{
    "abstract": "Neoadjuvant therapy (NAT) is a cornerstone in the treatment of locally advanced gastric cancer, improving surgical outcomes and survival. However, the optimal timing for surgery following NAT remains controversial. This study evaluates the impact of the interval between NAT and surgery on overall survival (OS) and explores associated clinicopathological factors.\nA retrospective analysis of 893 patients undergoing NAT and curative surgery for gastric adenocarcinoma across three centers in China was conducted. Surgical intervals were categorized (\u223c28 days, 29-42 days, >42 days). Survival analyses employed restricted cubic spline (RCS) models, Kaplan-Meier methods, and Cox proportional hazards regression.\nPatients operated on within 28 days post-NAT had the most favorable OS, while intervals longer than 28 days were independently associated with worse outcomes. RCS analysis revealed increased risks for intervals longer than 28 days. Prolonged intervals showed declining effectiveness in tumor regression. Stratified analyses indicated that patients with poor NAT response (TRG 3) particularly benefited from surgery within 4 weeks, while delays were detrimental.\nTimely surgery, especially within 4 weeks post-NAT, optimizes survival outcomes, particularly in patients with limited NAT response. This study underscores the need for individualized surgical timing and calls for prospective multicenter validation.",
    "authors": [
        {
            "affiliation": "Second Department of Gastric Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China; Department of Medical Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.",
            "firstname": "Jie",
            "initials": "J",
            "lastname": "Chen"
        },
        {
            "affiliation": "Department of Medical Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China; Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.",
            "firstname": "Keshu",
            "initials": "K",
            "lastname": "Hu"
        },
        {
            "affiliation": "Second Department of Gastric Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China; Department of Medical Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.",
            "firstname": "Jun",
            "initials": "J",
            "lastname": "Lu"
        },
        {
            "affiliation": "Second Department of Gastric Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China; Department of Medical Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.",
            "firstname": "Hongda",
            "initials": "H",
            "lastname": "Pan"
        },
        {
            "affiliation": "Second Department of Gastric Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China; Department of Medical Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.",
            "firstname": "Yakai",
            "initials": "Y",
            "lastname": "Huang"
        },
        {
            "affiliation": "Department of General Surgery, Shanghai Key Laboratory of Gastric Neoplasms, Shanghai Institute of Digestive Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.",
            "firstname": "Zhenjia",
            "initials": "Z",
            "lastname": "Yu"
        },
        {
            "affiliation": "Department of General Surgery, The Second Hospital of Lanzhou University, 730030, China.",
            "firstname": "Tianyu",
            "initials": "T",
            "lastname": "Gao"
        },
        {
            "affiliation": "Department of General Surgery, The Second Hospital of Lanzhou University, 730030, China. Electronic address: fanyong1972@163.com.",
            "firstname": "Yong",
            "initials": "Y",
            "lastname": "Fan"
        },
        {
            "affiliation": "Department of General Surgery, Shanghai Key Laboratory of Gastric Neoplasms, Shanghai Institute of Digestive Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China. Electronic address: leedoctor@sina.com.",
            "firstname": "Chen",
            "initials": "C",
            "lastname": "Li"
        },
        {
            "affiliation": "Second Department of Gastric Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China; Department of Medical Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China. Electronic address: fenglinliu@hotmail.com.",
            "firstname": "Fenglin",
            "initials": "F",
            "lastname": "Liu"
        }
    ],
    "conclusions": null,
    "copyrights": "Copyright \u00a9 2025 The Authors. Published by Elsevier Ltd.. All rights reserved.",
    "doi": "10.1016/j.ejso.2025.110063",
    "journal": "European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology",
    "keywords": [
        "Gastric cancer",
        "Neoadjuvant therapy",
        "Surgical interval",
        "Tumor regression grade"
    ],
    "methods": null,
    "publication_date": "2025-04-28",
    "pubmed_id": "40288218",
    "results": "Patients operated on within 28 days post-NAT had the most favorable OS, while intervals longer than 28 days were independently associated with worse outcomes. RCS analysis revealed increased risks for intervals longer than 28 days. Prolonged intervals showed declining effectiveness in tumor regression. Stratified analyses indicated that patients with poor NAT response (TRG 3) particularly benefited from surgery within 4 weeks, while delays were detrimental.",
    "title": "Optimizing surgical timing following neoadjuvant therapy for gastric Cancer: Insights from a multicenter retrospective analysis.",
    "xml": "<Element 'PubmedArticle' at 0x7885070a82c0>"
}