局部晚期胃癌（AGC）根治性手术后的辅助化疗可显着改善患者的长期预后。然而，由于各种原因，延迟化疗（DC）导致患者无法及时接受治疗是临床实践中的普遍现象。本研究旨在探讨DC对II-III期局部AGC患者预后的影响并探讨相关危险因素。汇总分析中纳入了四项前瞻性研究的数据。计划化疗（PC）组定义为手术与首次化疗的时间间隔 ≤ 49 d，DC组定义为手术与化疗的时间间隔 > 49 d。比较预后、复发和危险因素，并建立预测 DC 的列线图。 总共纳入 596 例患者，其中 531 例（89.1%）患有 PC，65 例（10.9%）患有 DC。生存分析显示，DC组的5年总生存率（OS）和无病生存率（DFS）显着低于PC组（对数秩P < 0.001）。 Cox单变量和多变量分析显示DC是II-III期患者OS和DFS的独立危险因素（P < 0.05）。基于DC的显着因素，建立了预测模型，该模型在训练集和验证集上拟合度好、准确度高（AUC = 0.780）且具有临床适用性。胃切除术后延迟化疗与长期预后不良相关局部晚期 II-III 期 GC 疾病患者。但术后标准化的全周期辅助化疗可能会起到一定的补救作用，并且可以在一定程度上弥补延迟化疗带来的不良效果。© 2024。作者获得国际胃癌协会和The International Gastric Cancer Association and The日本胃癌协会。

Adjuvant chemotherapy following curative surgery for locally advanced gastric cancer (AGC) significantly improves long-term patient prognosis. However, delayed chemotherapy (DC), in which patients are unable to receive timely treatment, is a common phenomenon in clinical practice for various reasons. This study aimed to investigate the impact of DC on the prognosis of patients with stage II-III locally AGC and explore the associated risk factors.Data from four prospective studies were included in the pooled analysis. The planned chemotherapy (PC) group was defined as the time interval between surgery and the first chemotherapy ≤ 49 d, while the DC group was defined as the time interval between surgery and chemotherapy > 49 d. The prognosis, recurrence, and risk factors were compared, and a nomogram for predicting DC was established.In total, 596 patients were included, of whom 531 (89.1%) had PC and 65 (10.9%) had DC. Survival analysis revealed that the 5-year overall survival (OS) and disease-free survival (DFS) were significantly lower in the DC group than those in the PC group (log-rank P < 0.001). Cox univariable and multivariable analyses showed that DC was an independent risk factor for OS and DFS in stage II-III patients (P < 0.05). Based on the significant factors for DC, a prediction model was established that had a good fit, high accuracy (AUC = 0.780), and clinical applicability in both the training and validation sets.Delayed chemotherapy after gastrectomy is associated with poor long-term prognosis in patients with locally advanced stage II-III GC disease. But standardized, full-cycle adjuvant chemotherapy after surgery may play a remedial role, and can to a certain extent compensate the poor effects caused by delayed chemotherapy.© 2024. The Author(s) under exclusive licence to The International Gastric Cancer Association and The Japanese Gastric Cancer Association.