AIMS: To assess the efficacy and safety of neoadjuvant chemotherapy (NAC) for advanced @entity356 (AGC). METHODS: By searching electronic databases (PubMed, Embase, Cochrane Library) and ASCO proceedings from 1990 to 2012, all randomized controlled trials (RCTs) which compared the effect of NAC-combined surgery versus surgery alone in AGC were included. All calculations and statistical tests were performed using RevMan 5.0 software. RESULTS: 12 RCTs with a total of 1820 @entity1 were included. All @entity1 had locally advanced but resectable @entity356 and received NAC. NAC can slightly improve the survival rate (OR = 1.32, 95% confidence interval (CI): 1.07-1.64, P = 0.01), with little or no significant benefits in subgroup analyses between either different population or regimens. NAC can significantly improve the 3-year progression-free survival (PFS) (OR: 1.85, 95% CI: 1.39-2.46, p < 0.0001), @entity5 down-staging rate (OR: 1.71, 95% CI: 1.26, 2.33, p = 0.0006) and R0 resection rate (OR: 1.38, 95% CI: 1.08-1.78, P = 0.01) of @entity1 with AGC. There was no difference between the two arms, in terms of relapse rates (OR: 1.03, 95% CI: 0.60-1.78, p = 0.92), operative complications (OR: 1.20, 95% CI: 0.90-1.58, p = 0.21), perioperative mortality (OR: 1.14, 95% CI: 0.64-2.05, p = 0.65) and grade 3/4 adverse effects: gastrointestinal problem (OR: 0.57, 95% CI: 0.25-1.30, p = 0.18), @entity1431 (OR: 0.88, 95% CI: 0.41-1.91, p = 0.75), @entity882 (OR: 1.27, 95% CI: 0.27-5.93, p = 0.76). CONCLUSION: NAC is effective and safe. However, further prospective multi-national and multi-center RCTs are still needed in order to investigate the long-term oncological and functional outcomes to define the clinical benefits of NAC and the most effective strategies for AGC.

Clinical effectiveness of neoadjuvant chemotherapy in advanced XXXX : an updated meta-analysis of randomized controlled trials.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity882 :: ('MESH:D013921', 'Disease') :: ['thrombocytopenia'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor'] @entity1431 :: ('MESH:D007970', 'Disease') :: ['leukopenia'] @entity356 :: ('MESH:D013274', 'Disease') :: ['gastric cancer']
@entity356 :: (MESH:D013274,Disease) :: ['gastric cancer']
