The impact of delayed adjuvant chemotherapy on survival in gastric cancer patients with and without preoperative chemotherapy
Abstract Aim Adjuvant chemotherapy (AC) is the standard treatment for patients with advanced gastric cancer (GC), yet the optimal timing for its initiation remains unclear. Besides, no studies have definitively established when AC should begin in patients receiving preoperative chemotherapy (PC). Th...
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| Format: | Article |
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Wiley
2025-07-01
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| Series: | Annals of Gastroenterological Surgery |
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| Online Access: | https://doi.org/10.1002/ags3.12911 |
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| author | Masataka Shimonosono Takaaki Arigami Daisuke Matsushita Yusuke Tsuruda Ken Sasaki Kenji Baba Takao Ohtsuka |
| author_facet | Masataka Shimonosono Takaaki Arigami Daisuke Matsushita Yusuke Tsuruda Ken Sasaki Kenji Baba Takao Ohtsuka |
| author_sort | Masataka Shimonosono |
| collection | DOAJ |
| description | Abstract Aim Adjuvant chemotherapy (AC) is the standard treatment for patients with advanced gastric cancer (GC), yet the optimal timing for its initiation remains unclear. Besides, no studies have definitively established when AC should begin in patients receiving preoperative chemotherapy (PC). This study aimed to determine the optimal timing for initiating AC in patients with GC who underwent curative gastrectomy, either with or without PC. Methods A total of 446 patients who underwent curative gastrectomy were evaluated, including 140 who received AC: 72 without PC and 68 with PC. Patients were categorized into two groups based on when they began AC: the early initiation group (within 8 weeks post‐surgery), and the late initiation group (8 weeks or later post‐surgery). Results In the non‐PC cohort, the 3‐year relapse‐free survival (RFS) rates were 71% in the early group versus 56% in the late group (p = 0.49), while the 3‐year overall survival (OS) rates were 94% versus 73% (p = 0.003). Similar trends were observed in the PC cohort; the 3‐year RFS rates were 59% versus 19% (p = 0.002), and the 3‐year OS rates were 69% versus 48% (p = 0.02). Multivariate analysis identified pretherapeutic distant metastasis (p < 0.001) and delayed AC initiation (≥8 weeks) (p = 0.001) as independent predictors of worse prognosis. Conclusion Delayed initiation of AC is associated with significantly poorer postoperative survival in patients with GC, irrespective of whether PC was administered. These findings emphasize the importance of timely AC initiation to improve long‐term outcomes in this patient population. |
| format | Article |
| id | doaj-art-1dbdde8bcb2e460593ed7b34bd06989d |
| institution | Kabale University |
| issn | 2475-0328 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | Annals of Gastroenterological Surgery |
| spelling | doaj-art-1dbdde8bcb2e460593ed7b34bd06989d2025-08-20T03:28:26ZengWileyAnnals of Gastroenterological Surgery2475-03282025-07-019466867710.1002/ags3.12911The impact of delayed adjuvant chemotherapy on survival in gastric cancer patients with and without preoperative chemotherapyMasataka Shimonosono0Takaaki Arigami1Daisuke Matsushita2Yusuke Tsuruda3Ken Sasaki4Kenji Baba5Takao Ohtsuka6Department of Digestive Surgery Kagoshima University Graduate School of Medical and Dental Sciences Kagoshima JapanDepartment of Digestive Surgery Kagoshima University Graduate School of Medical and Dental Sciences Kagoshima JapanDepartment of Digestive Surgery Kagoshima University Graduate School of Medical and Dental Sciences Kagoshima JapanDepartment of Digestive Surgery Kagoshima University Graduate School of Medical and Dental Sciences Kagoshima JapanDepartment of Digestive Surgery Kagoshima University Graduate School of Medical and Dental Sciences Kagoshima JapanDepartment of Digestive Surgery Kagoshima University Graduate School of Medical and Dental Sciences Kagoshima JapanDepartment of Digestive Surgery Kagoshima University Graduate School of Medical and Dental Sciences Kagoshima JapanAbstract Aim Adjuvant chemotherapy (AC) is the standard treatment for patients with advanced gastric cancer (GC), yet the optimal timing for its initiation remains unclear. Besides, no studies have definitively established when AC should begin in patients receiving preoperative chemotherapy (PC). This study aimed to determine the optimal timing for initiating AC in patients with GC who underwent curative gastrectomy, either with or without PC. Methods A total of 446 patients who underwent curative gastrectomy were evaluated, including 140 who received AC: 72 without PC and 68 with PC. Patients were categorized into two groups based on when they began AC: the early initiation group (within 8 weeks post‐surgery), and the late initiation group (8 weeks or later post‐surgery). Results In the non‐PC cohort, the 3‐year relapse‐free survival (RFS) rates were 71% in the early group versus 56% in the late group (p = 0.49), while the 3‐year overall survival (OS) rates were 94% versus 73% (p = 0.003). Similar trends were observed in the PC cohort; the 3‐year RFS rates were 59% versus 19% (p = 0.002), and the 3‐year OS rates were 69% versus 48% (p = 0.02). Multivariate analysis identified pretherapeutic distant metastasis (p < 0.001) and delayed AC initiation (≥8 weeks) (p = 0.001) as independent predictors of worse prognosis. Conclusion Delayed initiation of AC is associated with significantly poorer postoperative survival in patients with GC, irrespective of whether PC was administered. These findings emphasize the importance of timely AC initiation to improve long‐term outcomes in this patient population.https://doi.org/10.1002/ags3.12911adjuvant chemotherapygastric cancerneoadjuvant chemotherapyperioperative medicinesurvival |
| spellingShingle | Masataka Shimonosono Takaaki Arigami Daisuke Matsushita Yusuke Tsuruda Ken Sasaki Kenji Baba Takao Ohtsuka The impact of delayed adjuvant chemotherapy on survival in gastric cancer patients with and without preoperative chemotherapy Annals of Gastroenterological Surgery adjuvant chemotherapy gastric cancer neoadjuvant chemotherapy perioperative medicine survival |
| title | The impact of delayed adjuvant chemotherapy on survival in gastric cancer patients with and without preoperative chemotherapy |
| title_full | The impact of delayed adjuvant chemotherapy on survival in gastric cancer patients with and without preoperative chemotherapy |
| title_fullStr | The impact of delayed adjuvant chemotherapy on survival in gastric cancer patients with and without preoperative chemotherapy |
| title_full_unstemmed | The impact of delayed adjuvant chemotherapy on survival in gastric cancer patients with and without preoperative chemotherapy |
| title_short | The impact of delayed adjuvant chemotherapy on survival in gastric cancer patients with and without preoperative chemotherapy |
| title_sort | impact of delayed adjuvant chemotherapy on survival in gastric cancer patients with and without preoperative chemotherapy |
| topic | adjuvant chemotherapy gastric cancer neoadjuvant chemotherapy perioperative medicine survival |
| url | https://doi.org/10.1002/ags3.12911 |
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