Improvement of survival in advanced gastric cancer over 15 years: real-world analysis by 5-year periods.
- 1Department of Medical Oncology, NHO Nagoya Medical Center, Aichi, Japan.
- 2Department of Surgery, NHO Nagoya Medical Center, Aichi, Japan.
- 3Gastroenterology, NHO Nagoya Medical Center, Aichi, Japan.
Abstract
Background
Although immunotherapy and molecular targeted agents have been introduced for advanced gastric cancer (AGC), it remains unclear whether these therapeutic advances have translated into improved survival outcomes in real-world settings.Patients and methods
We conducted a retrospective cohort study of patients with advanced gastric or oesophagogastric junction adenocarcinoma who received first-line chemotherapy. Patients were stratified into three chronological periods: A (2009-2014), B (2014-2019), and C (2019-2024). Overall survival (OS) was the primary endpoint. Multivariable Cox proportional hazards models were used to evaluate independent prognostic factors.Results
Of the 677 screened patients, 322 were eligible. The baseline characteristics were generally comparable across periods, although the median age was slightly higher in period C than in periods A and B. The use of immune checkpoint inhibitors and molecular targeted agents increased substantially in period C. The median OS sequentially improved: 9.2, 10.7, and 13.6 months in A, B, and C, respectively. Subgroup analyses showed no significant improvement in the OS of patients with peritoneal metastasis. Patients with performance status (PS) 1-2 achieved significantly improved OS, whereas those with PS 0 showed only a modest trend. Multivariable analysis confirmed that a later treatment period was an independent favourable factor, with a significant benefit in C versus A.Conclusions
Survival outcomes of patients with AGC improved over time in real-world settings, consistent with the trends observed in clinical trials. However, the lack of improvement in patients with peritoneal metastasis highlights a critical unmet need for this subgroup.
Related
- Integrating overall survival and health-related quality of life to prioritize first-line systemic therapies for unresectable advanced gastric cancer: a network meta-analysis
- Retrospective Analysis of Zolbetuximab‐Associated Hypoalbuminemia in Claudin 18.2‐Positive Advanced Gastric Cancer
- Prognostic associations between patient-reported outcomes and progression-free and overall survival in advanced gastric or gastroesophageal junction adenocarcinoma with PD-L1 TAP score ≥ 5%: results from the RATIONALE-305 trial
- Multimodal prediction of neoadjuvant chemotherapy response in locally advanced gastric cancer: a multicenter cohort study
- Peripheral Lymphocyte Subsets Predict Efficacy and Overall Survival in Gastric Cancer Patients Receiving Preoperative Chemotherapy: A Retrospective Cohort Study
BibTeX
@article{kato2026improvement,
title = {{Improvement of survival in advanced gastric cancer over 15 years: real-world analysis by 5-year periods.}},
author = {K Kato and K Sugiyama and T Ito and M Yaguchi and S Owaki and M Sato and R Ino and K Shiraishi and Y Uno and M Hattori and M Suenaga and M Murayama and M Shimada and Y Kodera and C Kitagawa},
journal = {ESMO gastrointestinal oncology},
year = {2026},
month = jun,
doi = {10.1016/j.esmogo.2026.100348},
url = {https://europepmc.org/article/MED/42948686},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Improvement of survival in advanced gastric cancer over 15 years: real-world analysis by 5-year periods.
AU - K Kato
AU - K Sugiyama
AU - T Ito
AU - M Yaguchi
AU - S Owaki
AU - M Sato
AU - R Ino
AU - K Shiraishi
AU - Y Uno
AU - M Hattori
AU - M Suenaga
AU - M Murayama
AU - M Shimada
AU - Y Kodera
AU - C Kitagawa
PY - 2026
DA - 2026/06/18
JO - ESMO gastrointestinal oncology
DO - 10.1016/j.esmogo.2026.100348
UR - https://europepmc.org/article/MED/42948686
AB - Background Although immunotherapy and molecular targeted agents have been introduced for advanced gastric cancer (AGC), it remains unclear whether these therapeutic advances have translated into improved survival outcomes in real-world settings.Patients and methods We conducted a retrospective cohort study of patients with advanced gastric or oesophagogastric junction adenocarcinoma who received first-line chemotherapy. Patients were stratified into three chronological periods: A (2009-2014), B (2014-2019), and C (2019-2024). Overall survival (OS) was the primary endpoint. Multivariable Cox proportional hazards models were used to evaluate independent prognostic factors.Results Of the 677 screened patients, 322 were eligible. The baseline characteristics were generally comparable across periods, although the median age was slightly higher in period C than in periods A and B. The use of immune checkpoint inhibitors and molecular targeted agents increased substantially in period C. The median OS sequentially improved: 9.2, 10.7, and 13.6 months in A, B, and C, respectively. Subgroup analyses showed no significant improvement in the OS of patients with peritoneal metastasis. Patients with performance status (PS) 1-2 achieved significantly improved OS, whereas those with PS 0 showed only a modest trend. Multivariable analysis confirmed that a later treatment period was an independent favourable factor, with a significant benefit in C versus A.Conclusions Survival outcomes of patients with AGC improved over time in real-world settings, consistent with the trends observed in clinical trials. However, the lack of improvement in patients with peritoneal metastasis highlights a critical unmet need for this subgroup.
SN - 2949-8198
ER -