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Comment
. 2011 Oct 28;17(40):4542-4.
doi: 10.3748/wjg.v17.i40.4542.

Neoadjuvant plus adjuvant chemotherapy benefits overall survival of locally advanced gastric cancer

Xin-Zu Chen, Kun Yang, Jie Liu, Xiao-Long Chen, Jian-Kun Hu
Comment

Neoadjuvant plus adjuvant chemotherapy benefits overall survival of locally advanced gastric cancer

Xin-Zu Chen et al. World J Gastroenterol. .

Abstract

Neoadjuvant chemotherapy (NAC) has drawn more attention to the treatment of locally advanced gastric cancer (AGC) in the current multidisciplinary treatment model. EORTC trial 40954 has recently reported that NAC plus surgery without postoperative adjuvant chemotherapy could not benefit the locally AGC patients in their overall survival. We performed a meta-analysis of 10 studies including 1518 gastric cancer patients. Stratified subgroups were NAC plus surgery and NAC plus both surgery and adjuvant chemotherapy (AC), while control was surgery alone. The results showed that NAC plus surgery did not benefit the patients with locally AGC in their overall survival [odds ratio (OR) = 1.20, 95% CI 0.80-1.80, P = 0.37] and the number needed to treat (NNT) was 74. However, the NAC plus both surgery and AC had a slight overall survival benefit (OR = 1.33, 95% CI 1.03-1.71, P = 0.03) and NNT was 14, which is superior to the NAC plus surgery. Therefore, we recommend that combined NAC and AC should be used to improve the overall survival of the locally AGC patients.

Keywords: Adjuvant chemotherapy; Gastric cancer; Neoadjuvant chemotherapy; Surgery; Survival.

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Figures

Figure 1
Figure 1
Subgroup comparison of neoadjuvant chemotherapy or neoadjuvant chemotherapy plus adjuvant chemotherapy vs surgery alone for locally advanced gastric cancer (based on the published meta-analysis and excluding the trials contaminated with adjuvant chemotherapy in control arm)[1]. M-H: Mantel-Haenszel test. NAC: Neoadjuvant chemotherapy; AC: Adjuvant chemotherapy.
Figure 2
Figure 2
Funnel plot analysis of publication bias. OR: Odds ratio; NAC: Neoadjuvant chemotherapy; AC: Adjuvant chemotherapy.
See this image and copyright information in PMC

Comment on

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