Results from a Meta-Analayses Evaluation Postoperative Chemoradiotherapy in Patients with Gastric Cancer with D2 Lymphadenectomy

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The administration of adjuvant chemoradiotherapy after D3 lymphadenectomy in patients with gastric cancer is a controversial method of treatment.

Research from the Liaoning Cancer Hospital & Institute in Shenyang, China, that was recently published in the European Journal of Surgical Oncology, set out to perform a meta-analysis to analyze the safety and efficacy of postoperative chemoradiotherapy and determine the best practice for patients with gastric cancer in this category.

The researchers used PubMed, Cohrane, Web of Science and Ovid to perform a statistical analysis on STAT version 12.0 software. The researchers used Jadad and the Newcastle–Ottawa quality assessment scale to establish the quality of their evidence.  The researchers identified 2,135 patients who were involved in one of six studies and included the data from those patients in their meta-analysis.

According to the results of their research, postoperative adjuvant chemoradiotherapy produced a significant improvement in 5-year relapse-free survival (HR = 0.81, 95% CI 0.70–0.93, P = 0.004) and 5-year overall survival (HR = 0.79, 95% CI 0.68–0.92, P = 0.002) compared with patients who didn’t receive adjuvant chemoradiotherapy. There was no difference in treatment-related toxicity and distant metastasis (RR = 0.93, 95% CI 0.82–1.06, P = 0.304) between the groups.

The researchers concluded, based on their findings, that adjuvant chemoradiotherapy is associated with longer 5-year relapse-free survival and 5-year disease-free survival in patients with D2 lymphadenectomy. The researchers state that there is a need for additional comparative studies of with high-quality methodology in order to further evaluate this controversial treatment.

The Changing Landscape of Gastrointestinal Cancer Treatment
Adjuvant chemoradiotherapy is associated wither longer survival in patients with D2 lymphadenectomy.

The objective of the present meta–analysis was to analyze efficacy and safety of postoperative chemoradiotherapy (CRT) and establish a consensus on whether it is suitable for the patients.

From the results of the study, postoperative adjuvant CRT may be associated with longer 5–year overall survival (OS) and 5–year RFS in patients with D2 lymphadenectomy, but might not improve 5–year disease–free survival compared to non–CRT. Methodologically high–quality comparative studies are needed for further evaluation.

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