{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T11:13:06Z","timestamp":1788779586215,"version":"build-2803163510"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T00:00:00Z","timestamp":1749686400000},"content-version":"vor","delay-in-days":11,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Ajou University Medical Center, Suwon, Korea"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,6,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Gastrectomy with D2 lymph node dissection followed by adjuvant chemotherapy (AC) with S-1 or capecitabine\/oxaliplatin (CAPOX) is the standard treatment for stage II and III gastric cancer (GC). However, there is no established guideline for the start timing of AC.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We analyzed data from the Korean Health Insurance Review and Assessment Service on 19\u00a0140 GC patients who received AC with S-1 (n\u2005=\u200510\u00a0442) or CAPOX (n\u2005=\u20058698) between January 2014 and December 2018. Patients were categorized based on AC initiation timing: within 6 weeks (n\u2005=\u200512\u00a0843), 6-8 weeks (n\u2005=\u20055386), and &amp;gt;8-16 weeks (n\u2005=\u2005911).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Initiating AC within 6 weeks significantly improved 5-year disease-free survival (DFS) and overall survival (OS) compared to later initiation, with consistent findings across both S-1 and CAPOX groups (all P\u2005&amp;lt;\u2005.005). These associations remained significant in multivariable analysis and after propensity score matching (all P\u2005&amp;lt;\u2005.0001). However, this nationwide big-data analysis has limitations, including potential survival status misclassification and the absence of some important variables such as pathologic stage, performance status, and postoperative complications.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>To optimize outcomes, AC for GC should be initiated within 6 weeks after gastrectomy, provided patients have fully recovered.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/oncolo\/oyaf132","type":"journal-article","created":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T14:28:40Z","timestamp":1749738520000},"source":"Crossref","is-referenced-by-count":3,"title":["Analysis of outcomes according to start timing of adjuvant chemotherapy in patients with gastric cancer: a retrospective nationwide cohort study"],"prefix":"10.1093","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6432-1378","authenticated-orcid":false,"given":"Tae-Hwan","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Hematology-Oncology, Ajou University School of Medicine , Suwon 16499 ,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eunyoung","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Neurology, McGovern Medical School at UTHealth , Houston, TX ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun Woo","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Hematology-Oncology, Ajou University School of Medicine , Suwon 16499 ,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mi Sun","family":"Ahn","sequence":"additional","affiliation":[{"name":"Department of Hematology-Oncology, Ajou University School of Medicine , Suwon 16499 ,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong Won","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Hematology-Oncology, Ajou University School of Medicine , Suwon 16499 ,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minsuk","family":"Kwon","sequence":"additional","affiliation":[{"name":"Department of Hematology-Oncology, Ajou University School of Medicine , Suwon 16499 ,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seok Yun","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Hematology-Oncology, Ajou University School of Medicine , Suwon 16499 ,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bumhee","family":"Park","sequence":"additional","affiliation":[{"name":"Office of Biostatistics, 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