Timing Matters: Does Waiting Longer for Stomach Cancer Surgery Affect Outcomes?
Ramírez-Giraldo C., et al. (2026). Timing of neoadjuvant therapy and its association with survival, disease-free survival and postoperative complications in patients with gastric cancer: A retrospective cohort study. Surgical Oncology Insight, 3, 100295. https://doi.org/10.1016/j.soi.2026.100295
For patients undergoing treatment for stomach (gastric) cancer, the time between finishing chemotherapy and having surgery can bring uncertainty. Is it better to have surgery as soon as possible? Could waiting several additional weeks allow the cancer to progress? Or might extra recovery time help patients prepare for surgery?
A new study published in Surgical Oncology Insight suggests that some flexibility in scheduling surgery after chemotherapy may not negatively affect survival or increase the risk of serious complications.
Understanding the Research
Researchers in Colombia examined the medical records of 122 patients with gastric adenocarcinoma, the most common type of stomach cancer, who received chemotherapy before undergoing surgery intended to remove their cancer.
Chemotherapy given before surgery is called neoadjuvant chemotherapy. Its purpose is to shrink tumors, treat cancer cells that may have spread beyond the original tumor, and improve the likelihood of successfully removing the cancer.
The researchers wanted to understand whether the amount of time between completing chemotherapy and undergoing surgery affected three important outcomes:
Overall survival: How long patients lived after surgery.
Disease-free survival: How long patients lived without the cancer returning, or without dying from any cause.
Postoperative complications: Whether patients experienced serious medical problems following surgery.
The average patient's waiting time, measured by the median, was 42 days (six weeks). Researchers compared patients who underwent surgery within six weeks with those whose surgery occurred later.
What Did the Study Find?
The findings suggest that moderate differences in surgical timing may not significantly influence outcomes for patients receiving chemotherapy before stomach cancer surgery.
1. Survival was similar regardless of surgical timing.
Researchers found no statistically significant difference in overall survival between patients who had surgery within six weeks and those who waited longer.
2. Waiting longer was not linked to an increased risk of cancer recurrence or death.
Disease-free survival was also similar between the two groups. Within the time periods studied, researchers did not find evidence that additional waiting time independently increased the likelihood of recurrence or death.
3. Serious surgical complications were not significantly different.
Approximately 26% of patients experienced major complications after surgery. The rates were 24.2% among patients who underwent surgery within six weeks and 28.3% among those who waited longer. This difference was not statistically significant.
4. Recovery and preparation may be important considerations.
Patients sometimes need additional time after chemotherapy to regain strength, improve nutrition, recover from side effects, or undergo further medical evaluations.
The findings suggest that allowing time for these needs may be reasonable when guided by an experienced medical team.
What Does This Mean for Patients?
For someone preparing for stomach cancer surgery, waiting can be emotionally difficult, especially after completing chemotherapy. Patients may worry that every additional day could affect their chances of successful treatment.
This research provides some reassurance that a modest delay does not necessarily mean a worse outcome.
Importantly, the findings do not mean that surgery can be postponed indefinitely or that timing is unimportant. The study was relatively small, was conducted at a single hospital, and examined patients who ultimately underwent surgery. Other research has reported different findings, and additional studies are needed.
Rather than following one rigid timeline, the researchers suggest that decisions about surgical timing should consider each patient's circumstances, including their response to chemotherapy, nutritional status, overall health, and readiness for surgery.
The Importance of Specialized, Coordinated Care
For patients with gastric cancer, treatment decisions often involve medical oncologists, surgical oncologists, radiologists, nutrition specialists, and other healthcare professionals working together.
This study reinforces the importance of an individualized approach, with treatment timing determined by both the characteristics of the cancer and the patient's medical needs.
Patients preparing for surgery may want to ask their healthcare team:
How long should I expect to wait between chemotherapy and surgery?
What factors determine the best time for my operation?
Are there nutritional or physical recovery goals I should meet before surgery?
Will I need additional scans or evaluations before my operation?
If my surgery is delayed, how will my team monitor my cancer and determine whether the treatment plan needs to change?
The Alliance's Takeaway
The right time for surgery is not necessarily the earliest possible date, but the time that offers the best balance of cancer treatment and patient readiness.
Although additional research is needed, this study highlights the value of personalized treatment planning and collaboration among cancer specialists.
For patients with stomach cancer, understanding the reasons behind treatment decisions and having access to an experienced multidisciplinary team can help them feel more informed and confident throughout their care.
The Abdominal Cancers Alliance encourages patients and caregivers to ask questions, explore their treatment options, and seek specialized expertise when making important decisions about cancer care.
