Esophagectomy versus definitive chemoradiotherapy as initial treatment for clinical stage I esophageal cancer: a systematic review and meta-analysis
| Autor: | Li-Xiang Mei, Lei Dai, Jun-Xian Mo, Yong Chen, Yongyong Wang, Mingwu Chen |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Esophageal Neoplasms medicine.medical_treatment Cochrane Library Lower risk Gastroenterology law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Internal medicine medicine Humans business.industry Hazard ratio General Medicine Odds ratio Chemoradiotherapy Esophagectomy 030220 oncology & carcinogenesis Meta-analysis 030211 gastroenterology & hepatology Neoplasm Recurrence Local business |
| Zdroj: | Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus. 35(3) |
| ISSN: | 1442-2050 |
| Popis: | Background Esophagectomy and definitive chemoradiotherapy are commonly used in the treatment of stage I esophageal cancer (EC). The present study aims to compare the efficacy and safety of esophagectomy and definitive chemoradiotherapy as the initial treatment for clinical stage I EC. Methods This study was registered with the International Prospective Register of Systematic Reviews (CRD42020197203). Relevant studies were identified through PubMed, Web of Science, EMBASE, and Cochrane Library from database inception to June 30, 2020. Hazard ratio (HR) with 95% confidence intervals (CI) was employed to compare overall survival (OS) and progression-free survival (PFS). Odds ratio (OR) with 95% CI was employed to compare treatment-related death, complications, and tumor recurrence. Results A total of 13 non-randomized controlled studies involving 3,346 patients were included. Compared with definitive chemoradiotherapy, esophagectomy showed an improved OS (HR 0.69, 95% CI 0.55–0.86; P Conclusions Current evidence shows esophagectomy has superior survival benefits as the initial treatment for clinical stage I EC. It is still the preferred choice for patients with clinical stage I EC. However, future high-quality randomized controlled trials are needed to validate this conclusion. |
| Databáze: | OpenAIRE |
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