A meta-analysis of randomized controlled trials that compared neoadjuvant chemoradiation and surgery to surgery alone for resectable esophageal cancer

Summary This study investigated whether neoadjuvant therapies, such as neoadjuvant chemoradiotherapy (NCRT), neoadjuvant chemotherapy (NCT), and neoadjuvant radiotherapy (NRT), would affect the incidence of anastomotic leakage (AL) after esophageal cancer surgery. Published randomized controlled trials were reviewed, and the incidence of AL after esophageal cancer was statistically analyzed in each study. Meta-analysis was performed using Revman and Stata software. A total of 17 randomized controlled trials with 2874 patients were reviewed showing that, in general, preoperative neoadjuvant therapies were not significant risk factors for AL after esophageal cancer surgery (relative risk [RR] = 0.82, 95% CI = 0.64–1.04). NCRT and NRT did not significantly increase the risk of postoperative AL in patients with esophageal cancer (RR = 0.81, 95% CI = 0.63–1.05; RR = 0.64, 95% CI = 0.14–2.97, respectively). Moreover, NCT has no significant correlation with the occurrence of AL (RR = 1.01, 95% CI = 0.57–1.80). NCRT, NCT, and NRT do not significantly increase the incidence of gastroesophageal AL after esophageal cancer surgery.

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Is Higher Dose Radiation Beneficial As Part of a Neoadjuvant Chemoradiation Therapy Protocol for Resectable Esophageal Cancer? A Meta-analysis

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2017.06.951 ◽

2017 ◽

Vol 99 (2) ◽

pp. E146-E147

Author(s):

A.W. Awerbuch ◽

S. Engel ◽

O. Picado ◽

D. Yakoub ◽

R. Yechieli

Keyword(s):

Esophageal Cancer ◽

Meta Analysis ◽

Neoadjuvant Chemoradiation ◽

Chemoradiation Therapy ◽

Neoadjuvant Chemoradiation Therapy ◽

Resectable Esophageal ◽

Resectable Esophageal Cancer ◽

Therapy Protocol ◽

Dose Radiation

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Cetuximab for esophageal cancer: an updated meta-analysis of randomized controlled trials

BMC Cancer ◽

10.1186/s12885-018-5040-z ◽

2018 ◽

Vol 18 (1) ◽

Cited By ~ 8

Author(s):

Ze-Hao Huang ◽

Xiao-Wen Ma ◽

Jing Zhang ◽

Xiao Li ◽

Na-Lin Lai ◽

...

Keyword(s):

Esophageal Cancer ◽

Randomized Controlled Trials ◽

Meta Analysis ◽

Controlled Trials ◽

Randomized Controlled

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Optimal radiation dosing in concurrent neoadjuvant chemoradiation for resectable esophageal cancer: a meta-analysis

Journal of Gastrointestinal Oncology ◽

10.21037/jgo.2019.01.02 ◽

2019 ◽

Vol 10 (3) ◽

pp. 391-399

Author(s):

Steven Engel ◽

Adam Awerbuch ◽

Deukwoo Kwon ◽

Omar Picado ◽

Raphael Yechieli ◽

...

Keyword(s):

Esophageal Cancer ◽

Meta Analysis ◽

Neoadjuvant Chemoradiation ◽

Resectable Esophageal ◽

Resectable Esophageal Cancer ◽

Radiation Dosing

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Anti-PD-1 Inhibitor for the Treatment of Esophageal Cancer Refractory or Intolerant to Previous Chemotherapy: A Meta-Analysis of Randomized Controlled Trials

10.21203/rs.3.rs-156736/v1 ◽

2021 ◽

Author(s):

Guixiang Liao ◽

Zhihong Zhao ◽

Tao Zheng ◽

Muhammad Khan ◽

Maosheng Yan ◽

...

