Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

77 questions · 80 findings · 9 reviews

No studies found 15 · 18.8%GRADE not reported 0 · 0%Very low 19 · 23.8%Low 12 · 15%Moderate 19 · 23.8%High 15 · 18.8%

Chemotherapy vs placebo, best supportive care (BSC) or no treatment

Any adverse events · advanced gastric and oesophago‐gastric junction adenocarcinoma

Chemotherapy showed no clear difference in any adverse events compared with placebo, best supportive care (BSC) or no treatment (high certainty).

1 finding from 1 review

Perioperative chemotherapy vs primary surgery

Overall survival among all patients · resectable adenocarcinoma of the stomach, gastroesophageal junction, and lower esophagus

Perioperative chemotherapy leads to lower overall survival among all patients compared with primary surgery (high certainty).

1 finding from 1 review

Perioperative chemotherapy vs primary surgery

Presence of tumor‐free resection margin · resectable adenocarcinoma of the stomach, gastroesophageal junction, and lower esophagus

Perioperative chemotherapy showed no clear difference in presence of tumor‐free resection margin compared with primary surgery (moderate certainty).

1 finding from 1 review

Perioperative chemotherapy vs primary surgery

Tumor stage at resection (T0 to T2 vs T3 to T4) · resectable adenocarcinoma of the stomach, gastroesophageal junction, and lower esophagus

Perioperative chemotherapy probably leads to higher tumor stage at resection (T0 to T2 vs T3 to T4) compared with primary surgery (moderate certainty).

1 finding from 1 review

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