Time to Surgery does not Affect Oncologic Outcomes in Locally Advanced Gastric Cancer after Neoadjuvant Chemotherapy: A Meta-Analysis

Abstract

Aim: The authors conducted a meta-analysis to determine the association between time-to-surgery (TTS) after neoadjuvant chemotherapy and patient outcomes in locally advanced gastric cancer. Methods: Electronic databases were searched to identify potential studies, in which the authors compared patient outcomes between those with TTS within 4 (and 6) weeks of completion of neoadjuvant chemotherapy and those after 4 (and 6) weeks. Results: Six studies, including 1238 patients, were eligible for inclusion. Pooled data showed no significant differences in rates of pathological complete response, major pathological response, ypN0, complications, R0 resection and operative time between groups of longer TTS and shorter TTS. Conclusion: There was no statistically advantageous impact of prolonged TTS on pathological and surgical outcomes. Large, population-based studies are warranted.

Textbook Neoadjuvant Outcome—Novel Composite Measure of Oncological Outcomes among Gastric Cancer Patients Undergoing Multimodal Treatment

“…A recent meta-analysis of retrospective observational studies that included 1171 patients undergoing gastrectomy after NAC within three timeframes-4-6 weeks, <4 weeks, and >6 weeks-reported comparable outcomes in terms of complete PR, R0 resection rate, and the incidence of serious postoperative complications, as well as 3-year progression-free survival (PFS) and OS [82]. A subsequent meta-analysis compared patient outcomes between TTS within 4-6 weeks and 4-6 weeks after NAC completion among patients with locally advanced GC [83]. Pooled data were not associated with significant differences in major and complete PR rates, ypN0, postoperative complications, R0 resection rates, and operative time between groups of longer TTS and shorter TTS.…”