neoadjuvant chemoradiotherapy (nCRT) and curative resection. METHODS: This study was completed in accordance to the PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. The electronic scholar databases (Medline, Web of Science, Scopus) were screened for eligible articles. The level of evidence (LoE) was assessed using the GRADE methodology. RESULTS: Overall, 23 non-randomized studies and 17,406 patients were included in the present meta-analysis. Pooled comparisons confirmed that AC improved overall survival (HR: 0.68, p=0.0003), but not disease-free (p=0.22) and recurrence-free survival (p=0.39). However, the LoE for all outcomes was characterized as "very low," due to the absence of RCTs. CONCLUSIONS: Considering the study limitations and the lack of randomized studies, further high-quality RCTs are required to confirm the findings of our study.
PURPOSE: The aim of this meta-analysis was to investigate the role of adjuvant chemotherapy (AC) in rectal cancerpatients with pathologic complete response (pCR) after neoadjuvant chemoradiotherapy (nCRT) and curative resection. METHODS: This study was completed in accordance to the PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. The electronic scholar databases (Medline, Web of Science, Scopus) were screened for eligible articles. The level of evidence (LoE) was assessed using the GRADE methodology. RESULTS: Overall, 23 non-randomized studies and 17,406 patients were included in the present meta-analysis. Pooled comparisons confirmed that AC improved overall survival (HR: 0.68, p=0.0003), but not disease-free (p=0.22) and recurrence-free survival (p=0.39). However, the LoE for all outcomes was characterized as "very low," due to the absence of RCTs. CONCLUSIONS: Considering the study limitations and the lack of randomized studies, further high-quality RCTs are required to confirm the findings of our study.
Authors: Luiz Felipe de Campos-Lobato; Luca Stocchi; Andre da Luz Moreira; Daniel Geisler; David W Dietz; Ian C Lavery; Victor W Fazio; Matthew F Kalady Journal: Ann Surg Oncol Date: 2011-01-05 Impact factor: 5.344
Authors: Rebecca L Siegel; Kimberly D Miller; Stacey A Fedewa; Dennis J Ahnen; Reinier G S Meester; Afsaneh Barzi; Ahmedin Jemal Journal: CA Cancer J Clin Date: 2017-03-01 Impact factor: 508.702
Authors: Andrea Cercek; Campbell S D Roxburgh; Paul Strombom; J Joshua Smith; Larissa K F Temple; Garrett M Nash; Jose G Guillem; Philip B Paty; Rona Yaeger; Zsofia K Stadler; Kenneth Seier; Mithat Gonen; Neil H Segal; Diane L Reidy; Anna Varghese; Jinru Shia; Efsevia Vakiani; Abraham J Wu; Christopher H Crane; Marc J Gollub; Julio Garcia-Aguilar; Leonard B Saltz; Martin R Weiser Journal: JAMA Oncol Date: 2018-06-14 Impact factor: 31.777
Authors: Nelleke P M Brouwer; Amanda C R K Bos; Valery E P P Lemmens; Pieter J Tanis; Niek Hugen; Iris D Nagtegaal; Johannes H W de Wilt; Rob H A Verhoeven Journal: Int J Cancer Date: 2018-09-29 Impact factor: 7.396