Evaluation of Tumor Resectability Rate and Pathologic Response to Preoperative Concurrent Chemoradiotherapy in Locally Advanced Proximal Gastric and Esophagogastric Junction Adenocarcinomas: A Clinical Trial

Aledavood, Seyed Amir; Sales, Soodabe Shahid; Anvari, Kazem; Forghani, Maryam; Memar, Bahram; Torghabeh, Ali Emadi

doi:10.5812/ijcm.7473

Cited by 1 publication

(1 citation statement)

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“…The full‐text publications for the remaining 191 studies were reviewed. Of these, 84 studies 7,26–108 met the inclusion and exclusion criteria and were included in this systematic review and meta‐analysis, yielding a total of 6451 patients who received neoadjuvant therapy and had tumor response measured pathologically after surgery. Of the 84 included trials, 13 (15%) were published between 1992 and 2001, 31 (37%) between 2002 and 2011, and 41 (49%) between 2012 and 2022.…”

Section: Resultsmentioning

confidence: 99%

Pathologic complete response in patients with esophageal cancer receiving neoadjuvant chemotherapy or chemoradiation: A systematic review and meta‐analysis

Gaber,

Sarker,

Abdelaziz

et al. 2024

Cancer Medicine

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BackgroundNeoadjuvant chemoradiation and chemotherapy are recommended for the treatment of nonmetastatic esophageal cancer. The benefit of neoadjuvant treatment is mostly limited to patients who exhibit pathologic complete response (pCR). Existing estimates of pCR rates among patients receiving neoadjuvant therapy have not been synthesized and lack precision.MethodsWe conducted an independently funded systematic review and meta‐analysis (PROSPERO CRD42023397402) of pCR rates among patients diagnosed with esophageal cancer treated with neoadjuvant chemo(radiation). Studies were identified from Medline, EMBASE, and CENTRAL database searches. Eligible studies included trials published from 1992 to 2022 that focused on nonmetastatic esophageal cancer, including the gastroesophageal junction. Histology‐specific pooled pCR prevalence was determined using the Freeman–Tukey transformation and a random effects model.ResultsAfter eligibility assessment, 84 studies with 6451 patients were included. The pooled prevalence of pCR after neoadjuvant chemotherapy in squamous cell carcinomas was 9% (95% CI: 6%–14%), ranging from 0% to 32%. The pooled prevalence of pCR after neoadjuvant chemoradiation in squamous cell carcinomas was 32% (95% CI: 26%–39%), ranging from 8% to 66%. For adenocarcinoma, the pooled prevalence of pCR was 6% (95% CI: 1%–12%) after neoadjuvant chemotherapy, and 22% (18%–26%) after neoadjuvant chemoradiation.ConclusionsUnder one‐third of patients with esophageal cancer who receive neoadjuvant chemo(radiation) experience pCR. Patients diagnosed with squamous cell carcinomas had higher rates of pCR than those with adenocarcinomas. As pCR represents an increasingly utilized endpoint in neoadjuvant trials, these estimates of pooled pCR rates may serve as an important benchmark for future trial design.

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Section: Resultsmentioning

confidence: 99%