[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-436085-105":59,"doc-detail-436085-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","is-postoperative-adjuvant-chemotherapy-needed-for-small-bowel-adenocarcinoma-after-surgical-resection","Is “postoperative adjuvant chemotherapy” needed for small bowel adenocarcinoma after surgical resection?","","Letter to the editor discussing whether postoperative adjuvant chemotherapy is necessary for patients with small bowel adenocarcinoma after complete surgical resection. The authors highlight reported favorable overall survival associations with high postoperative PNI, absence of LVSI, and oxaliplatin-based adjuvant chemotherapy, questioning whether all patients truly benefit when some did not receive it. The letter also critiques the apparent lack of stage impact on PFS/OS and emphasizes the value of real-world data and adequate postoperative nutrition.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/is-postoperative-adjuvant-chemotherapy-needed-for-small-bowel-adenocarcinoma-after-surgical-resection/436085/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/is-postoperative-adjuvant-chemotherapy-needed-for-small-bowel-adenocarcinoma-after-surgical-resection/436085.png","ImageObject",300,407,{"name":92,"@type":93},"Oliver","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-03","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":34},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What does the letter focus on regarding adjuvant treatment?","Question",{"text":112,"@type":113},"It addresses whether “postoperative adjuvant chemotherapy” is needed after surgical resection for small bowel adenocarcinoma and how strongly the evidence supports treating all patients with oxaliplatin-based chemotherapy.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Which prognostic factors are emphasized as associated with favorable overall survival?",{"text":117,"@type":113},"High postoperative PNI, absence of LVSI, and receipt of postoperative adjuvant oxaliplatin-based chemotherapy are described as being associated with favorable overall survival.",{"name":119,"@type":110,"acceptedAnswer":120},"How is uncertainty raised for patients who did not receive adjuvant oxaliplatin-based chemotherapy?",{"text":121,"@type":113},"The letter points out that a subset of patients reportedly did not receive oxaliplatin-based adjuvant chemotherapy and questions whether the study’s findings imply that those patients should also have been treated.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},436085,1790949260,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":34,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":8,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":81,"preview_page_count":4},8796095461610,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","J Chin MedAssoc  \nLetter to the editor  \nIs “postoperative adjuvant chemotherapy” needed for small bowel adenocarcinoma after surgical resection?  \nYiu-Tai Lia, Wen-Hsun Changb,c,*  \naDepartment of Obstetrics and Gynecology, Kuo General Hospital, Tainan, Taiwan, ROC; bDepartment of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; cDepartment of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan, ROC  \nDEAR EDITOR,  \nThe article by Li et al1 piqued our interest to show the prognostic factors involving with survival in patients with small bowel adenocarcinoma after surgical resection. Based on their results, we believe that high postoperative prognostic nutritional index (PNI), absence of lymphovascular space invasion (LVSI), and administration of postoperative adjuvant oxaliplatin-based chemotherapy (CT) were associated with favorable overall survival (OS) of patients with small bowel adenocarcinoma after complete surgical resection.1 Moreover, because these factors have been identified by “multivariate analysis,” it suggested that all three factors are independent.  \nAs shown by Li et al,1 more than three-quarters of patients (77.3%, 34/44) had received adjuvant oxaliplatin-based CT, and this therapy adhered to the treatment guideline of National Comprehensive Cancer Network (NCCN) . In our limited knowledge, we believe that these 34 patients may be really beneficial for adjuvant oxaliplatin-based CT to the disease control and subsequently take advantages of survival, because NCCN guideline has already recommended this therapeutic choice. However, there is uncertainty about the remaining 10 patients without postoperative adjuvant oxaliplatin-based CT in Dr. Li’s study. According to the findings by Dr. Li et al,1 postoperative adjuvant CT provides a very significant and powerful protection to prevent the patients from dying of their diseases. The hazard ratio (HR) was 0.055, suggesting that patients without postoperative adjuvant CT had an at least 18-fold increase of risk to die of diseases. If we compared other prognostic factors, such as presence of LVSI (an 8-fold increase) and postoperative PNI \u003C45.2 (an 11-fold increase) as shown by authors, the value of adding postoperative adjuvant CT to the patients with small bowel adenocarcinoma after surgical resection is much apparent and dominant, hinting us to reconsider whether all patients in their study had better be treated with postoperative adjuvant CT. For many types of cancers needing surgical treatment, CT,  \n*Address correspondence. Ms. Wen-Hsun Chang, Department of Nursing, Taipei Veterans General Hospital, 201, Section 2, Shi-Pai Road, Taipei 112, Taiwan,  \n[ROC. E-mail addresses: whchang@vghtpe.gov.tw](ROC. E-mail addresses: whchang@vghtpe.gov.tw); [whchang818@gmail.com](whchang818@gmail.com)  \n(W.-H. Chang).  \nConflicts of interest: The authors declare no conflicts of interest related to the subject matter or materials discussed in this article.  \nJournal of Chinese Medical Association. (2024): 1098-1098.  \ndoi: 10. 1097/JCMA.0000000000001166  \nCopyright © 2024, the Chinese Medical Association. This is an open access article under the CC BY-NC-ND license ([http://creativecommons.org/licenses/](http://creativecommons.org/licenses/)[ ](http://creativecommons.org/licenses/)[by-nc-nd/4.0/](by-nc-nd/4.0/))  \neither administered before or after definite surgery has already played an essential component of multi-modality strategy, particularly for those patients at locally-or far-advanced cancers or accompanied with worse prognostic factors.2–5 However, not all patients need. Regarding the need of adjuvant therapy, clinical guides are often based on benefits/risks of this approach and also considered cost-effectiveness globally.5 Either overtreatment or undertreatment is not a standard of care for these patients.5  \nAdditionally, nobody will be in doubt that “stage,”particularly for surgery-based cancers, which are always the most im","cbCaifx2Jn1NUZGQ","https://ap.wps.com/l/cbCaifx2Jn1NUZGQ","pdf",251958,"English","# Letter to the editor\n## Need for postoperative adjuvant chemotherapy\n## Interpretation of prognostic factors and guideline adherence\n## Uncertainty about patients without oxaliplatin-based chemotherapy\n## Role of stage, nutrition, and real-world data","[{\"question\":\"What does the letter focus on regarding adjuvant treatment?\",\"answer\":\"It addresses whether “postoperative adjuvant chemotherapy” is needed after surgical resection for small bowel adenocarcinoma and how strongly the evidence supports treating all patients with oxaliplatin-based chemotherapy.\"},{\"question\":\"Which prognostic factors are emphasized as associated with favorable overall survival?\",\"answer\":\"High postoperative PNI, absence of LVSI, and receipt of postoperative adjuvant oxaliplatin-based chemotherapy are described as being associated with favorable overall survival.\"},{\"question\":\"How is uncertainty raised for patients who did not receive adjuvant oxaliplatin-based chemotherapy?\",\"answer\":\"The letter points out that a subset of patients reportedly did not receive oxaliplatin-based adjuvant chemotherapy and questions whether the study’s findings imply that those patients should also have been treated.\"}]","Is “postoperative adjuvant chemotherapy” needed for small bowel adenocarcinoma after surgical resection? | PDF",1790676716]