Perioperative chemotherapy versus adjuvant chemotherapy in patients with resectable gastric cancer: A systematic review with meta-analysis

Chenyu Wei; Xuelin Du; Jiexuan Hu; Yin Dong; Yan Chen; Bangwei Cao

doi:10.1016/j.critrevonc.2023.104082

Perioperative chemotherapy versus adjuvant chemotherapy in patients with resectable gastric cancer: A systematic review with meta-analysis

Crit Rev Oncol Hematol. 2023 Aug 1:198:104082. doi: 10.1016/j.critrevonc.2023.104082. Online ahead of print.

Authors

Chenyu Wei¹, Xuelin Du², Jiexuan Hu¹, Yin Dong¹, Yan Chen³, Bangwei Cao⁴

Affiliations

¹ Department of Oncology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
² Clinical Trial Institution, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
³ Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
⁴ Department of Oncology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China. Electronic address: oncology@ccmu.edu.cn.

PMID: 37532103
DOI: 10.1016/j.critrevonc.2023.104082

Abstract

Purpose: The study aimed to investigate the prognosis and safety of perioperative chemotherapy (PC) compared with adjuvant chemotherapy (AC).

Methods: We systematically searched and assessed studies in PubMed, Embase, and the Cochrane Library from inception to 1st September 2022.

Results: Eighteen studies were eligible for the analysis, including 4686 patients in total. Our study found that patients with resectable gastric cancer undergoing PC had favorable prognosis on OS (HR 0.77; 95% CI 0.69-0.87) and DFS (HR 0.76; 95% CI 0.69-0.84) than those who undergoing AC. Addition of neoadjuvant chemotherapy (NAC) to AC provided higher R0 resection rate but did not increase the risk of postoperative complication rate and most of the adverse event rates.

Conclusion: Our study demonstrated that PC shows better OS and DFS in Asians with resectable gastric cancer compared with AC. PC should be preferred because of its favorable prognosis and similar safety.

Keywords: Gastric cancer; Meta-analysis; Neoadjuvant chemotherapy; Perioperative chemotherapy.

Publication types

Review