The role of c-MYC in gastric cancer prognosis: a Kaplan-Meier-derived patient data meta-analysis

Gastric cancer (GC) is the fifth leading cause of cancer‐related death worldwide, with a median overall survival of approximately 12 months. The proto‐oncogene c-MYC is among the most frequently activated oncogenes, implicated in roughly 20% of all malignancies. PubMed, Embase, and Web of Science were systematically searched for studies evaluating the association between c-MYC expression and (1) disease-specific survival (DSS) and (2) overall survival (OS). Hazard ratios (HRs) and odds ratios (ORs) with 95% confidence intervals (CIs) were pooled using a fixed-effects model. A two-sided p ≤ 0.05 was considered statistically significant. Across 15 studies encompassing 2,372 gastric cancer patients (802 c-MYC–positive; 410 male), male gender was strongly associated with c-MYC positivity (OR 8.83; 95% CI 5.74–13.56; p < 0.00001), as were deeper invasion (T3–T4 vs T1–T2: OR 0.38; 95% CI 0.24–0.60; p < 0.00001) and advanced stage (III–IV vs I–II: OR 2.69; 95% CI 1.71–4.23; p < 0.00001). Patients with c-MYC–negative tumors exhibited a markedly higher DSS compared to those with c-MYC–positive tumors (HR 3.73; 95% CI, 2.22–6.26; p < 0.0001). Our findings identify c-MYC as a significant prognostic biomarker for disease‐specific survival in gastric cancer.