Send to

Choose Destination
J BUON. 2019 Jan-Feb;24(1):201-214.

Neoadjuvant chemotherapy brings more survival benefits than postoperative chemotherapy for resectable gastric cancer: a Meta-analysis of randomized controlled trials.

Author information

Department of Oncology, Qilu Hospital, Shandong University, Jinan, China.



To find out which treatment, neoadjuvant chemotherapy (NAC) or postoperative chemotherapy (PAC), can bring greater survival benefits to gastric cancer patients.


Pubmed, Embase and Cochrane Library databases were searched for randomized controlled trials (RCTs)about multidisciplinary treatment of resectable gastric cancer (NAC vs PAC, NAC + surgery vs surgery alone, and surgery alone vs surgery + PAC). Quality was assessed by collaboration recommendation in Cochrane. All outcomes were evaluated by odds ratio (OR) and 95% confidence interval (CI). Pairwise comparisons were conducted by R3.12 software. Aggregate Data Drug Information System (ADDIS software 1.16.5) was used to perform network meta-analysis.


Simple meta-analysis showed NAC could bring more survival benefits than PAC for resectable gastric cancer. NAC was significantly better than PAC in 1-year (I2=0, p=0.4085, fixed effects model, OR=2.28, 95%CI: 1.27-4.04), 3-year (I2=0,p=0.6979,fixed effects model, OR=2.10, 95%CI: 1.09-4.03), and 5-year survival (I2=37.8%, p=0.2048,fixed effects model, OR=2.04, 95%CI: 1.03-4.06). Network meta-analysis showed NAC + surgery was better compared with surgery + PAC and surgery alone. NAC + surgery were significantly better than surgery + PAC and surgery alone in 1-year or 3-year survival. For 5-year survival, NAC + surgery were significantly better than surgery alone, but no significant difference was observed when compared with surgery + PAC. NAC + surgery ranked first in 1-year, 3-year and 5-year probability sequence diagram.


NAC brings greater survival benefits than PAC for patients with resectable gastric cancer.


Supplemental Content

Loading ...
Support Center