title: Survival benefit of neoadjuvant chemotherapy for resectable cancer of the gastric and gastroesophageal junction: a meta-analysis.
abstract: BACKGROUND
  The objective of the present meta-analysis was to estimate the magnitude of survival benefits of neoadjuvant chemotherapy (NAT) in resectable cancer of the gastric and gastroesophageal junction.
  
  
  METHODS
  We searched PubMed, Embase, the Cochrane Library, ISI Web of Knowledge, Chinese biomedical literature database, Chinese Scientific Journals full-text database of retrieved articles from their inception to 2013. Two reviewers independently retrieved study and data extraction of included studies. Results regarding the overall survival and progression-free survival in the meta-analysis were expressed as hazard ratios (HRs) with 95% confidence intervals (CI).
  
  
  RESULTS
  Twelve randomized control trials (n=1755) were eligible for final meta-analysis. NAT was associated with a statistically significant benefit in terms of overall survival (HR=0.72; 95% CI, 0.56-0.93, P=0.01), progression-free survival (HR=0.73; 95% CI, 0.62-0.87, P=0.0003), 5-year survival rate [relative risk (RR)=1.36; 95% CI, 1.10-1.67, P=0.0004], and curative resection rate (RR=1.11; 95% CI, 1.03-1.20, P=0.009). Five-year survival rate increased from 30% to 42% with NAT. No significant difference with regards to overall postoperative complications rate (RR=1.08; 95% CI, 0.92-1.27, P=0.28) was found between 2 groups.
  
  
  CONCLUSIONS
  There is convincing evidence for a survival benefit of NAT over surgery alone in patient with cancer of the gastric and gastroesophageal junction.
authors.affiliation: *The First Hospital of Lanzhou University †Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, Gansu, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Jiang
authors.forename: Ke-hu
authors.initials: KH
authors.lastname: Yang
authors.forename: Quan-lin
authors.initials: QL
authors.lastname: Guan
authors.forename: Yan
authors.initials: Y
authors.lastname: Chen
authors.forename: Peng
authors.initials: P
authors.lastname: Zhao
authors.forename: Jin-hui
authors.initials: JH
authors.lastname: Tian
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant / Q000401:mortality; D018572:Disease-Free Survival; D004943:Esophagogastric Junction / Q000601:surgery; D006801:Humans; D020360:Neoadjuvant Therapy / Q000401:mortality; D011183:Postoperative Complications / Q000209:etiology; D016032:Randomized Controlled Trials as Topic; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery*; D015996:Survival Rate
chemical_list: D000970:Antineoplastic Agents