Survival and Complications After Neoadjuvant Chemotherapy or Chemoradiotherapy for Esophageal Cancer: A Meta-Analysis

Abstract

<b>Objectives:</b> To identify the effective approach between neoadjuvant chemotherapy (NCT) and chemoradiotherapy (NCRT) by comparing patient survival and complications. <b>Methods:</b> A systematic literature search of articles published between January 1980 and October 2020 was conducted. Data were extracted and analyzed with STATA 12.0. <b>Results:</b> Five randomized trials and 15 retrospective studies, including 4529 patients (NCT: 2035; NCRT: 2494), were enrolled. Compared with NCT, NCRT provided a higher 3-year survival benefit, higher R0 resection and pathological complete response rates and lower local recurrence and distant metastasis rates, but no increase in 5-year survival. Perioperative mortality and cardiovascular complications were more common in patients with adenocarcinoma. <b>Conclusions:</b> Further studies should concentrate on identifying the optimal neoadjuvant approach and suitable beneficiaries.