P-OGC48 Definitive Chemoradiotherapy versus Neoadjuvant Chemoradiotherapy Followed by Radical Surgery for Locally Advanced Esophageal Squamous Cell Carcinoma: Systematic Review and Meta-analysis

Abstract Background Debate exists surrounding definitive chemoradiotherapy (dCRT) over neoadjuvant and surgery (nCRS) as a primary treatment for esophageal squamous cell carcinoma (ESCC) owing to the heterogeneity in quality of current evidence. This study aimed compare long-term survival dCRT with nCRT ESCC from high-quality studies. Methods systematic review was performed according PRISMA guidelines eligible studies were identified through search PubMed, Scopus Cochrane CENTRAL databases up 23rd July 2021. Primary outcome overall (OS) secondary outcomes disease-free (DFS) recurrence rates. A meta-analysis conducted using random-effects modelling determine pooled adjusted multivariable hazard ratios (HRs). Results included ten including 14,092 patients, which 30% received nCRT. Three randomized controlled trials (RCT), six single-center. regimens reported surgical control two Outcomes OS DFS eight three studies, respectively. had significantly longer (HR: 0.68, CI95%: 0.54 - 0.87, p < 0.001) 0.50, 0.36 0.70, than dCRT. Conclusions nCRS followed by planned esophagectomy appears remain optimum curative regime patients loco-regional ESCC. Thus, remains an integral component management As adjuvant immunotherapy develop, ongoing prospective assessment role radiotherapy combination modern modalities should be studied