title: Neoadjuvant Chemoradiotherapy Improving Survival Outcomes for Esophageal Carcinoma: An Updated Meta-analysis.
abstract: BACKGROUND
  The effectiveness of neoadjuvant chemoradiotherapy (NCRT) treatment for patients with esophageal carcinoma (EC) remains controversial. The aim of this study was to compare the effect of NCRT followed by surgery (NCRTS) with surgery alone (SA) for EC.
  
  
  METHODS
  The PubMed, EMBASE, and the Cochrane Library databases were electronically searched up to August 2015 for all the published studies that investigated EC patients receiving either NCRTS or SA, and the reference lists were also manually examined for the eligible studies. The risk ratio (RR) with 95% confidence intervals (CI s) as effective size was determined to assess the 1-, 3-, 5-year survival rates (SRs), postoperative morbidity, and postoperative mortality. Heterogeneity was determined using the Q-test. The Begg's test and Egger's test were used for assessing any potential publication bias.
  
  
  RESULTS
  Of 1120 identified studies, 16 eligible studies were included in this analysis (involving 2549 patients). Overall, the pooled results suggested that NCRTS was associated with significantly improved 1-year (RR: 1.07, 95% CI: 1.02-1.13), 3-year (RR: 1.26, 95% CI: 1.14-1.39), and 5-year (RR: 1.36, 95% CI: 1.18-1.56) SRs. However, the results also indicated that NCRTS had no or little effect on postoperative morbidity (RR: 0.93, 95% CI: 0.82-1.05) and postoperative mortality (RR: 1.17, 95% CI: 0.56-2.44).
  
  
  CONCLUSIONS
  Compared with SA, NCRTS can increase 1-, 3-, and 5-year SRs in patients with EC.
authors.affiliation: Department of Cardiothoracic Surgery, Tianjin Hospital, Tianjin 300211, China.
authors.forename: Dong-Bin
authors.initials: DB
authors.lastname: Wang
authors.affiliation: Department of Cardiothoracic Surgery, Tianjin Hospital, Tianjin 300211, China.
authors.forename: Zhong-Yi
authors.initials: ZY
authors.lastname: Sun
authors.affiliation: Department of Cardiothoracic Surgery, Tianjin Hospital, Tianjin 300211, China.
authors.forename: Li-Min
authors.initials: LM
authors.lastname: Deng
authors.affiliation: Department of Cardiothoracic Surgery, Tianjin Hospital, Tianjin 300211, China.
authors.forename: De-Qing
authors.initials: DQ
authors.lastname: Zhu
authors.affiliation: Department of Cardiothoracic Surgery, Tianjin Hospital, Tianjin 300211, China.
authors.forename: Hong-Gang
authors.initials: HG
authors.lastname: Xia
authors.affiliation: Department of Cardiothoracic Surgery, Tianjin Hospital, Tianjin 300211, China.
authors.forename: Peng-Zhi
authors.initials: PZ
authors.lastname: Zhu
mesh_terms: D059248:Chemoradiotherapy / Q000379:methods; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D020360:Neoadjuvant Therapy / Q000379:methods*; D015996:Survival Rate