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Meta-Analysis
. 2014 Jul 16:9:151.
doi: 10.1186/1746-1596-9-151.

Meta-analysis of postoperative efficacy in patients receiving chemoradiotherapy followed by surgery for resectable esophageal carcinoma

Jiaying Deng, Chunyu Wang, Mingqiong Xiang, Fatao Liu, Yun Liu  1 , Kuaile Zhao
Affiliations
Meta-Analysis

Meta-analysis of postoperative efficacy in patients receiving chemoradiotherapy followed by surgery for resectable esophageal carcinoma

Jiaying Deng et al. Diagn Pathol. .

Abstract

Background: Many studies have demonstrated that chemoradiotherapy followed by surgery (CRTS) prolongs the 5-year survival rate of resectable esophageal carcinoma patients. However, the effect of CRTS on postoperative complications, local recurrence and distant metastasis remains controversial. We performed a systematic review of the literature and conducted a meta-analysis to assess the postoperative efficacy of CRTS compared with surgery alone (SA).

Methods: Pubmed, Web of Science and the Cochrane library Databases were used to identify published studies between 2000 and 2013 that directly compared CRTS with SA. The pooled relative risk (RR) and its corresponding 95% confidence interval (95% CI) constituted the principal measure of treatment effects. Heterogeneity was assessed by the χ2 and I2 statistic.

Results: The final analysis included 1930 resectable esophageal carcinoma cases from 13 randomized controlled trials (RCTs). Compared with SA, CRTS was associated with significantly decreased postoperative mortality, local recurrence and distant metastasis rates, with RR (95% CI) = 0.64 (0.49-0.84), 0.53 (0.39-0.73), 0.82 (0.68-0.98); p = 0.001, <0.00001, =0.03, respectively. However, there was no significant difference in postoperative complication incidence between the two groups (RR, 1.09; 95% CI, 0.96-1.24; p = 0.18).

Conclusions: CRTS significantly decreased postoperative mortality, local recurrence and distant metastasis rates compared to SA. Additionally, there were no increased postoperative complications for patients with resectable esophageal carcinoma.

Virtual slides: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1531519216130950.

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Figures

Figure 1
Figure 1
Flow chart of the meta-analysis.
Figure 2
Figure 2
The forest plots of postoperative mortality and complication of chemoradiotherapy followed by surgery (CRTS) versus surgery alone (SA) using a fixed effects model.
Figure 3
Figure 3
The forest plots of postoperative local recurrence and distant metastasis rates of chemoradiotherapy followed by surgery (CRTS) versus surgery alone (SA) using a fixed effects model.
See this image and copyright information in PMC

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