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Candidate variables were chosen from a systematic literature review and expert consultation. Significant prognostic factors in the multivariable model were identified using univariable Cox proportional hazards models with a\n                      <jats:italic>p<\/jats:italic>\n                      -value of\u2009&lt;\u20090.1. Multivariable Cox proportional hazards models were developed using clinicopathological and PRO variables, with model selection refined using least absolute shrinkage and selection operator (LASSO). The model\u2019s discrimination and calibration were assessed using concordance indices (C-statistics) and calibration plots.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Univariable analysis identified 9 clinicopathological variables and 4 PRO domains that were prognostic for overall survival: body mass index (BMI), ECOG performance status, number of metastatic sites, liver involvement, treatment with regorafenib, neutrophil\u2013lymphocyte ratio (NLR), LDH, albumin, CA 19\u20139, appetite loss, constipation, fatigue, and pain. The initial multivariable model (M1) incorporated geographic region (Asia vs non-Asia), performance status, number of metastatic sites, treatment with regorafenib, NLR, BMI, LDH, CA 19\u20139, and albumin. The preferred multivariable model (M2), including the abovementioned variables plus the 4 PROs, demonstrated superior discriminative ability with higher C-statistic values than models without PROs. Plots supported the model\u2019s calibration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Incorporating PROs into prognostic models for AGOC improved the accuracy of survival predictions. Further research is needed to validate its use in routine clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10120-025-01654-2","type":"journal-article","created":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T05:14:20Z","timestamp":1757999660000},"page":"1241-1251","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Development and validation of a prognostic model incorporating patient reported outcomes for advanced gastric and esophageal carcinoma (AGOC) using individual patient data from two AGITG randomized clinical trials"],"prefix":"10.1007","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9540-2760","authenticated-orcid":false,"given":"Sayeda Kamrun","family":"Naher","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Espinoza","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Grimison","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kohei","family":"Shitara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nick","family":"Pavlakis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Goldstein","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin R.","family":"Stockler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca","family":"Mercieca-Bebber","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katrin Marie","family":"Sjoquist","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,9,16]]},"reference":[{"key":"1654_CR1","first-page":"209","volume":"71","author":"H Sung","year":"2021","unstructured":"Sung H, Ferlay J, Siegel RL, et al. 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Kohei Shitara: Honoraria\u2014Bristol Myers Squibb, Janssen, AstraZeneca, Lilly, Ono Pharmaceutical, and Astellas Pharma; Consulting or Advisory Role\u2014Bristol Myers Squibb, Takeda, Ono Pharmaceutical, MSD, Novartis, Daiichi Sankyo, Amgen, Astellas Pharma, Guardant Health, Bayer, Zymeworks, AstraZeneca, and ALX Oncology; Research Funding\u2014MSD (Inst), Daiichi Sankyo (Inst), Taiho Pharmaceutical (Inst), Chugai Pharma (Inst), Ono Pharmaceutical (Inst), Astellas Pharma (Inst), Eisai (Inst), Amgen (Inst), and PRA Health Sciences (Inst). Katrin Sjoquist: Honoraria\u2014BMS, Merck, MSD, Servier, Novotech (Inst), Astellas Pharma, Lisata (Inst), and Bayer (Inst); Research Funding\u2014Bayer (Inst); Other Relationship\u2014Novotech. List of where and when the study has been presented: ASCO Gastrointestinal Cancers Symposium (GI) 2025\u2014mini oral and poster presentation.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The trials were approved by HRECs prior to initiation\/patient recruitment. For INTEGRATE IIa\u2014ClinicalTrials.gov identifier: NCT04879368. For INTEGRATE trial- clinical trial registration: ANZCTR 12612000239864.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions. Informed consent was obtained from all patients.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Human rights statement and informed consent"}}]}}