Survival of gastric cancer in China from 2000 to 2022: A nationwide systematic review of hospital-based studies

BACKGROUND: Gastric cancer (GC) mortality continues to fall in industrialized countries, but still remains a public health concern in China, accounting for more than 370 000 deaths. We aimed to evaluate the survival of GC in China from 2000 to 2022 through a nationwide systematic review of hospital-based studies and to identify whether hospital-based studies show higher survival rates than population-based studies. METHODS: We searched PubMed, Embase, Web of Science, and the Chinese databases of CNKI and Wanfang for hospital-based studies on GC survival published between January 1, 2000, and January 20, 2022. We calculated the nationwide GC survival rate (SR) and its 95% confidence interval (CI) and conducted subgroup analyses on histologic type, subsite, tumour node metastasis (TNM) stage, therapy type, study design, and participant region. The study protocol was registered in PROSPERO (CRD-42019121559). RESULTS: The initial literature search returned 36 613 publications, among which 664 studies (180 798 participants) matched the inclusion criteria and were included in the meta-analysis. The pooled one-, two-, three- and five-year SRs of GC were 75.4% (95% CI = 74.0%-76.8%), 54.3% (95% CI = 50.1%-58.6%), 53.4% (95% CI = 50.4%-56.4%), and 44.5% (95% CI = 41.5%-47.5%), respectively. Subgroup analyses revealed an increase in three- and five-year SRs from 2006 to 2022. The five-year SR was highest among patients without lymph node metastasis (pooled SR = 67.8%, 95% CI = 62.8%-72.7%) and lowest among those with distant metastasis (pooled SR = 8.4%, 95% CI = 5.1%-11.7%). CONCLUSIONS: Our findings illustrate that the long-term survival of GC has improved in China since 2000. Hospital-based studies have presented higher SRs than population-based surveillance.