Zhou SQ, Ke QH. Rethinking the timing of adjuvant chemotherapy in advanced gastric cancer: From feasibility to precision sequencing. World J Gastrointest Oncol 2026; 18(9): 118773 [DOI: 10.4251/wjgo.118773]
Corresponding Author of This Article
Qing-Hua Ke, PhD, Chief Physician, Department of Chemoradiotherapy, Jingzhou No. 1 People's Hospital and First Affiliated Hospital of Yangtze University, No. 10 Tianhu Road, Shashi District, Jingzhou 434000, Hubei Province, China. 3803354759@qq.com
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Oncology
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review-article
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Zhou SQ, Ke QH. Rethinking the timing of adjuvant chemotherapy in advanced gastric cancer: From feasibility to precision sequencing. World J Gastrointest Oncol 2026; 18(9): 118773 [DOI: 10.4251/wjgo.118773]
World J Gastrointest Oncol. Sep 15, 2026; 18(9): 118773 Published online Sep 15, 2026. doi: 10.4251/wjgo.118773
Rethinking the timing of adjuvant chemotherapy in advanced gastric cancer: From feasibility to precision sequencing
Shi-Qiong Zhou, Qing-Hua Ke
Shi-Qiong Zhou, Qing-Hua Ke, Department of Chemoradiotherapy, Jingzhou No. 1 People’s Hospital and First Affiliated Hospital of Yangtze University, Jingzhou 434000, Hubei Province, China
Author contributions: Ke QH conceived and designed the study; Zhou SQ and Ke QH performed the literature review, analyzed the data, and drafted the manuscript; both authors contributed equally to the manuscript and approved the final version.
AI contribution statement: Limited auxiliary AI tools were used only for basic grammatical correction and linguistic refinement. No large language models such as ChatGPT, DeepL were applied for full-text writing or content creation.
Conflict-of-interest statement: The authors declare that there are no relevant conflicts of interest associated with this article.
Corresponding author: Qing-Hua Ke, PhD, Chief Physician, Department of Chemoradiotherapy, Jingzhou No. 1 People's Hospital and First Affiliated Hospital of Yangtze University, No. 10 Tianhu Road, Shashi District, Jingzhou 434000, Hubei Province, China. 3803354759@qq.com
Received: January 12, 2026 Revised: January 21, 2026 Accepted: January 28, 2026 Published online: September 15, 2026 Processing time: 227 Days and 10.9 Hours
Core Tip
Core Tip: The optimal timing for adjuvant chemotherapy (AC) in gastric cancer (GC) is undefined. A previous study demonstrated that ultra-early AC (10-13 days post-surgery) is feasible and safe under Enhanced Recovery After Surgery protocols, with a signal for reduced peritoneal recurrence but no survival advantage. The study’s limitations, including a lack of molecular profiling and small sample size, underscore the need for a more sophisticated approach. We propose a “precision timing” framework that integrates tumor biology (e.g., molecular subtypes and circulating tumor DNA), patient recovery, and dynamic monitoring to guide AC initiation. This shift from a traditional feasibility paradigm to biomarker-driven, individualized sequencing holds the key to improving outcomes in high-risk GC.
