Management of advanced gastric cancer: An overview of major findings from meta-analysis

// Xiaolong Qi 1,* , Yanna Liu 1,* , Wei Wang 2,* , Danxian Cai 1 , Wende Li 3 , Jialiang Hui 1 , Chuan Liu 1 , Yanxia Zhao 4 and Guoxin Li 1 1 Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China 2 Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China 3 Guangdong Laboratory Animal Monitoring Institute, Guangzhou, China 4 Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China * These authors contributed equally to this work Correspondence to: Xiaolong Qi, email: // Guoxin Li, email: // Yanxia Zhao, email: // Keywords : advanced gastric cancer, management, surgery, chemotherapy, meta-analysis Received : June 30, 2016 Accepted : August 26, 2016 Published : September 17, 2016 Abstract This study aims to provide an overview of different treatment for advanced gastric cancer. In the present study, we systematically reviewed the major findings from relevant meta-analyses. A total of 54 relevant papers were searched via the PubMed, Web of Science, and Google scholar databases. They were classified according to the mainstay treatment modalities such as surgery, chemotherapy and others. Primary outcomes including overall survival, response rate, disease-free survival, recurrence-free survival, progression-free survival, time-to-progression, time-to failure, recurrence and safety were summarized. The recommendations and uncertainties regarding the treatment of advanced gastric cancer were also proposed. It was suggested that laparoscopic gastrectomy was a safe and technical alternative to open gastrectomy. Besides, neoadjuvant chemotherapy and adjuvant chemotherapy were thought to benefit the survival over surgery alone. And it was demonstrated in the study that targeted therapy like anti-angiogenic and anti-HER2 agents but anti-EGFR agent might have a significant survival benefit.