The Prognostic Value of a Pathologic Complete Response After Neoadjuvant Therapy for Digestive Cancer: Systematic Review and Meta-Analysis of 21 Studies

Annals of Surgical Oncology
Tao WanYan-Ming Zhou

Abstract

Neoadjuvant therapy (NAT) before radical excision has become the preferred initial option for locally advanced digestive cancers such as esophageal cancer (EC), esophagogastric junction adenocarcinoma (EGJAC), gastric adenocarcinoma (GAC), rectal cancer (RC), and pancreatic cancer (PC). Although some patients reportedly achieve a pathologic complete response (pCR) after neoadjuvant therapy, the published data are inconsistent regarding whether pCR yields a survival benefit. The current meta-analysis was performed to assess the potential prognostic value of pCR after preoperative therapy for patients with digestive cancers. An extensive electronic search in PubMed, Web of Science, and the Cochrane Library was performed for relevant articles, from which data relative to independent correlations of pCR with overall survival (OS) and disease-free survival (DFS) were extracted for analysis. A random-effects model was used to calculate the pooled hazard ratios (HRs) with their corresponding 95% confidence intervals (CIs). The study identified 6780 patients who met the inclusion and exclusion criteria. The results showed that pCR was significantly correlated with better OS (HR, 0.50; 95% CI, 0.43-0.58; P < 0.001) and DFS (HR, 0.49; 95...Continue Reading

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Citations

Oct 1, 2019·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·C TerziI Oztop
Oct 1, 2020·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·Sabrina M SaeedJose M Pimiento
Sep 5, 2020·World Journal of Gastroenterology : WJG·Shi-Wen MeiQian Liu
Oct 7, 2020·Journal of Surgical Oncology·Naomi M SellHiroko Kunitake
Dec 30, 2020·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·Chengqiang LiHecheng Li
Feb 18, 2020·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Jordan M CloydAllan Tsung

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