This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS

Meta‐analysis of postoperative morbidity and perioperative mortality in patients receiving neoadjuvant chemotherapy or chemoradiotherapy for resectable oesophageal and gastro‐oesophageal junctional cancers. BJS 2014; 101: 321-338.

Published: 3rd February 2014

Authors: K. Kumagai, I. Rouvelas, J. A. Tsai, D. Mariosa, F. Klevebro, M. Lindblad et al.

Background

The long‐term survival benefits of neoadjuvant chemotherapy (NAC) and chemoradiotherapy (NACR) for oesophageal carcinoma are well established. Both are burdened, however, by toxicity that could contribute to perioperative morbidity and mortality.

Method

MEDLINE, the Cochrane Library and Embase were searched to capture the incidence of any postoperative complications, cardiac complications, respiratory complications, anastomotic leakage, postoperative 30‐day mortality, total postoperative mortality and treatment‐related mortality in randomized clinical trials comparing NAC or NACR with surgery alone, or NAC versus NACR. Meta‐analyses comparing NAC and NACR were conducted by using adjusted indirect comparison.

Results

Twenty‐three relevant studies were identified. Comparing NAC or NACR with surgery alone, there was no increase in morbidity or mortality attributable to neoadjuvant therapy. Subgroup analysis of NACR for squamous cell carcinoma (SCC) suggested an increased risk of total postoperative mortality and treatment‐related mortality compared with surgery alone: risk ratio 1·95 (95 per cent confidence interval 1·06 to 3·60; P = 0·032) and 1·97 (1·07 to 3·64; P = 0·030) respectively. A combination of direct comparison and adjusted indirect comparison showed no difference between NACR and NAC regarding morbidity or mortality.

Conclusion

Neither NAC nor NACR for oesophageal carcinoma increases the risk of postoperative morbidity or perioperative mortality compared with surgery alone. There was no clear difference between NAC and NACR. Care should be taken with NACR in oesophageal SCC, where an increased risk of postoperative mortality and treatment‐related mortality was apparent.

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Meta‐analysis of postoperative morbidity and perioperative mortality in patients receiving neoadjuvant chemotherapy or chemoradiotherapy for resectable oesophageal and gastro‐oesophageal junctional cancers. BJS 2014; 101: 321-338.

Background

Method

Results

Conclusion

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Morphological lymphocytic reaction, patient prognosis and PD‐1 expression after surgical resection for oesophageal cancer. BJS 2019; 106: 1352-1361.

Quality of life from a randomized trial of laparoscopic or open liver resection for colorectal liver metastases. BJS 2019; 106: 1372-1380.

Effect of neoadjuvant chemoradiation on preoperative pulmonary physiology, postoperative respiratory complications and quality of life in patients with oesophageal cancer. BJS 2019; 106: 1341-1351.

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