Neoadjuvant chemotherapy for patients with resectable colorectal cancer liver metastases: A systematic review and meta-analysis

作     者：Yue Zhang Long Ge Jun Weng Wen-Yu Tuo Bin Liu Shi-Xun Ma Ke-Hu Yang Hui Cai 

作者机构：General Surgery Clinical Medical CenterGansu Provincial HospitalLanzhou 730000Gansu ProvinceChina Evidence Based Social Science Research CenterSchool of Public HealthLanzhou UniversityLanzhou 730000Gansu ProvinceChina 

出 版 物：《World Journal of Clinical Cases》 (世界临床病例杂志)

年 卷 期：2021年第9卷第22期

页      面：6357-6379页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：Supported by the Natural Science Foundation of Gansu Province,China,No.18JR3RA052 the Gansu Province Da Vinci Robot High End Diagnosis and Treatment Personnel Training Project the National Key Research and Development Program Task Book,No.2018YFC1311506 the Lanzhou Talent Innovation and Entrepreneurship Project Task Contract,No.2016-RC-56 

主　　题：Colorectal neoplasm Neoadjuvant chemotherapy Systematic review Randomized controlled trials Meta-analysis Colorectal liver metastases 

摘      要：BACKGROUND In recent years,neoadjuvant chemotherapy(NAC)has been increasingly used in patients with resectable colorectal liver ***,the efficacy and safety of NAC in the treatment of resectable colorectal liver metastases(CRLM)are still *** To assess the efficacy and application value of NAC in patients with resectable *** We searched PubMed,Embase,Web of Science,and the Cochrane Library from inception to December 2020 to collect clinical studies comparing NAC with *** processing and statistical analyses were performed using Stata V.15.0 and Review Manager 5.0 *** In total,32 studies involving 11236 patients were included in this *** divided the patients into two groups,the NAC group(that received neoadjuvant chemotherapy)and the non-NAC group(that received no neoadjuvant chemotherapy).The meta-analysis outcome showed a statistically significant difference in the 5-year overall survival and 5-year disease-free survival between the two *** hazard ratio(HR)and 95%confidence interval(CI)were HR=0.49,95%CI:0.39-0.61,P=0.000 and HR=0.4895%CI:0.36-0.63,P=*** duration of surgery in the NAC group was longer than that of the non-NAC group[standardized mean difference(SMD)=0.41,95%CI:0.01-0.82,P=0.044)].The meta-analysis showed that the number of liver metastases in the NAC group was significantly higher than that in the non-NAC group(SMD=0.73,95%CI:0.02-1.43,P=0.043).The lymph node metastasis in the NAC group was significantly higher than that in the non-NAC group(SMD=1.24,95%CI:1.07-1.43,P=0.004).CONCLUSION We found that NAC could improve the long-term prognosis of patients with resectable *** the same time,the NAC group did not increase the risk of any adverse event compared to the non-NAC group.