ArticleGut2014
Improved survival of gastric cancer with tumour Epstein-Barr virus positivity: an international pooled analysis.
Article in Gut, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 219 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
219 citing papers in PubMed, 5 syntheses or guidelines pooled it, 366 citations in OpenAlex.
- Prognostic Significance of MSI and EBV Positivity in PD-L1 Positive Gastric Cancer: A Systematic Review and Meta-Analysis.Cancer medicine · 2026Pooled it
- Global Epidemiology of PD-L1 Expression in Epstein-Barr Virus-Associated Gastric Cancer: A Systematic Review and Meta-Analysis.Journal of gastrointestinal cancer · 2025Pooled it
- Estimating the global burden of Epstein-Barr virus-related cancers.Journal of cancer research and clinical oncology · 2022Pooled it
- Circulating Antibodies against Epstein-Barr Virus (EBV) and p53 in EBV-Positive and -Negative Gastric Cancer.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2020Pooled it
- Prognostic significance of Epstein-Barr virus infection in gastric cancer: a meta-analysis.BMC cancer · 2015Pooled it
- Proportion of histologic component predicts lymph node metastasis risk in undifferentiated-type mucosal and submucosal gastric cancers.Virchows Archiv : an international journal of pathology · 2026Article
- Article
- Molecular characteristics and clinical outcomes of patients with gastroesophageal cancer diagnosed at ages younger than 50 years.JNCI cancer spectrum · 2026Article
- Incorporating tumor deposits into the TNM staging of gastric cancer: a retrospective cohort study for prognostic validation and staging optimization.BMC cancer · 2026Article
- Epstein-Barr virus-associated tumors: commonalities in pathogenesis and the tumor immune microenvironment.Frontiers in immunology · 2026Review
- Artificial intelligence for biomarker prediction in gastric cancer: from histopathology to multimodal integration.Frontiers in oncology · 2026Review
- Gastric cancer in Abidjan: care strategies and survival in a resource-limited setting.Frontiers in oncology · 2026Article
- Association of Helicobacter pylori and Epstein-Barr virus co-infection in gastric cancer patients: a prospective analytical study.Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery · 2026Article
- An EBNA1-YAP signaling axis drives immune escape through CD276 in EBV-associated gastric cancer.Cell death & disease · 2025Article
- Article
- LMP2A regulates S901 phosphorylation of EphA2 to maintain EBV latent infection in gastric cancer.British journal of cancer · 2025Article
- Prevalence of Epstein-Barr virus and JC virus in tissue samples of gastric cancer, non-malignant, and controls by polymerase chain reaction in northwest Iran.Virus genes · 2025Article
- Gut microbiome and gastric cancer: microbial interactions and therapeutic potential.Gut pathogens · 2025Review
- The Current Evidence and Future Direction of Adjuvant Treatment for Gastric Cancer in the Era of Precision Medicine.Cancer research and treatment · 2025Review
- Article
159 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
24 authors at 14 institutions in 9 countries.
Funding
Abstract
BACKGROUND AND
objectiveAbout 9% of gastric carcinomas have Epstein-Barr virus (EBV) in the tumour cells, but it is unclear whether viral presence influences clinical progression. We therefore examined a large multicentre case series for the association of tumour EBV status with survival after gastric cancer diagnosis, accounting for surgical stage and other prognostic factors.
methodsWe combined individual-level data on 4599 gastric cancer patients diagnosed between 1976 and 2010 from 13 studies in Asia (n=8), Europe (n=3), and Latin America (n=2). EBV positivity of tumours was assessed by in situ hybridisation. Mortality HRs for EBV positivity were estimated by Cox regression models stratified by study, adjusted for distributions of sex (71% male), age (mean 58 years), stage (52% tumour-node-metastasis stages III or IV), tumour histology (49% poorly differentiated, 57% Lauren intestinal-type), anatomic subsite (70% non-cardia) and year of diagnosis. Variations by study and continent were assessed using study-specific HRs for EBV positivity.
resultsDuring median 3.0 years follow-up, 49% of patients died. Stage was strongly predictive of mortality, with unadjusted HRs (vs stage I) of 3.1 for stage II, 8.1 for stage III and 13.2 for stage IV. Tumour EBV positivity was 8.2% overall and inversely associated with stage (adjusted OR: 0.79 per unit change). Adjusted for stage and other confounders, EBV positivity was associated with lower mortality (HR, 0.72; 95% CI 0.61 to 0.86), with low heterogeneity among the study populations (p=0.2). The association did not significantly vary across patient or tumour characteristics. There was no significant variation among the three continent-specific HRs (p=0.4).
conclusionsOur findings suggest that tumour EBV positivity is an additional prognostic indicator in gastric cancer. Further studies are warranted to identify the mechanisms underlying this protective association.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.