Identifying Optimal Surgical Intervention-Based Chemotherapy for Gastric Cancer Patients With Liver Metastases

BackgroundThis study aimed at evaluating the effects of surgical treatments-based chemotherapy in the treatment of gastric cancer with liver metastases (GCLM). It has not been established whether Liver-directed treatment (LDT) options such as hepatectomy and gastrectomy plus chemotherapy (HGCT), rad...

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Autores principales:	Min Sun, Hangliang Ding, Zhiqiang Zhu, Shengsheng Wang, Xinsheng Gu, Lingyun Xia, Tian Li
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	gastric cancer liver metastasis hepatectomy interventional therapy network analysis Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/80fb7cab37c8414b92b36d7d853ca6da
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spelling	oai:doaj.org-article:80fb7cab37c8414b92b36d7d853ca6da2021-12-01T13:18:10ZIdentifying Optimal Surgical Intervention-Based Chemotherapy for Gastric Cancer Patients With Liver Metastases2234-943X10.3389/fonc.2021.675870https://doaj.org/article/80fb7cab37c8414b92b36d7d853ca6da2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fonc.2021.675870/fullhttps://doaj.org/toc/2234-943XBackgroundThis study aimed at evaluating the effects of surgical treatments-based chemotherapy in the treatment of gastric cancer with liver metastases (GCLM). It has not been established whether Liver-directed treatment (LDT) options such as hepatectomy and gastrectomy plus chemotherapy (HGCT), radiofrequency ablation and gastrectomy plus chemotherapy (RFAG), transarterial chemoembolization and gastrectomy plus chemotherapy (TACEG), gastrectomy plus chemotherapy (GCT) enhance the survival of GCLM patients.MethodsWe performed systematic literature searches in PubMed, EMBASE, and Cochrane library from inception to September 2021. We created a network plot to comprehensively analyze the direct and indirect evidence, based on a frequentist method. A contribution plot was used to determine inconsistencies, a forest plot was used to evaluate therapeutic effects, the publication bias was controlled by funnel plot, while the value of surface under the cumulative ranking curves (SUCRA) was calculated to estimate rank probability.ResultsA total of 23 retrospective studies were identified, involving 5472 GCLM patients. For OS and 1-, 2-, 3-year survival rate of all trials, meta-analysis of the direct comparisons showed significant better for HGCT treatments compared with GCT or PCT. In the comparison of the 5 treatments for 1-, 2-, 3-year survival rate, HGCT and RFAG were found to be more effective than GCT and PCT, respectively. By OS and 2-, 3-year survival rate analysis, RFAG was identified as the best option, followed by HGCT, TACEG, GCT and PCT. By 1-year survival rate analysis, HGCT and RFAG were identified as the most effective options.ConclusionHGCT and RFAG has remarkable survival benefits for GCLM patients when compared to TACEG, GCT and PCT. HGCT was found to exhibit superior therapeutic effects for GCLM patients for 1-year survival rate while RFAG was found to be a prospective therapeutic alternative for OS and 2-, 3-year survival rate.Systematic Review Registrationidentifier [10.37766/inplasy2020.12.0009].Min SunMin SunMin SunHangliang DingZhiqiang ZhuShengsheng WangXinsheng GuLingyun XiaTian LiTian LiFrontiers Media S.A.articlegastric cancerliver metastasishepatectomyinterventional therapynetwork analysisNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENFrontiers in Oncology, Vol 11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	gastric cancer liver metastasis hepatectomy interventional therapy network analysis Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	gastric cancer liver metastasis hepatectomy interventional therapy network analysis Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Min Sun Min Sun Min Sun Hangliang Ding Zhiqiang Zhu Shengsheng Wang Xinsheng Gu Lingyun Xia Tian Li Tian Li Identifying Optimal Surgical Intervention-Based Chemotherapy for Gastric Cancer Patients With Liver Metastases
description	BackgroundThis study aimed at evaluating the effects of surgical treatments-based chemotherapy in the treatment of gastric cancer with liver metastases (GCLM). It has not been established whether Liver-directed treatment (LDT) options such as hepatectomy and gastrectomy plus chemotherapy (HGCT), radiofrequency ablation and gastrectomy plus chemotherapy (RFAG), transarterial chemoembolization and gastrectomy plus chemotherapy (TACEG), gastrectomy plus chemotherapy (GCT) enhance the survival of GCLM patients.MethodsWe performed systematic literature searches in PubMed, EMBASE, and Cochrane library from inception to September 2021. We created a network plot to comprehensively analyze the direct and indirect evidence, based on a frequentist method. A contribution plot was used to determine inconsistencies, a forest plot was used to evaluate therapeutic effects, the publication bias was controlled by funnel plot, while the value of surface under the cumulative ranking curves (SUCRA) was calculated to estimate rank probability.ResultsA total of 23 retrospective studies were identified, involving 5472 GCLM patients. For OS and 1-, 2-, 3-year survival rate of all trials, meta-analysis of the direct comparisons showed significant better for HGCT treatments compared with GCT or PCT. In the comparison of the 5 treatments for 1-, 2-, 3-year survival rate, HGCT and RFAG were found to be more effective than GCT and PCT, respectively. By OS and 2-, 3-year survival rate analysis, RFAG was identified as the best option, followed by HGCT, TACEG, GCT and PCT. By 1-year survival rate analysis, HGCT and RFAG were identified as the most effective options.ConclusionHGCT and RFAG has remarkable survival benefits for GCLM patients when compared to TACEG, GCT and PCT. HGCT was found to exhibit superior therapeutic effects for GCLM patients for 1-year survival rate while RFAG was found to be a prospective therapeutic alternative for OS and 2-, 3-year survival rate.Systematic Review Registrationidentifier [10.37766/inplasy2020.12.0009].
format	article
author	Min Sun Min Sun Min Sun Hangliang Ding Zhiqiang Zhu Shengsheng Wang Xinsheng Gu Lingyun Xia Tian Li Tian Li
author_facet	Min Sun Min Sun Min Sun Hangliang Ding Zhiqiang Zhu Shengsheng Wang Xinsheng Gu Lingyun Xia Tian Li Tian Li
author_sort	Min Sun
title	Identifying Optimal Surgical Intervention-Based Chemotherapy for Gastric Cancer Patients With Liver Metastases
title_short	Identifying Optimal Surgical Intervention-Based Chemotherapy for Gastric Cancer Patients With Liver Metastases
title_full	Identifying Optimal Surgical Intervention-Based Chemotherapy for Gastric Cancer Patients With Liver Metastases
title_fullStr	Identifying Optimal Surgical Intervention-Based Chemotherapy for Gastric Cancer Patients With Liver Metastases
title_full_unstemmed	Identifying Optimal Surgical Intervention-Based Chemotherapy for Gastric Cancer Patients With Liver Metastases
title_sort	identifying optimal surgical intervention-based chemotherapy for gastric cancer patients with liver metastases
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/80fb7cab37c8414b92b36d7d853ca6da
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Identifying Optimal Surgical Intervention-Based Chemotherapy for Gastric Cancer Patients With Liver Metastases

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