Adjuvant chemotherapy after curative resection for gastric cancer in non-Asian patients: Revisiting a meta-analysis of randomised trials

The aim of this study was to assess whether adjuvant chemotherapy after cur ative resection of gastric cancer increases survival rates. Data sources: M EDLINE (1966-1999), CancerLit (1983-1999), bibliographies, personal reprint files, and review articles were searched for relevant articles. Studies ha d to be randomised controlled trials of adjuvant chemotherapy versus observ ation following curative resection of stomach cancer that took place in non -Asian countries. Two reviewers independently evaluated the trials for elig ibility, quality assessment and data abstraction. 13 trials met the eligibi lity criteria. The odds ratio for death in the treated group was 0.80 (95% confidence interval (CI) 0.66-0.97), corresponding to a relative risk of 0. 94 (95% CI 0.89-1.00), Subgroup analyses showed a trend towards a larger ma gnitude of the effect when analysis was restricted to trials in which at le ast 2/3 of patients had node-positive disease. Our results suggest that adj uvant chemotherapy may produce a small survival benefit of borderline stati stical significance in patients with curatively resected gastric carcinoma. Continued trials to find and confirm an effective adjuvant strategy are wa rranted. (C) 1999 Elsevier Science Ltd. All rights reserved.