Neoadjuvant chemotherapy for gastric cancer. Is it a must or a fake?

Table 3 Characteristics and outcomes of randomized controlled trial describing the type of lymph node dissection and the site of primary tumor in both arms

Ref.	No. patients randomization	Site of primary tumor	Node dissection (D1, D2, others)	Survival rate (HR, p)	HR for site of primary tumor
Nio et al[36], 2004	295 Tot 193 S 102 NAC + S	Stomach	D2 in less than 50% overall 48% S 56% NAC + S	Overall No Adv NAC + S P = 0.6878 stage II/III -pN+ Adv NAC + S P = 0.0486	NR
Cunningham et al[17], 2006	503 Tot 250 S 253 NAC + S	Stomach 73.9% EGJ 11.5% LE 14.6%	D2 in less than 50% 40% S 42% NAC + S	Adv NAC + S OS/DFS 5 yr-SR 23%/NR S 36.3%/NR NAC + S HR = 0.75/0.66 P = 0.009/0.001	HR LE 0.7 EGJ: 0.5 Stomach: 0.8
Schumacher et al[15], 2010	282/144 Tot 72 S 72 NAC + S	Stomach 47.2% EGJ 52.8% (Siewert II, III)	Proper D2 in 94% overall 92.6% S 95.7% NAC+S	No adv NAC + S 52 ms S 64 ms NAC + S HR = 0.84 P = 0.46	NR
Imano et al[38], 2010	63 Tot 16 S 15 CDDP 16 5-FU 16 5-FU + CDDP	Stomach	Proper D2 in all patients of both arms	No differences for all arms	NR
Biffi et al[39], 2010	240/70 Tot 35 S 34 NAC + S	Stomach 59% EGJ 41% (Siewert II, III)	Proper D2 in almost all cases	not evaluated premature interruption for low accrual	NR
Ychou et al[18], 2011	224 Tot 111 S 113 NAC + S	LE 11%, EGJ 64%, Stomach 25%	D2 recommended No data on LND performed	OS (NAC + S/S) 38/24 HR = 0.69 P = 0.02 DFS (NAC + S/S) 34/19 HR = 0.65 P = 0.003	HR LE 1.14 EGJ 0.57 Stomach 0.92

S: Surgery; NAC: Neoadjuvant chemotherapy; Adv: Advantage; LND: Lymph node dissection; OS: Overall survival; DFR: Disease free survival; HR: Hazard ratio; LN+: Lymph node positive; D2: D2 lymph node dissection; NR: Not reported; LE: Lower esophagus; EGJ: Esophagogastric junction; pN+: Positive lymph nodes at pathological examinations.