title: Neoadjuvant chemotherapy for gastric cancer: a meta-analysis of randomized, controlled trials.
abstract: OBJECTIVE
  Although the effect of neoadjuvant chemotherapy in gastric cancer has been extensively studied, the data of survival benefit are still controversial. The purpose of this work was to assess the effectiveness of neoadjuvant chemotherapy followed by surgery in patients with gastric cancer.
  
  
  METHODS
  We searched systematically electronic through the databases of PUBMED, EMBASE, China Biological Medicine, and China National Knowledge Infrastructure Whole Article for studies published from 1975. Two reviewers independently evaluated the relevant reports and searched manually reference from these reports for additional trials. Outcomes assessed by meta-analysis included overall survival rate, progression-free survival rate, R0 resection rate, downstaging effect, postoperative complications, and perioperative mortality.
  
  
  RESULTS
  Six randomized, controlled trials with 781 patients were included in the meta-analysis. Odds ratio (95% confidence interval; P-value), expressed as neoadjuvant chemotherapy and surgery versus surgery alone, was 1.16 (0.85-1.58; P = 0.36) for overall survival, 1.24 (0.78-1.96; P = 0.36) for R0 resection, 1.25 (0.75-2.09; P = 0.39) for postoperative complications, and 3.60 (0.59-22.45; P = 0.17) for perioperative mortality.
  
  
  CONCLUSIONS
  Compared with surgery alone, neoadjuvant chemotherapy followed by surgery was not associated with a higher rate of overall survival or complete resection (R0 resection). It does not increase treatment-related morbidity and mortality. This meta-analysis did not demonstrate a survival benefit for the combination of neoadjuvant chemotherapy and surgery.
authors: Department of Gastrointestinal Surgery, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors: Yi
authors: Y
authors: Liao
authors: Zu-li
authors: ZL
authors: Yang
authors: Jun-sheng
authors: JS
authors: Peng
authors: Jun
authors: J
authors: Xiang
authors: Jian-ping
authors: JP
authors: Wang
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000628:therapy*; D017024:Chemotherapy, Adjuvant / Q000401:mortality*; D013505:Digestive System Surgical Procedures / Q000401:mortality; D006801:Humans; D020360:Neoadjuvant Therapy / Q000401:mortality*; D016032:Randomized Controlled Trials as Topic; D013274:Stomach Neoplasms / Q000401:mortality / Q000628:therapy*; D015996:Survival Rate; D016896:Treatment Outcome