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World J Gastroenterol. Oct 14, 2026; 32(38): 115891
Published online Oct 14, 2026. doi: 10.3748/wjg.115891
Published online Oct 14, 2026. doi: 10.3748/wjg.115891
Letter to the Editor: Ultra-early adjuvant chemotherapy after gastrectomy: Dose intensity, peritoneal recurrence, and evidence gaps
Le Zhang, Dan-Dan Jin, Min Lu, Ying Deng, Shao-Heng Zhang, Xin-Ying Wang, Le Liu, Department of Gastroenterology, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, Guangdong Province, China
Li-Ping Liang, Department of Gastroenterology and Hepatology, Guangzhou First People’s Hospital, Guangzhou 510180, Guangdong Province, China
Co-first authors: Le Zhang and Li-Ping Liang.
Co-corresponding authors: Xin-Ying Wang and Le Liu.
Author contributions: Liu L and Wang XY jointly supervised the project and critically revised the manuscript; Zhang L and Liang LP contributed equally to drafting and critical analysis and are co-first authors; Jin DD, Lu M, Deng Y, and Zhang SH contributed to literature review, interpretation, and manuscript refinement. All authors approved the final version. We designated Liu L and Wang XY as co-corresponding authors because they together determined the focus and key messages, coordinated the literature appraisal and interpretation, and provided critical revisions throughout multiple rounds to ensure accuracy, balance, and clarity of the arguments presented. Both authors are fully accountable for all aspects of the work and are equally to address editorial queries, reviewer comments, and post-publication correspondence in a timely manner.
Supported by National Natural Science Foundation of China, No. 82200612; and Guangdong Basic and Applied Basic Research Foundation, No. 2023A1515111183 and No. 2021A1515110208.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Corresponding author: Le Liu, MD, PhD, Department of Gastroenterology, Zhujiang Hospital, Southern Medical University, No. 253 Middle Industrial Avenue, Guangzhou 510280, Guangdong Province, China. 1402744723@smu.edu.cn
Received: October 28, 2025
Revised: February 11, 2026
Accepted: March 4, 2026
Published online: October 14, 2026
Processing time: 311 Days and 9.7 Hours
Revised: February 11, 2026
Accepted: March 4, 2026
Published online: October 14, 2026
Processing time: 311 Days and 9.7 Hours
Core Tip
Core Tip: Ultra-early adjuvant chemotherapy (10-13 days) after gastrectomy is feasible in selected patients but commonly requires dose reduction. Current evidence is underpowered and lacks biomarker stratification, limiting clinical generalization. The peritoneal recurrence signal is hypothesis-generating and should be tested in prospective trials with standardized dosing algorithms, recovery-based eligibility criteria, and molecular/circulating tumor DNA-guided risk stratification.