Keyword(s):

Esophageal Cancer ◽

Randomized Controlled Trials ◽

Meta Analysis ◽

Objective Response ◽

Cochrane Library ◽

Controlled Trials ◽

Therapeutic Effects ◽

Advanced Esophageal Cancer ◽

Chemotherapy Group ◽

Randomized Controlled

Abstract Background Clinical studies have suggested that PD-1 inhibitor is useful in the management of advanced Esophageal Cancer. However, the efficacy and safety of Anti-PD-1 inhibitor for the treatment of advanced Esophageal Cancer is inconclusive. Thus, we conducted a meta-analysis aiming to comprehensively explore the effectiveness and safety of the therapeutic effects of PD-1 inhibitors on patients with advanced esophageal cancer. Methods & Materials: The PubMed (since its inception), Cochrane library (since its inception), EMBASE (since its inception),and ClinicalTrials.gov (since its inception) were searched till 1st December 2020 for the randomized controlled trials (RCTs) that evaluated the effectiveness and safety of PD-1 inhibitors for patients with esophageal cancer. Two investigators independently performed study selection, data extraction and assessment of the methodological quality. RevMan 5.3 was applied statistical analysis. Results Three RCTs were included for this meta-analysis ,with a total of 1477 patients. Compared with chemotherapy, PD-1 inhibitors had superior objective response rates(Odds ratio(OR) = 14.96, 95% confidence interval (CI):0.47,476.97; P = 0.13). PD-1 inhibitors group had better overall survival compared to chemotherapy group(Hazard ratio(HR):0.80,95% CI:0.70,0.91,P = 0.0007) .The progression-free survival (HR:0.94,95% CI:0.71,1.26,P = 0.69) were similar between the two groups. The grade 3 or more adverse events rate were lower in the PD-1 inhibitors group as compared to those of chemotherapy group(OR:0.25,95% CI:0.13,0.46,P < 0.0001). Conclusions Our study indicated that PD-1 inhibitors are efficacious and safe for the management of EC refractory or intolerant to previous chemotherapy.

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Perioperative immunonutrition in esophageal cancer patients undergoing esophagectomy: the first meta-analysis of randomized clinical trials

Diseases of the Esophagus ◽

10.1093/dote/doz111 ◽

2020 ◽

Vol 33 (4) ◽

Author(s):

Wang Mingliang ◽

Ke Zhangyan ◽

Fan Fangfang ◽

Wang Huizhen ◽

Li Yongxiang

Keyword(s):

Esophageal Cancer ◽

Randomized Controlled Trials ◽

Anastomotic Leakage ◽

Large Scale ◽

Randomized Clinical Trials ◽

Meta Analysis ◽

Cochrane Library ◽

Controlled Trials ◽

Randomized Controlled ◽

Significant Difference

Summary Although several randomized controlled trials have been published in recent years, the effect of perioperative immunonutrition in esophageal cancer (EC) patients remains unclear. This initial meta-analysis was conducted to assess whether perioperative enteral immunonutrition reduces postoperative complications in patients undergoing esophagectomy for EC. Relevant randomized controlled trials published before 1st September 2019 were retrieved from the Cochrane Library, PubMed, and EMBASE databases. After the literature was screened, two researchers extracted the information and data from eligible studies according to predefined selection criteria. Obtained data were pooled and analyzed by RevMan 5.3 software. The results were presented as risk ratios (RRs) with 95% confidence intervals (CIs). The heterogeneity among studies was tested by I2 test. Seven high-quality randomized controlled trials were included, with a total of 606 patients, 311 of whom received immunonutrition before and after surgery, while 295 received perioperative standard nutrition. No significant difference was observed between the two groups in the incidence of postoperative infection complications, including total infection complications (RR = 0.97, CI: 0.78–1.20, P = 0.76), pneumonia (RR = 0.97, CI: 0.71–1.33, P = 0.84), wound infection (RR = 0.80, CI: 0.46–1.40, P = 0.44), sepsis (RR = 1.35, CI: 0.67–2.71, P = 0.40), and urinary tract infection (RR = 0.87, CI: 0.54–1.40, P = 0.56). The prevalence of anastomotic leakage in the two groups was 9.4 and 5.4%, but the difference was not statistically significant (RR = 0.59, CI: 0.33–1.04, P = 0.07). Perioperative enteral immunonutrition provided no benefit in terms of the incidence of infection complications and anastomotic leakage in EC patients undergoing esophagectomy. Further large-scale randomized controlled trials are needed to confirm this conclusion.

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