To assess the association between NCRTS and survival outcomes and evaluate whether the newly published or updated clinical trials can influence the results of our previous study, a comprehensive search of randomized clinical trials (RCTs) comparing NCRTS versus SA was carried out, and an up-to-date meta-analysis was performed in this study.
sup] The criteria for eligibility of the studies were as follows: (1) RCTs evaluating NCRTS versus SA; (2) articles that provided survival data between patients from the NCRTS and SA groups; (3) articles that described the cases and controls in the diagnosis and the sources; and (4) having risk ratio ( RR ) with 95% confidence interval ( CI ) or data that could be calculated.
The following data were extracted from newly included RCTs by two investigators independently: number of participants, publication time, country, tumor histology, NCRTS regimen and sequence (concurrent CRTS or sequential CRTS), patient outcomes including 1-, 3-, and 5-year SRs, and postoperative morbidity and mortality.
A total of 14 studies reported the effect of NCRTS versus SA and the 1-year SR.
The data for the effect of NCRTS on postoperative morbidity were available from 13 studies.
Although nonsignificant heterogeneity was observed for the outcomes, we conducted subgroup analyses for 1-, 3-, and 5-year SRs to evaluate the effect of NCRTS in specific subpopulations [Table 2].
This updated meta-analysis for survival benefits of NCRTS included the data from previously published studies and five new RCTs, with 80% more patients in comparison with the previous meta-analysis.
The results of the previously published meta-analysis indicated that NCRTS increased the SR in patients with EC, which were similar to this updated meta-analysis.
This updated meta-analysis indicated that the recurrence patterns in EC patients treated with NCRTS showed a lower recurrence rate, compared to the SA group.