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. 2021 Feb 5;2021(2):CD005343. doi: 10.1002/14651858.CD005343.pub5

Comparison 1. NACT vs PDS.

Outcome or subgroup title No. of studies No. of participants Statistical method Effect size
1.1 Overall survival 3 1521 Hazard Ratio (IV, Random, 95% CI) 0.95 [0.84, 1.07]
1.2 Overall survival by age 2 1220 Hazard Ratio (IV, Random, 95% CI) 0.92 [0.81, 1.05]
1.2.1 Age < 50 years 1 84 Hazard Ratio (IV, Random, 95% CI) 0.91 [0.54, 1.55]
1.2.2 Age <60 years 1 157 Hazard Ratio (IV, Random, 95% CI) 0.71 [0.50, 1.01]
1.2.3 Age 50‐70 years 1 439 Hazard Ratio (IV, Random, 95% CI) 0.96 [0.77, 1.19]
1.2.4 Age 60‐70 years 1 215 Hazard Ratio (IV, Random, 95% CI) 0.95 [0.70, 1.28]
1.2.5 Age > 70 years 2 325 Hazard Ratio (IV, Random, 95% CI) 0.98 [0.77, 1.25]
1.3 Overall survival by residual disease 1 597 Hazard Ratio (IV, Random, 95% CI) 1.09 [0.89, 1.34]
1.3.1 No residual tumour 1 214 Hazard Ratio (IV, Random, 95% CI) 1.17 [0.82, 1.67]
1.3.2 Residual tumour 1‐10 mm 1 161 Hazard Ratio (IV, Random, 95% CI) 1.22 [0.84, 1.77]
1.3.3 Residual tumour > 1 cm 1 222 Hazard Ratio (IV, Random, 95% CI) 0.91 [0.64, 1.30]
1.4 Progression‐free survival 4 1631 Hazard Ratio (IV, Random, 95% CI) 0.97 [0.87, 1.07]
1.5 Severe adverse effects (grade 3+) 5   Risk Ratio (IV, Random, 95% CI) Subtotals only
1.5.1 Haemorrhage 2 1106 Risk Ratio (IV, Random, 95% CI) 0.99 [0.25, 3.89]
1.5.2 Need for transfusion 4 1085 Risk Ratio (IV, Random, 95% CI) 0.80 [0.65, 0.99]
1.5.3 Venous thromboembolism 4 1490 Risk Ratio (IV, Random, 95% CI) 0.28 [0.09, 0.90]
1.5.4 Infection 4 1490 Risk Ratio (IV, Random, 95% CI) 0.30 [0.16, 0.56]
1.5.5 Gastrointestinal fistula 4 1490 Risk Ratio (IV, Random, 95% CI) 0.39 [0.11, 1.39]
1.5.6 Urinary/vaginal fistula 2 1106 Risk Ratio (IV, Random, 95% CI) 1.06 [0.15, 7.49]
1.5.7 Nausea 2 577 Risk Ratio (IV, Random, 95% CI) 0.42 [0.02, 8.23]
1.5.8 Vomiting 2 577 Risk Ratio (IV, Random, 95% CI) 0.41 [0.03, 6.03]
1.5.9 Diarrhoea 1 474 Risk Ratio (IV, Random, 95% CI) 0.58 [0.11, 3.15]
1.5.10 Neutropenia 1 103 Risk Ratio (IV, Random, 95% CI) 1.15 [0.48, 2.74]
1.5.11 Neutrotoxicity 1 103 Risk Ratio (IV, Random, 95% CI) 1.02 [0.15, 6.97]
1.5.12 Thrombocytopenia 1 103 Risk Ratio (IV, Random, 95% CI) 5.10 [0.25, 103.61]
1.5.13 Febrile neutropenia 1 103 Risk Ratio (IV, Random, 95% CI) 3.06 [0.13, 73.36]
1.5.14 Renal toxicity 1 103 Risk Ratio (IV, Random, 95% CI) Not estimable
1.5.15 Stoma formation 2 581 Risk Ratio (IV, Random, 95% CI) 0.43 [0.26, 0.72]
1.5.16 Bowel resection 3 1213 Risk Ratio (IV, Random, 95% CI) 0.49 [0.26, 0.92]
1.6 Postoperative mortality 5 1571 Risk Ratio (IV, Random, 95% CI) 0.18 [0.06, 0.54]
1.7 EORTC QLQ‐C30 QoL at 6 months 2   Mean Difference (IV, Random, 95% CI) Subtotals only
1.7.1 Global health 2 307 Mean Difference (IV, Random, 95% CI) ‐1.34 [‐2.36, ‐0.32]
1.7.2 Fatigue 2 307 Mean Difference (IV, Random, 95% CI) ‐0.55 [‐6.02, 4.93]
1.7.3 Nausea 2 307 Mean Difference (IV, Random, 95% CI) 2.12 [‐0.36, 4.61]
1.7.4 Pain 2 307 Mean Difference (IV, Random, 95% CI) 0.35 [‐7.41, 8.12]
1.7.5 Constipation 2 307 Mean Difference (IV, Random, 95% CI) ‐2.17 [‐7.24, 2.89]
1.7.6 Insomnia 2 307 Mean Difference (IV, Random, 95% CI) 0.30 [‐0.86, 1.47]
1.7.7 Apetite loss 2 307 Mean Difference (IV, Random, 95% CI) 0.47 [‐0.31, 1.24]
1.7.8 Dyspneoa 2 307 Mean Difference (IV, Random, 95% CI) 2.47 [‐3.42, 8.36]
1.7.9 Diarrhoea 2 307 Mean Difference (IV, Random, 95% CI) ‐0.77 [‐12.69, 11.15]
1.7.10 Financial difficulties 2 307 Mean Difference (IV, Random, 95% CI) 2.46 [‐5.33, 10.25]
1.8 EORTC QLQ‐C30 QoL at 12 months 1   Mean Difference (IV, Random, 95% CI) Totals not selected
1.8.1 Global health 1   Mean Difference (IV, Random, 95% CI) Totals not selected
1.8.2 Fatigue 1   Mean Difference (IV, Random, 95% CI) Totals not selected
1.8.3 Nausea 1   Mean Difference (IV, Random, 95% CI) Totals not selected
1.8.4 Pain 1   Mean Difference (IV, Random, 95% CI) Totals not selected
1.8.5 Dyspneoa 1   Mean Difference (IV, Random, 95% CI) Totals not selected
1.8.6 Insomnia 1   Mean Difference (IV, Random, 95% CI) Totals not selected
1.8.7 Apetite loss 1   Mean Difference (IV, Random, 95% CI) Totals not selected
1.8.8 Constipation 1   Mean Difference (IV, Random, 95% CI) Totals not selected
1.8.9 Diarrhoea 1   Mean Difference (IV, Random, 95% CI) Totals not selected
1.8.10 Financial difficulties 1   Mean Difference (IV, Random, 95% CI) Totals not selected
1.9 Global QoL score 1   Mean Difference (IV, Random, 95% CI) Subtotals only
1.9.1 At 6 months 1 217 Mean Difference (IV, Random, 95% CI) 7.60 [1.89, 13.31]
1.9.2 At 12 months 1 133 Mean Difference (IV, Random, 95% CI) 5.70 [‐2.23, 13.63]