# CXCL12 expression and the survival of patients with gastric cancer: a meta-analysis

## TL;DR

High CXCL12 expression in gastric cancer is linked to worse survival outcomes, according to a meta-analysis of 1361 patients.

## Contribution

This study provides a meta-analysis confirming CXCL12 as a prognostic biomarker for gastric cancer survival.

## Key findings

- High CXCL12 expression is associated with poorer overall survival in gastric cancer patients.
- Subgroup analyses show stronger survival associations when high expression is defined above the median.
- CXCL12 expression is also linked to worse progression-free survival.

## Abstract

Gastric cancer (GC) remains a leading cause of cancer-related mortality worldwide. CXCL12, a chemokine involved in tumor progression and metastasis, has been inconsistently associated with GC survival. This meta-analysis aimed to evaluate the prognostic significance of CXCL12 expression in GC patients. A comprehensive literature search was conducted in PubMed, Embase, and Web of Science. Observational studies assessing tumor CXCL12 expression and survival outcomes in GC patients were included. Hazard ratios (HRs) with 95% confidence intervals (CIs) were pooled using a random-effects model by incorporating heterogeneity. Ten studies comprising 1361 GC patients were included. High CXCL12 expression was significantly associated with poorer overall survival (OS) (HR: 1.85, 95% CI 1.51–2.26, p < 0.001) with mild heterogeneity (I2 = 17%). Subgroup analyses revealed that the association between high CXCL12 expression and OS was stronger in studies defining high expression as above the median density value (HR: 2.63, 95% CI 1.79–3.86) than in those using any positive expression (HR: 1.61, 95% CI 1.30–2.00; p for subgroup difference = 0.03). Additionally, a more pronounced association was observed in studies with follow-up durations ≥ 36 months (HR: 2.42, 95% CI 1.84–3.18) compared to those with < 36 months (HR: 1.59, 95% CI 1.28–1.99; p = 0.03). The pooled results also indicated an association between high CXCL12 expression and worse progression-free survival (PFS) (HR: 1.52, 95% CI 1.05–2.20, p = 0.03). High CXCL12 expression is associated with poorer survival outcomes in GC patients.

The online version contains supplementary material available at 10.1007/s10238-025-01674-3.