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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 14, 2025; 31(42): 110069
Published online Nov 14, 2025. doi: 10.3748/wjg.v31.i42.110069
Published online Nov 14, 2025. doi: 10.3748/wjg.v31.i42.110069
Early vs conventional initiation of adjuvant chemotherapy in advanced gastric cancer: A propensity-matched outcomes study
Li Lin, Guo-Yan Liu, Department of Gastrointestinal Surgery, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen 361102, Fujian Province, China
Li Lin, Guo-Yan Liu, Department of Gastrointestinal Surgery, Xiang’an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen 361102, Fujian Province, China
Peng Zhang, Li-Bing Wen, Wei-Ping Chen, School of Clinical Medicine, Fujian Medical University, Fuzhou 350122, Fujian Province, China
Ya-Yue Wang, Yi-Fan Cai, Yi-Fan Xiao, Zhi-Kun Li, Guo-Yan Liu, School of Medicine, Xiamen University, Xiamen 361001, Fujian Province, China
Co-first authors: Li Lin and Peng Zhang.
Author contributions: Lin L, Wang YY, Cai YF, Wen LB, and Chen WP contributed to the writing - review & editing; Lin L, Zhang P, Wen LB, Chen WP, Xiao YF, and Li ZK participated in the methodology of the manuscript; Lin L and Zhang P were involved in the data curation; Lin L, Zhang P, Wen LB, Chen WP, and Liu GY contributed to the conceptualization; Lin L and Liu GY were major in the project administration; Lin L, Zhang P, Wang YY, Cai YF, Wen LB, Chen WP, Xiao YF, and Li ZK participated in the formal analysis; Zhang P contributed to the investigation, writing - original draft, and visualization; Wang YY, Cai YF, Wen LB, Chen WP, Xiao YF, and Li ZK were response to the validation; Liu GY took part in the supervision and resources. Lin L and Zhang P contributed equally to the manuscript and are co-first authors.
Supported by Xiamen Natural Science Foundation of China, No. 3502Z20227347.
Institutional review board statement: This research was carried out following the Declaration of Helsinki and received approval from the Ethics Committee of Zhongshan Hospital of Xiamen University (approval No. 2024-174).
Informed consent statement: Given the retrospective design of this investigation, the Ethics Committee of Zhongshan Hospital of Xiamen University granted us an exemption from obtaining written informed consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: The data included in this study can be obtained from the corresponding author.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Guo-Yan Liu, MD, PhD, Professor, Department of Gastrointestinal Surgery, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, No. 209 Hubin South Road, Siming District, Xiamen 361102, Fujian Province, China.
Received: May 29, 2025
Revised: July 12, 2025
Accepted: October 9, 2025
Published online: November 14, 2025
Processing time: 168 Days and 19 Hours
Revised: July 12, 2025
Accepted: October 9, 2025
Published online: November 14, 2025
Processing time: 168 Days and 19 Hours
Core Tip
Core Tip: This study pioneers the evaluation of adjuvant chemotherapy initiated within 10-13 days postgastrectomy under enhanced recovery protocols. Early initiation shows comparable survival outcomes to conventional timing but requires tailored dosing to mitigate toxicity. These findings suggest that early chemotherapy is both feasible and safe when carefully managed, and they emphasize the importance of integrating surgical recovery with oncologic treatment, offering a paradigm shift in personalized gastric cancer management.