title: Meta-analysis of postoperative efficacy in patients receiving chemoradiotherapy followed by surgery for resectable esophageal carcinoma.
abstract: BACKGROUND
  Many studies have demonstrated that chemoradiotherapy followed by surgery (CRTS) prolongs the 5-year survival rate of resectable esophageal carcinoma patients. However, the effect of CRTS on postoperative complications, local recurrence and distant metastasis remains controversial. We performed a systematic review of the literature and conducted a meta-analysis to assess the postoperative efficacy of CRTS compared with surgery alone (SA).
  
  
  METHODS
  Pubmed, Web of Science and the Cochrane library Databases were used to identify published studies between 2000 and 2013 that directly compared CRTS with SA. The pooled relative risk (RR) and its corresponding 95% confidence interval (95% CI) constituted the principal measure of treatment effects. Heterogeneity was assessed by the χ2 and I2 statistic.
  
  
  RESULTS
  The final analysis included 1930 resectable esophageal carcinoma cases from 13 randomized controlled trials (RCTs). Compared with SA, CRTS was associated with significantly decreased postoperative mortality, local recurrence and distant metastasis rates, with RR (95% CI) = 0.64 (0.49-0.84), 0.53 (0.39-0.73), 0.82 (0.68-0.98); p = 0.001, <0.00001, =0.03, respectively. However, there was no significant difference in postoperative complication incidence between the two groups (RR, 1.09; 95% CI, 0.96-1.24; p = 0.18).
  
  
  CONCLUSIONS
  CRTS significantly decreased postoperative mortality, local recurrence and distant metastasis rates compared to SA. Additionally, there were no increased postoperative complications for patients with resectable esophageal carcinoma.
  The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1531519216130950.
authors.forename: Jiaying
authors.initials: J
authors.lastname: Deng
authors.forename: Chunyu
authors.initials: C
authors.lastname: Wang
authors.forename: Mingqiong
authors.initials: M
authors.lastname: Xiang
authors.forename: Fatao
authors.initials: F
authors.lastname: Liu
authors.affiliation: Department of Radiation Oncology, Fudan University Shanghai Cancer Center, 270 Dongan Road, Shanghai 200032, China. superliuyun@gmail.com.
authors.forename: Yun
authors.initials: Y
authors.lastname: Liu
authors.forename: Kuaile
authors.initials: K
authors.lastname: Zhao
mesh_terms: D059248:Chemoradiotherapy; D004938:Esophageal Neoplasms / Q000401:mortality* / Q000628:therapy*; D006801:Humans; D020360:Neoadjuvant Therapy / Q000379:methods*; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000401:mortality; D011183:Postoperative Complications / Q000453:epidemiology