{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T09:17:52Z","timestamp":1785403072737,"version":"3.56.0"},"reference-count":28,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T00:00:00Z","timestamp":1777680000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/013aysd81","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Despite significant advances in diagnosis and treatment, gastric cancer remains a major global malignancy. This study aimed to evaluate the impact of Surveillance, Epidemiology, and End Result (SEER) stages on all-cause and cause-specific mortality in gastric cancer. Methods: This nationwide population-based cohort study analyzed data from the Cancer Public Library Database (CPLD). Patients aged \u2265 30 years diagnosed with gastric cancer between 2012 and 2019 were followed up until 31 December 2020. Cox proportional hazards models and Fine\u2013Gray models were used to compare the risk of all-cause and cause-specific mortality based on SEER stages. The Kaplan\u2013Meier method and cumulative incidence functions were applied to analyze cumulative incidences of all-cause and cause-specific mortality. Statistical significance was assessed using the log-rank test and Gray\u2019s test. Additionally, a subgroup analysis was performed. Results: Among 218,491 individuals, 59,952 died during a median follow-up of 3.62 years. Compared with the localized stage, the risk of all-cause mortality was 4.31 and 24.73 times higher in patients with the regional and distant stages, respectively, after adjusting for sex, age, income, residential area, and comorbidities. The regional stage was associated with an 8.70-, 6.08-, 1.28-, and 1.43-fold higher risk of stomach cancer death, cancer death, cardiovascular death, and respiratory death, respectively. The distant stage was associated with 51.67-, 35.97-, 1.74, and 1.54-fold higher risk of stomach cancer death, cancer death, cardiovascular death, and respiratory death, respectively. Conclusions: Higher SEER stage in gastric cancer is associated with an increased risk of all-cause mortality, gastric cancer-specific mortality, overall cancer mortality, cardiovascular disease-related mortality, and respiratory disease-related mortality. Notably, cardiopulmonary mortality increased with advancing SEER stage, particularly among younger patients, underscoring the need for vigilant monitoring.<\/jats:p>","DOI":"10.3390\/jcm15093484","type":"journal-article","created":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T01:12:09Z","timestamp":1777857129000},"page":"3484","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["All-Cause and Cause-Specific Mortality by SEER Stage in Gastric Cancer: A Nationwide Population-Based Cohort Study"],"prefix":"10.3390","volume":"15","author":[{"given":"Jihoon","family":"Hong","sequence":"first","affiliation":[{"name":"Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mi Jin","family":"Oh","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9143-9654","authenticated-orcid":false,"given":"Bokyung","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul 07061, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seunghan","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoon Jin","family":"Choi","sequence":"additional","affiliation":[{"name":"Center for Gastric Cancer, National Cancer Center, Goyang 10408, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyungdo","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Statistics and Actuarial Science, Soongsil University, 369 Sangdo-ro, Dongjak-gu, Seoul 06978, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7144-0589","authenticated-orcid":false,"given":"Soo-Jeong","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1016\/S0140-6736(20)31288-5","article-title":"Gastric cancer","volume":"396","author":"Smyth","year":"2020","journal-title":"Lancet"},{"key":"ref_2","first-page":"229","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA Cancer J. 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