Meta-Analysis of Adjuvant Chemotherapy Trials for Gastric Cancer at the Cancer Institute Hospital, Tokyo

Despite a long history of clinical trials for adjuvant chemotherapy for gastric cancer, standard adjuvant chemotherapy is not yet established. Most Western trials produced no survival benefit with postoperative adjuvant chemotherapy [1], but there are a few encouraging reports from Japan [2, 3, 4]. The Japanese studies reported a marginal survival benefit in certain subsets, but it did not, as a whole, reach statistical significance. Failure to prove statistical significance is partly attributed to small sample size. Repeating a trial with encouraging but old regimens to confirm marginal efficacy is not a realistic solution: It is time-consuming and not attractive to clinical investigators. Meta-analysis may be, in such cases, an alternate approach to evaluating the clinical significance of previous trials of adjuvant chemotherapy.