Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Gastrointest Oncol. Jul 15, 2026; 18(7): 119040
Published online Jul 15, 2026. doi: 10.4251/wjgo.v18.i7.119040
Published online Jul 15, 2026. doi: 10.4251/wjgo.v18.i7.119040
Prognostic factors and optimal timing for initiating adjuvant chemotherapy in stage IIIC gastric cancer
Jun-Wei Wu, Fan Li, Shi-Dian Wang, Yu-Kun Guo, Bing-Huang Li, Chuan-Hui Lu, The Graduate School of Fujian Medical University, Fuzhou 350122, Fujian Province, China
Jun-Wei Wu, Fan Li, Xin Zhou, Guo-Qiang Su, Chuan-Hui Lu, Department of Colorectal Cancer Surgery, The First Affiliated Hospital of Xiamen University, Xiamen 361000, Fujian Province, China
Co-first authors: Jun-Wei Wu and Fan Li.
Author contributions: Wu JW drafted the initial version of the paper; Li F was in charge of analyzing data as well as drawing the charts; Wu JW and Li F have made crucial and indispensable contributions towards the completion of the project, they contributed equally to this article, they are the co-first authors of this manuscript; Wang SD, Guo YK, and Li BH in charge of collecting data; Zhou X participated in the review and editing; Su GQ reviewed and revised the paper and acquired funding; Lu CH conceptualized and designed this study; and all of the authors read and approved the final version of the manuscript to be published.
Supported by National Natural Science Foundation of China, No. 81970462; and Key Medical and Health Project of Xiamen, No. 3502Z20204001.
Institutional review board statement: This study was approved by the Medical Ethics Committee of the First Affiliated Hospital of Xiamen University, approval No. (2024) Scientific Research Ethics Review (014).
Informed consent statement: The patient signed the informed consent form.
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: For this study, the data supporting the research findings can be obtained from the corresponding author upon reasonable request.
Corresponding author: Chuan-Hui Lu, Chief Physician, The Graduate School of Fujian Medical University, No. 1 Xuefu North Road, Shangjie Town, Minhou County, Fuzhou 350122, Fujian Province, China. 46601533@qq.com
Received: January 21, 2026
Revised: February 9, 2026
Accepted: April 14, 2026
Published online: July 15, 2026
Processing time: 166 Days and 5.6 Hours
Revised: February 9, 2026
Accepted: April 14, 2026
Published online: July 15, 2026
Processing time: 166 Days and 5.6 Hours
Core Tip
Core Tip: We identified age ≥ 60 years, carcinoembryonic antigen ≥ 5.0 μg/L, metastatic lymph node ratio ≥ 0.5 and time interval (TI) from surgery to initiation of adjuvant chemotherapy are independent risk factors for postoperative recurrence. Crucially, our findings demonstrate that initiating adjuvant chemotherapy within 6 weeks of surgery significantly improves disease-free survival in stage IIIC patients. Notably, the S-1 plus oxaliplatin regimen exhibits significant time-sensitivity, with an optimal window of within 6 weeks. Whereas the capecitabine plus oxaliplatin regimen does not. These insights provide a rationale for optimizing individualized therapeutic strategies for this high-risk subgroup.