Multimodal treatments for resectable esophagogastric junction cancer: A Bayesian network meta-analysis

Pengfei Shao; Shazhen Nima; Yang Tse; Zhuoma Suolang; Cangjue Pubu

doi:10.1007/s00423-023-02862-z

Multimodal treatments for resectable esophagogastric junction cancer: A Bayesian network meta-analysis

Langenbecks Arch Surg. 2023 Mar 18;408(1):123. doi: 10.1007/s00423-023-02862-z.

Authors

Pengfei Shao¹, Shazhen Nima¹, Yang Tse¹, Zhuoma Suolang¹, Cangjue Pubu²

Affiliations

¹ Gastroenterology Department, Lhasa People's Hospital, No.1 Beijing East Road, Chengguan District, Lhasa, 850000, Tibet Autonomous Region, China.
² Gastroenterology Department, Lhasa People's Hospital, No.1 Beijing East Road, Chengguan District, Lhasa, 850000, Tibet Autonomous Region, China. cjpubu2000@outlook.com.

PMID: 36934163
DOI: 10.1007/s00423-023-02862-z

Abstract

Purpose: To comprehensively investigate the optimal multimodal treatment of resectable esophagogastric junction (EGJ) cancer.

Methods: PubMed, Embase, Cochrane Library and Web of Science were searched until March 11, 2022. The outcomes were overall survival (OS), locoregional and distant recurrence, and R0 resection. Network plots, forest plots and league tables were drawn for each outcome. Rank probabilities for different treatments in each outcome were also depicted.

Results: A total of 23 studies with 18,319 EGJ participants were included. No significant differences in OS between any two of the 6 treatments. Perioperative chemoradiotherapy (pCRT) had the highest probability (36.03%) to be the optimal treatment as regards OS. Patients undergoing pCRT had a significantly lower incidence of locoregional recurrence than those undergoing adjuvant chemotherapy (aCT), neoadjuvant chemotherapy (nCT), perioperative chemotherapy (pCT), or surgery alone (S). Patients with pCRT had the greatest likelihood (68.86%) to have the lowest incidence of locoregional recurrence. Comparable impacts of the 6 treatments on the incidence of distant recurrence, and pCRT was most likely (46.65%) to be the optimal treatment with respect to distant recurrence. Neoadjuvant CRT (nCRT) was associated with a significantly increased incidence of R0 resection compared with nCT or S, and nCRT had the highest probability (97.68%) to be the best therapy regarding R0 resection.

Conclusion: For patients with resectable EGJ cancer, pCRT may be the optimal multimodal treatment regarding survival and recurrence.

Keywords: Multimodal treatments; Network meta-analysis; Resectable esophagogastric junction cancer.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Adenocarcinoma*
Bayes Theorem
Chemoradiotherapy / methods
Combined Modality Therapy
Esophageal Neoplasms* / therapy
Esophagogastric Junction / surgery
Humans
Neoadjuvant Therapy / methods
Neoplasm Recurrence, Local / epidemiology
Neoplasm Recurrence, Local / therapy
Network Meta-Analysis