Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2016 Dec 20;129(24):2974-2982.
doi: 10.4103/0366-6999.195464.

Neoadjuvant Chemoradiotherapy Improving Survival Outcomes for Esophageal Carcinoma: An Updated Meta-analysis

Dong-Bin Wang  1 , Zhong-Yi Sun  1 , Li-Min Deng  1 , De-Qing Zhu  1 , Hong-Gang Xia  1 , Peng-Zhi Zhu  1
Affiliations
Meta-Analysis

Neoadjuvant Chemoradiotherapy Improving Survival Outcomes for Esophageal Carcinoma: An Updated Meta-analysis

Dong-Bin Wang et al. Chin Med J (Engl). .

Abstract

Background: The effectiveness of neoadjuvant chemoradiotherapy (NCRT) treatment for patients with esophageal carcinoma (EC) remains controversial. The aim of this study was to compare the effect of NCRT followed by surgery (NCRTS) with surgery alone (SA) for EC.

Methods: The PubMed, EMBASE, and the Cochrane Library databases were electronically searched up to August 2015 for all the published studies that investigated EC patients receiving either NCRTS or SA, and the reference lists were also manually examined for the eligible studies. The risk ratio (RR) with 95% confidence intervals (CI s) as effective size was determined to assess the 1-, 3-, 5-year survival rates (SRs), postoperative morbidity, and postoperative mortality. Heterogeneity was determined using the Q-test. The Begg's test and Egger's test were used for assessing any potential publication bias.

Results: Of 1120 identified studies, 16 eligible studies were included in this analysis (involving 2549 patients). Overall, the pooled results suggested that NCRTS was associated with significantly improved 1-year (RR: 1.07, 95% CI: 1.02-1.13), 3-year (RR: 1.26, 95% CI: 1.14-1.39), and 5-year (RR: 1.36, 95% CI: 1.18-1.56) SRs. However, the results also indicated that NCRTS had no or little effect on postoperative morbidity (RR: 0.93, 95% CI: 0.82-1.05) and postoperative mortality (RR: 1.17, 95% CI: 0.56-2.44).

Conclusions: Compared with SA, NCRTS can increase 1-, 3-, and 5-year SRs in patients with EC.

PubMed Disclaimer

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Flowchart of study selection and exclusion process.
Figure 2
Figure 2
Forest plot and pooled data showing the relative risk on the 1-year survival rate in the NCRTS and surgery alone groups. NCRTS: Neoadjuvant chemoradiotherapy followed by surgery; RR: Risk ratio; CI: Confidence interval.
Figure 3
Figure 3
Forest plot and pooled data showing the relative risk in the 3-year survival rate in the NCRTS and surgery alone groups. NCRTS: Neoadjuvant chemoradiotherapy followed by surgery; RR: Risk ratio; CI: Confidence interval.
Figure 4
Figure 4
Forest plot and pooled data showing the relative risk in the 5-year survival rate in the NCRTS and surgery alone groups. NCRTS: Neoadjuvant chemoradiotherapy followed by surgery; RR: Risk ratio; CI: Confidence interval.
Figure 5
Figure 5
Forest plot and pooled data showing the relative risk of the postoperative morbidity in the NCRTS and surgery alone groups. NCRTS: Neoadjuvant chemoradiotherapy followed by surgery; RR: Risk ratio; CI: Confidence interval.
Figure 6
Figure 6
Forest plot and pooled data showing the relative risk of the postoperative mortality in the NCRTS and surgery alone groups. NCRTS: Neoadjuvant chemoradiotherapy followed by surgery; RR: Risk ratio; CI: Confidence interval.
Figure 7
Figure 7
Funnel plot for studies reported 1-, 3-, and 5-year SRs, postoperative morbidity and postoperative mortality between the NCRTS and surgery alone groups. SRs: Survival rates; NCRTS: Neoadjuvant chemoradiotherapy followed by surgery; SE: Standard error; RR: Risk ratio.
See this image and copyright information in PMC

References

    1. Daly JM, Fry WA, Little AG, Winchester DP, McKee RF, Stewart AK, et al. Esophageal cancer: Results of an American College of Surgeons Patient Care Evaluation Study. J Am Coll Surg. 2000;190:562–72. doi: 10.1016/S1072-7515(00)00238-6. - PubMed
    1. Kumagai K, Rouvelas I, Tsai JA, Mariosa D, Klevebro F, Lindblad M, et al. Meta-analysis of postoperative morbidity and perioperative mortality in patients receiving neoadjuvant chemotherapy or chemoradiotherapy for resectable oesophageal and gastro-oesophageal junctional cancers. Br J Surg. 2014;101:321–38. doi: 10.1002/bjs.9418. - PubMed
    1. Duan XF, Tang P, Yu ZT. Neoadjuvant chemoradiotherapy for resectable esophageal cancer: An in-depth study of randomized controlled trials and literature review. Cancer Biol Med. 2014;11:191–201. doi: 10.7497/j.issn.2095-3941.2014.03.005. - PMC - PubMed
    1. Zhang SK, Guo LW, Chen Q, Zhang M, Liu SZ, Quan PL, et al. The association between human papillomavirus 16 and esophageal cancer in Chinese population: A meta-analysis. BMC Cancer. 2015;15:1096. doi: 10.1186/s12885-015-1096-1. - PMC - PubMed
    1. Roerecke M, Shield KD, Higuchi S, Yoshimura A, Larsen E, Rehm MX, et al. Estimates of alcohol-related oesophageal cancer burden in Japan: Systematic review and meta-analyses. Bull World Health Organ. 2015;93:329–38C. doi: 10.2471/BLT.14.142141. - PMC - PubMed

Publication types