What do systematic reviews say?

Neoadjuvant chemotherapy prior to interval surgery (NACT) vs surgery followed by chemotherapy (PDS)

Neoadjuvant chemotherapy prior to interval surgery (NACT) probably leads to lower surgically‐related severe adverse effects (grade 3+) ‐ stoma… compared with surgery followed by chemotherapy (PDS) (moderate certainty).

• Neoadjuvant chemotherapy before surgery versus surgery followed by chemotherapy for initial treatment in advanced… 2021 · Cochrane Headline outcomes only
  RR 0.29 [0.12, 0.74]
  2 studies · 632 participants
  Moderate

Neoadjuvant chemotherapy prior to interval surgery (NACT) vs surgery followed by chemotherapy (PDS)

Neoadjuvant chemotherapy prior to interval surgery (NACT) probably leads to lower surgically‐related severe adverse effects (grade 3+) ‐ bowel… compared with surgery followed by chemotherapy (PDS) (moderate certainty).

• Neoadjuvant chemotherapy before surgery versus surgery followed by chemotherapy for initial treatment in advanced… 2021 · Cochrane Headline outcomes only
  RR 0.49 [0.3, 0.79]
  4 studies · 1565 participants
  Moderate

Neoadjuvant chemotherapy prior to interval surgery (NACT) vs surgery followed by chemotherapy (PDS)

Neoadjuvant chemotherapy prior to interval surgery (NACT) probably leads to lower surgically‐related severe adverse effects (grade 3+) ‐ postoperative… compared with surgery followed by chemotherapy (PDS) (moderate certainty).

• Neoadjuvant chemotherapy before surgery versus surgery followed by chemotherapy for initial treatment in advanced… 2021 · Cochrane Headline outcomes only
  RR 0.22 [0.13, 0.38]
  2 studies · 435 participants
  Moderate

Neoadjuvant chemotherapy prior to interval surgery (NACT) vs surgery followed by chemotherapy (PDS)

Neoadjuvant chemotherapy prior to interval surgery (NACT) leads to lower surgically‐related postoperative mortality (28 days to 6 months of… compared with surgery followed by chemotherapy (PDS) (high certainty).

• Neoadjuvant chemotherapy before surgery versus surgery followed by chemotherapy for initial treatment in advanced… 2021 · Cochrane Headline outcomes only
  RR 0.16 [0.06, 0.46]
  5 studies · 1623 participants
  High

Neoadjuvant chemotherapy prior to interval surgery (NACT) vs surgery followed by chemotherapy (PDS)

Neoadjuvant chemotherapy prior to interval surgery (NACT) showed no clear difference in overall survival ( compared with surgery followed by chemotherapy (PDS) (high certainty).

• Neoadjuvant chemotherapy before surgery versus surgery followed by chemotherapy for initial treatment in advanced… 2021 · Cochrane Headline outcomes only
  HR 0.96 [0.86, 1.08]
  4 studies · 2000 participants
  High

Neoadjuvant chemotherapy prior to interval surgery (NACT) vs surgery followed by chemotherapy (PDS)

Neoadjuvant chemotherapy prior to interval surgery (NACT) showed no clear difference in progression‐free survival ( compared with surgery followed by chemotherapy (PDS) (moderate certainty).

• Neoadjuvant chemotherapy before surgery versus surgery followed by chemotherapy for initial treatment in advanced… 2021 · Cochrane Headline outcomes only
  HR 0.98 [0.88, 1.08]
  4 studies · 1847 participants
  Moderate

Neoadjuvant chemotherapy prior to interval surgery (NACT) vs surgery followed by chemotherapy (PDS)

• Neoadjuvant chemotherapy before surgery versus surgery followed by chemotherapy for initial treatment in advanced… 2021 · Cochrane Headline outcomes only
  no estimate extracted
  3 studies · 524 participants
  Very low