Cochrane · systematic review · CD011498
Non‐surgical versus surgical treatment for oesophageal cancer
Best, LMJ, Mughal, M, Gurusamy, KS · Cochrane Database of Systematic Reviews · 2016 · Cochrane Library
GutAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
15
current version
GRADE rated
15
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 11 · 73.3%Low 4 · 26.7%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Non‐surgical versus surgical treatment of oesophageal cancer (primary outcomes)
Population: people with oesophageal cancer
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Short‐term mortality All‐cause mortality either in‐hospital or within 3 months Non‐surgical vs surgical treatment of oesophageal cancer (primary outcomes) | RR 0.39 [0.11, 1.35] | 5 studies · 689 participants | Very low Downgraded: inconsistency |
Long‐term mortality (binary outcome) All‐cause mortality for the duration of Non‐surgical vs surgical treatment of oesophageal cancer (primary outcomes) | RR 1.03 [0.92, 1.14] | 3 studies · 511 participants | Low |
Long‐term mortality (time‐to‐event outcome): chemoradiotherapy versus surgery All‐cause mortality for the duration of Non‐surgical vs surgical treatment of oesophageal cancer (primary outcomes) | HR 0.88 [0.76, 1.03] | 4 studies · 602 participants | Low |
Long‐term mortality (time‐to‐event outcome): radiotherapy versus surgery All‐cause mortality for the duration of Non‐surgical vs surgical treatment of oesophageal cancer (primary outcomes) | HR 1.39 [1.18, 1.64] | 3 studies · 512 participants | Very low Downgraded: inconsistency |
Long‐term mortality (binary): definitive chemoradiotherapy versus surgery with neoadjuvant chemotherapy All‐cause mortality for the duration of Non‐surgical vs surgical treatment of oesophageal cancer (primary outcomes) | RR 1.04 [0.93, 1.16] | 2 studies · 431 participants | Low |
Long‐term mortality (time‐to‐event): definitive chemoradiotherapy versus surgery with neoadjuvant chemotherapy or chemoradiotherapy All‐cause mortality for the duration of Non‐surgical vs surgical treatment of oesophageal cancer (primary outcomes) | HR 0.99 [0.78, 1.26] | 2 studies · 431 participants | Very low Downgraded: imprecision |
Proportion with a serious adverse event within 3 months Serious adverse event within 3 months as defined by ICH‐GCP International Conference on Harmonisation ‐ Good Clinical Practice guideline (ICH‐GCP 1996) or reasonable variations thereof Non‐surgical vs surgical treatment of oesophageal cancer (primary outcomes) | RR 0.61 [0.25, 1.47] | 1 study · 80 participants | Very low Downgraded: imprecision |
Short‐term health‐related quality of life Any validated scale Non‐surgical vs surgical treatment of oesophageal cancer (primary outcomes) | no estimate extracted | 1 study · 165 participants | Very low Downgraded: imprecision |
Medium‐term health‐related quality of life Any validated scale Non‐surgical vs surgical treatment of oesophageal cancer (primary outcomes) | no estimate extracted | 1 study · 62 participants | Very low Downgraded: imprecision |
Non‐surgical versus surgical treatment of oesophageal cancer (secondary outcomes)
Population: people with oesophageal cancer
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Long‐term recurrence (binary outcome) Local recurrence, surgical wound recurrence, or distal metastases Non‐surgical vs surgical treatment of oesophageal cancer (secondary outcomes) | RR 1.05 [0.87, 1.28] | 2 studies · 339 participants | Very low Downgraded: inconsistency |
Long‐term recurrence (time‐to‐event outcome) Local recurrence, surgical wound recurrence, or distal metastases Non‐surgical vs surgical treatment of oesophageal cancer (secondary outcomes) | HR 0.96 [0.8, 1.16] | 2 studies · 349 participants | Low |
Local recurrence (binary) Non‐surgical vs surgical treatment of oesophageal cancer (secondary outcomes) | RR 0.89 [0.7, 1.12] | 3 studies · 449 participants | Very low Downgraded: imprecision, inconsistency |
Proportion with any adverse event within 3 months Any adverse event within 3 months of any severity Non‐surgical vs surgical treatment of oesophageal cancer (secondary outcomes) | RR 1.73 [1.11, 2.67] | 1 study · 80 participants | Very low Downgraded: imprecision |
Length of hospital stay (days) Including the index admission for oesophagectomy (the hospital admission during which the oesophagectomy is performed) and any surgical complication‐related readmissions Non‐surgical vs surgical treatment of oesophageal cancer (secondary outcomes) | no estimate extracted | 2 studies · 342 participants | Very low Downgraded: imprecision |
Dysphagia at maximal Non‐surgical vs surgical treatment of oesophageal cancer (secondary outcomes) | RR 1.48 [1.01, 2.19] | 1 study · 139 participants | Very low Downgraded: imprecision |