The event rate and confidence intervals (CIs) were calculated. Statistical analysis Pooled event rate and 95% CI were using a random effects model (15). We tested heterogeneity

with Cochran’s Q statistic, with P<0.10 indicating heterogeneity, and quantified the degree of heterogeneity using the I2 statistic, which represents the percentage of the total Inhibitors,research,lifescience,medical variability across studies which is due to heterogeneity. I2 values of 25%, 50% and 75% corresponded to low, moderate and high degrees of heterogeneity respectively (16). The quantified publication bias using the Egger’s regression model (17), with the effect of bias assessed using the fail-safe number method. The fail-safe number was the number of studies that we would need to have missed for our Inhibitors,research,lifescience,medical observed result to be nullified to statistical non-significance at the P<0.05 level. Publication bias is generally regarded as a concern if the fail-safe number is less than 5n+10, with n being the number of studies included in the meta-analysis (18). All analyses were performed with Comprehensive

Meta-analysis (version 2.0), Biostat, Inhibitors,research,lifescience,medical Englwood, NJ, USA [2005]. Results The original search strategy 418 retrieved studies (Figure 1). The abstracts were reviewed and after applying the inclusion and exclusion criteria, articles were selected for full-text evaluation. Of the articles selected, only nine studies (180 patients) met full criteria for analysis and are summarised in

Table 1. The years of publication ranged from 2007 to 2012. Figure 1 Flow of included studies. Table 1 Characteristics of the studies included in the systematic review and meta-analysis The overall procedural success rate was 95% (95% CI, 0.895-0.977). There Inhibitors,research,lifescience,medical was a substantial decrease in the dysphagia scores standard difference in means (SDM) –0.81 [standard error (SE) 0.15, 95% CI, –1.1 to –0.51] (Figure 2), similar increase Inhibitors,research,lifescience,medical in weight SDM 0.591 (SE 0.434, 95% CI, –0.261 to 1.442) and serum albumin SDM 0.35 (SE 0.271, 95% CI, –0.181 to 0.881). The incidence of major adverse events included stent migration 32% (95% CI, 0.258-0.395) and chest discomfort 51.4% (95% CI, 0.206-0.812) (Figure 3). Figure 2 Dysphagia scores. CI, confidence interval. Anacetrapib Figure 3 Stent migration. CI, confidence interval. Heterogeneity and publication bias The heterogeneity of outcomes has been summarized in Tables 2 and ​and3.3. The reason for significant heterogeneity may be attributed to different population groups. No publication bias was detected using the Egger’s regression model. Table 2 Overall odds ratio and 95% CI for patient outcomes Table 3 Standard difference in means and 95% CI for patient outcomes Discussion The current standard of care is to offer neoadjuvant therapy to patients with locally advanced esophageal cancer (28). These patients receive three to six weeks of therapy before surgery (29,30).