Neoadjuvant therapy in locally advanced colon cancer: a meta-analysis and systematic review

Journal of Gastrointestinal Oncology
Chin Kai CheongChoon Seng Chong

Abstract

The role of perioperative or neoadjuvant chemotherapy for locally advanced colon cancer is unclear. Emerging evidence such as the FOXTROT trial is challenging the conventional norm of upfront operation for these patients. However, these trials have yet to reach statistical significance. MEDLINE, Embase, Cochrane Library, China Knowledge Resource Integrated Database (CNKI) and ClinicalTrials.gov were searched. Randomized controlled trials (RCTs) and observational studies of patients with locally advanced colon cancer were included. The intervention arm was neoadjuvant chemotherapies while the comparator arm was adjuvant chemotherapies. Studies which reported outcomes of interests included overall survival, disease-free survival, R0 resection rate, perioperative complications and adverse effects of chemotherapy were chosen. We identified five eligible randomized trials and two observational studies, including 29,504 patients. Neoadjuvant therapies exhibited statistically significant improvement in overall survival [hazard ratio (HR) =0.76, 95% confidence interval (CI): 0.65-0.89, P=0.0005], and disease-free survival (HR =0.74, 95% CI: 0.58-0.95, P=0.02). R0 resection rate fell slightly short of significance [odds ratio (OR) =1.86...Continue Reading

Citations

Jun 24, 2021·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·Emma RosanderCaroline Nordenvall
Aug 13, 2021·Scientific Reports·Yuexiang LiangJingquan Li
Oct 26, 2021·The British Journal of Surgery·A KananiK Søreide

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