Surgery with adjuvant or neoadjuvant treatment vs surgery alone for resectable pancreatic cancer: A network meta-analysis

Table 2 Pooled hazard ratio of overall survival from direct and network meta-analysis

Intervention	Direct meta-analysis		Network meta-analysis
	HR	Evidence	HR	Evidence
Compared to surgery alone
Neoadjuvant CRT + S	0.96 (0.68, 1.37)	⊝⊝ Low1,2	1.10 (0.64, 1.90)	Low
S + adjuvant CT	0.75 (0.63, 0.89)	High	0.70 (0.62, 0.79)	High
S + adjuvant CRT	0.88 (0.51, 1.54)	⊝Moderate3	1.10 (0.97, 1.30)	Moderate
Compared to neoadjuvant CRT + S
S + adjuvant CT	-	-	0.63 (0.36, 1.10)	Low
S + adjuvant CRT	-	-	1.00 (0.57, 1.80)	Low
Compared to S + adjuvant CT
S + adjuvant CRT	0.98(0.59, 1.64)	⊝⊝ Low4	1.6 (1.40, 1.80)	Moderate

¹Risk of bias: one of included trial did not report allocation concealment and random sequence generation.

²Imprecision: small sample size.

³Inconsistency: heterogeneity was found in this comparison (I² = 72%).

⁴Imprecision: wide confidence interval. HR: Hazard ratio; CRT: Chemoradiotherapy; S: Surgery; CT: Chemotherapy.