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Article

Prognostic and Predictive Factors for the Curative Treatment of Esophageal and Gastric Cancer in Randomized Controlled Trials: A Systematic Review and Meta-Analysis

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Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University Medical Centers, (UMC) location AMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
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Department of Surgery, Cancer Center Amsterdam, Amsterdam University Medical Centers, (UMC) location AMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
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Department of Radiotherapy, Cancer Center Amsterdam, Amsterdam University Medical Centers (UMC), Location AMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
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Author to whom correspondence should be addressed.
Cancers 2019, 11(4), 530; https://doi.org/10.3390/cancers11040530
Received: 2 February 2019 / Revised: 5 April 2019 / Accepted: 9 April 2019 / Published: 12 April 2019
Background: An overview of promising prognostic variables and predictive subgroups concerning the curative treatment of esophageal and gastric cancer from randomized controlled trials (RCTs) is lacking. Therefore, we conducted a systematic review and meta-analysis. Methods: PubMed, EMBASE, CENTRAL, and ASCO/ESMO conferences were searched up to March 2019 for RCTs on the curative treatment of esophageal or gastric cancer with data on prognostic and/or predictive factors for overall survival. Prognostic factors were deemed potentially clinically relevant according to the following criteria; (1) statistically significant (p < 0.05) in a multivariate analysis, (2) reported in at least 250 patients, and (3) p < 0.05, in ≥33% of the total number of patients in RCTs reporting this factor. Predictive factors were potentially clinically-relevant if (1) the p-value for interaction between subgroups was <0.20 and (2) the hazard ratio in one of the subgroups was significant (p < 0.05). Results: For gastric cancer, 39 RCTs were identified (n = 13,530 patients) and, for esophageal cancer, 33 RCTs were identified (n = 8618 patients). In total, we identified 23 potentially clinically relevant prognostic factors for gastric cancer and 16 for esophageal cancer. There were 15 potentially clinically relevant predictive factors for gastric cancer and 10 for esophageal cancer. Conclusion: The identified prognostic and predictive factors can be included and analyzed in future RCTs and be of guidance for nomograms. Further validation should be performed in large patient cohorts. View Full-Text
Keywords: prognosis; chemotherapy; adjuvant; neoadjuvant therapy; stomach neoplasms; esophageal neoplasms prognosis; chemotherapy; adjuvant; neoadjuvant therapy; stomach neoplasms; esophageal neoplasms
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MDPI and ACS Style

van den Ende, T.; ter Veer, E.; Mali, R.M.A.; van Berge Henegouwen, M.I.; Hulshof, M.C.C.M.; van Oijen, M.G.H.; van Laarhoven, H.W.M. Prognostic and Predictive Factors for the Curative Treatment of Esophageal and Gastric Cancer in Randomized Controlled Trials: A Systematic Review and Meta-Analysis. Cancers 2019, 11, 530. https://doi.org/10.3390/cancers11040530

AMA Style

van den Ende T, ter Veer E, Mali RMA, van Berge Henegouwen MI, Hulshof MCCM, van Oijen MGH, van Laarhoven HWM. Prognostic and Predictive Factors for the Curative Treatment of Esophageal and Gastric Cancer in Randomized Controlled Trials: A Systematic Review and Meta-Analysis. Cancers. 2019; 11(4):530. https://doi.org/10.3390/cancers11040530

Chicago/Turabian Style

van den Ende, Tom, Emil ter Veer, Rosa M.A. Mali, Mark I. van Berge Henegouwen, Maarten C.C.M. Hulshof, Martijn G.H. van Oijen, and Hanneke W.M. van Laarhoven 2019. "Prognostic and Predictive Factors for the Curative Treatment of Esophageal and Gastric Cancer in Randomized Controlled Trials: A Systematic Review and Meta-Analysis" Cancers 11, no. 4: 530. https://doi.org/10.3390/cancers11040530

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