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Related Experiment Video

Updated: May 29, 2025

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Impact of pre-treatment waiting intervals on short-term postoperative outcomes in neoadjuvant chemotherapy followed

Jingpu Wang1, Cas de Jongh1, Zhouqiao Wu2

  • 1Department of Surgery, University Medical Center Utrecht, Utrecht, the Netherlands.

European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
|February 2, 2025
PubMed
Summary

For gastric cancer patients undergoing neoadjuvant chemotherapy (nCT) and gastrectomy, longer pre-treatment waiting intervals do not negatively impact short-term postoperative outcomes. This includes both the time before nCT and the total preoperative period.

Keywords:
Gastric cancerNeoadjuvant chemotherapyShort-term outcomeWaiting time

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Area of Science:

  • Oncology
  • Surgical Oncology
  • Gastroenterology

Background:

  • Gastric cancer treatment often involves neoadjuvant chemotherapy (nCT) followed by gastrectomy.
  • The waiting intervals before and during treatment (pre-nCT and preoperative) are critical periods.
  • Understanding the impact of these distinct waiting intervals on patient outcomes is essential for optimizing treatment pathways.

Purpose of the Study:

  • To investigate the association between pre-treatment waiting intervals and short-term postoperative outcomes in gastric cancer patients.
  • To analyze the impact of both the pre-neoadjuvant chemotherapy (pre-nCT) interval and the overall preoperative interval on outcomes.

Main Methods:

  • Retrospective analysis of 1242 gastric cancer patients (cT1-4aN0-3M0) who underwent nCT plus gastrectomy.
  • Data sourced from the Dutch national DUCA-database between 2010 and 2021.
  • Multivariate logistic regression models were used to assess the impact of pre-nCT intervals (≤5, 5-8, 8-12 weeks) and preoperative intervals (≤17, 17-22, >22 weeks) on short-term postoperative outcomes.

Main Results:

  • No significant association was found between longer pre-nCT waiting intervals (5-8 and 8-12 weeks) and adverse 30-day mortality, overall complications, pulmonary complications, gastrointestinal complications, re-interventions, or 30-day readmission compared to intervals ≤5 weeks.
  • Similarly, longer preoperative waiting intervals (17-22 and >22 weeks) were not linked to worse 30-day mortality, overall complications, pulmonary complications, gastrointestinal complications, re-interventions, or 30-day readmission compared to intervals ≤17 weeks.
  • Statistical p-values consistently indicated no significant negative impact across all assessed outcomes for extended waiting periods in both interval categories.

Conclusions:

  • Extended pre-nCT and preoperative waiting intervals do not appear to compromise short-term postoperative outcomes for Western gastric cancer patients undergoing neoadjuvant chemotherapy followed by gastrectomy.
  • These findings suggest flexibility in scheduling treatment initiation and surgery without compromising immediate recovery.
  • Further research may explore long-term oncological outcomes in relation to these waiting periods.