Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

2,293 questions · 2,395 findings · 172 reviews · Gut

No studies found 420 · 17.5%GRADE not reported 60 · 2.5%Very low 821 · 34.3%Low 602 · 25.1%Moderate 397 · 16.6%High 95 · 4%

Perioperative chemotherapy vs primary surgery

Tumor stage at resection (N0 vs N+) · resectable adenocarcinoma of the stomach, gastroesophageal junction, and lower esophagus

Perioperative chemotherapy may leads to higher tumor stage at resection (N0 vs N+) compared with primary surgery (low certainty).

1 finding from 1 review

Perioperative chemotherapy vs primary surgery

Disease-free survival · resectable adenocarcinoma of the stomach, gastroesophageal junction, and lower esophagus

Perioperative chemotherapy showed no clear difference in disease‐free survival (landmark time 6 months) compared with primary surgery (high certainty).

1 finding from 1 review

Perioperative chemotherapy vs primary surgery

Overall survival by type of data ‐ Individual patient data · resectable adenocarcinoma of the stomach, gastroesophageal junction, and lower esophagus

Perioperative chemotherapy leads to lower overall survival by type of data ‐ Individual patient data compared with primary surgery (high certainty).

1 finding from 1 review

Perioperative chemotherapy vs primary surgery

Overall survival by type of data ‐ Aggregated data · resectable adenocarcinoma of the stomach, gastroesophageal junction, and lower esophagus

Perioperative chemotherapy probably leads to lower overall survival by type of data ‐ Aggregated data compared with primary surgery (moderate certainty).

1 finding from 1 review

Perioperative chemotherapy vs primary surgery

Overall survival by tumor site ‐ Esophagus · resectable adenocarcinoma of the stomach, gastroesophageal junction, and lower esophagus

Perioperative chemotherapy showed no clear difference in overall survival by tumor site ‐ Esophagus compared with primary surgery (high certainty).

1 finding from 1 review

Perioperative chemotherapy vs primary surgery

Overall survival by tumor site ‐ GE junction · resectable adenocarcinoma of the stomach, gastroesophageal junction, and lower esophagus

Perioperative chemotherapy leads to lower overall survival by tumor site ‐ GE junction compared with primary surgery (high certainty).

1 finding from 1 review

Perioperative chemotherapy vs primary surgery

Overall survival by tumor site ‐ Stomach · resectable adenocarcinoma of the stomach, gastroesophageal junction, and lower esophagus

Perioperative chemotherapy showed no clear difference in overall survival by tumor site ‐ Stomach compared with primary surgery (high certainty).

1 finding from 1 review

Perioperative chemotherapy vs primary surgery

Overall survival by chemo‐/radiotherapy ‐ Chemotherapy only · resectable adenocarcinoma of the stomach, gastroesophageal junction, and lower esophagus

Perioperative chemotherapy leads to lower overall survival by chemo‐/radiotherapy ‐ Chemotherapy only compared with primary surgery (high certainty).

1 finding from 1 review

Perioperative chemotherapy vs primary surgery

Overall survival by chemo‐/radiotherapy ‐ Chemoradiotherapy · resectable adenocarcinoma of the stomach, gastroesophageal junction, and lower esophagus

Perioperative chemotherapy probably leads to lower overall survival by chemo‐/radiotherapy ‐ Chemoradiotherapy compared with primary surgery (moderate certainty).

1 finding from 1 review