Meta-analysis?the Effects Of Neoadjuvant Chemotherapy For Radical Resection Rates And 5-years Urvival Rates Of The Patients With Gastric Cancer

[Objective]To evaluate the effects of neoadjuvant chemotherapy(NAC)on 5-year survival and R0 resection rates of patients with gastric cancer by META-analysis,so as to provide evidence for the choice of optimal surgical therapeutic schedule.[Method]Clinical randomized trials on neoadjuvant chemotherapy for gastric cancer in MEDLINE,Cochrane Library,CNKI?Ovid?Wanfang System were searched.Metaanalysis was carried out by collecting information based on inclusion and exclusion criteria from all trails available,and the publication bias analysis and the susceptivity analysis were also performed to evaluate the stability of the results.[Results]Seven RCTs were selected.A total of 1584 patients were available for analysis,with 764 in the neoadjuvant chemotherapy plus surgery group and 820 in the surgery alone group.As to R0 resection,an odds ratio of 1.47(95 per cent c.i 1.15 to 1.88)was obtained.The NAC group tended to have a higher R0 resection rate 47%(P=0.002).As to 5-year survival,an odds ratio of 1.39(95 per cent c.i 1.09 to 1.78)was obtained.The NAC group tended to have a higher 5-year survival rate of 39%(P=0.008).[Conclusion]Neoadjuvant chemotherapy might increase R0 resection rate and 5-year survival of patients with locally advanced gastric cancer.Well-designed RCTs are still needed to confirm its efficacy and survival benefit.