Affiliation: School of Medicine, Department of Allied Health Sciences, Physician Assistant Program
Purpose: Gastric cancer is the third leading cause of cancer-related death worldwide. From 1974-1975,
patients who received gastric resection only had a 5-year survival rate of 15.3%.16 With the introduction
of chemoradiotherapy, the 5-year survival rate increased to 23.2% from 1995-2001.16 One question
which can be imposed is how necessary is neoadjuvant chemotherapy in addition to surgery compared
to surgery then adjuvant chemoradiotherapy in improvement of 5-year survivability of a gastric
Methods and Materials: 7 random control trials using neoadjuvant chemotherapy and 2 random control
trials using adjuvant chemoradiotherapy were examined using a network meta-analysis to determine
which was the more beneficial for 3-year, 5-year, and Overall Survival. Secondary outcome was to
determine which caused more life-altering side effects
Results: There was no statistical benefit found in the use of adjuvant chemoradiotherapy over the use of
neoadjuvant chemotherapy. The 5-year and Overall mortality were consistently higher in the adjuvant
chemoradiotherapy group, but the strength of data in the network meta-analysis was inconclusive.
Conclusion: Further study the use of neoadjuvant chemotherapy plus surgery in the treatment of gastric
adenocarcinomas in order to improve quality of life for the patients is recommended as well as further
study of adjuvant chemoradiotherapy to improve survivability.