Local recurrence of esophageal squamous cell carcinoma after treatment: Comparison of frequentist and Bayesian network meta-analysis

Abstract

Background: We aimed to compare the treatments of esophageal cancer in association with the risk of disease recurrence, and to compare the frequentist and Bayesian methods in data analysis. Methods: Web of Science, Medline, Scopus, the Cochrane Library and EMBASE were searched. We assessed statistical heterogeneity, and the assumption of consistency was assessed using loop-specific and design-bytreatment interaction methods. The Markov chain Monte Carlo method was used to obtain the pooled estimates of effect size in the Bayesian approach. The random effect model was used to report the pooled Risk Ratios (RR). The results of this study were reported with 95% Confidence Interval (CI), and Credible interval (CrI). Results: We included 17 randomized controlled trials (RCTs) that reported the local recurrence of esophageal cancer. The RR of local recurrence for surgery plus paclitaxel, cisplatin, and radiotherapy (SPCRT) compared to surgery alone was 0.42 (95% CI: 0.21, 0.88). The RR for SPCRT compared with surgery plus cisplatin and vindesine (SCV) was 0.38 (95% CI: 0.12, 1.18). Compared to cisplatin, fluorouracil, and radiotherapy plus surgery (CFRTS), SPCRT was a better treatment (RR = 0.46, 95% CI: 0.17, 1.24). Conclusions: This network meta-analysis indicated that SPCRT compared to surgery alone and other treatments was a better treatment. In terms of ranking, SPCRT and radiotherapy plus surgery (RTS) were the first and second treatments in the network. It seems the precision of frequentist is better than Bayesian approach, however, the results of the ranking of treatments were same in both frequentist and Bayesian approaches.