SynthesisJournal of gastrointestinal cancer2026
Efficacy and Safety of Conversion Surgery Versus Non-Surgical Treatment for Initially Unresectable Esophageal Cancer: A Systematic Review and Meta-Analysis.
Synthesis in Journal of gastrointestinal cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
3 authors.
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Abstract
objectiveThis systematic review and meta-analysis aimed to evaluate the efficacy and safety of conversion surgery compared with non-surgical treatment in patients with initially unresectable esophageal cancer who underwent conversion therapy.
methodsA comprehensive literature search was conducted across PubMed, Embase, Cochrane Library, and Web of Science through October 2025. Studies comparing conversion surgery versus non-surgical treatment following conversion therapy were included. Primary outcomes were overall survival (OS) and progression-free survival (PFS) at one, two, and three years. Risk ratios with 95% confidence intervals were pooled using random-effects models. Study quality was assessed using the Newcastle-Ottawa Scale.
resultsTen studies comprising 973 patients (356 conversion surgery, 617 non-surgical treatment) were included. Conversion surgery was associated with significant improvements in OS at one year (RR = 1.53, 95% CI 1.34–1.76, p < 0.001), two years (RR = 1.65, 95% CI 1.41–1.93, p < 0.001), and three years (RR = 2.03, 95% CI 1.63–2.53, p < 0.001). Similarly, conversion surgery demonstrated superior PFS at one year (RR = 1.77, 95% CI 1.31–2.40, p < 0.001), two years (RR = 1.59, 95% CI 1.26–1.99, p < 0.001), and three years (RR = 1.76, 95% CI 1.30–2.38, p < 0.001). Common adverse events during conversion therapy included hematologic toxicities and radiation esophagitis, while postoperative complications in the surgical group primarily comprised respiratory complications, anastomotic leakage, and recurrent laryngeal nerve injury. No significant publication bias was detected.
conclusionsConversion surgery following effective conversion therapy is associated with significantly improved survival outcomes compared with continued non-surgical treatment in initially unresectable esophageal cancer. Treatment-related adverse events were manageable, with hematologic toxicities predominating during conversion therapy and surgical complications including anastomotic and respiratory issues.
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