Retrospective Analysis of Real-Life Data Evaluating the Optimal Time Between Gastrectomy and Adjuvant Chemotherapy in Resected Gastric Cancer

Purpose Although adjuvant chemotherapy (AC) increases survival in early-stage gastric cancer, the effect of the time between gastrectomy and the initiation of AC on survival has not been clearly demonstrated. This study aimed to examine the effect of AC timing on survival. Methods The data of patients who received AC in the postoperative period with the diagnosis of stage II and stage III gastric cancer were analyzed retrospectively. The patients were separated into two groups based on a 4-week cut-off value between the date of gastrectomy and the initiation of AC. Results There were 151 patients enrolled in the study. It was determined that 63 (41.7%) patients started AC in the first 4 weeks and 88 (58.3%) patients after the first 4 weeks. Patients who received AC during the first 4 weeks had a median recurrence-free survival (RFS) of 46 months, while those who received AC after 4 weeks had a median RFS of 29 months ( p = 0.039). The median overall survival (OS) for patients administered AC in the first 4 weeks was 65 months, compared to 45 months for those administered AC after 4 weeks ( p = 0.036). The early time interval from surgery to AC resulted as an independent prognostic factor for both OS and RFS. Conclusion The optimal time to start AC in patients with gastric cancer who underwent curative resection is unknown. This study reported that an interval shorter than 4 weeks was an independent prognostic risk factor for both OS and RFS.