Application of symptom network analysis among patients with gastric cancer: A scoping review

Objective To map evidence on symptom network analysis in patients with gastric cancer by summarizing study characteristics, commonly used assessment tools, central and bridge symptoms, temporal symptom relationships, and associated factors, and to provide a basis for precision symptom management. Methods This scoping review was guided by the Arksey and O’Malley framework and reported in accordance with the PRISMA extension for Scoping Reviews (PRISMA-ScR). PubMed, Web of Science, CINAHL, Cochrane Library, Embase, CNKI, Wanfang Data, VIP, and CBM were systematically searched from database inception to April 1, 2026. Original studies published in Chinese or English that applied symptom network analysis to gastric cancer populations, including eligible mixed cancer populations with gastric cancer patients, during the perioperative period or chemotherapy were included. Literature screening, data extraction, and narrative synthesis were performed. Results A total of 9 studies were included. Six symptom assessment tools were identified, with the Chinese version of the MD Anderson Symptom Inventory–Gastrointestinal Cancer Module (MDASI-GI-C) being the most frequently used tool (reported in 7 studies). Nine core symptoms were identified across the included studies, with fatigue being the most frequently reported core symptom (identified in 5 studies). Ten bridge symptoms were identified; however, considerable variation was observed in the identification of bridge symptoms across studies. Longitudinal analyses suggested that phlegm-dampness constitution was associated with subsequent changes in taste, while changes in taste were associated with subsequent appetite loss. Conclusions The symptom profiles of patients with gastric cancer are characterized by complexity, dynamic changes across treatment stages, and population heterogeneity. Symptom management strategies may benefit from individualized and stage-specific approaches targeting core symptoms, bridge symptoms, and key symptom pathways. Future research should focus on standardizing symptom assessment tools and assessment time points, conducting multicenter longitudinal studies, and supporting the development and evaluation of interventions for clinical practice. Trial registration OSF Registration DOI: https://doi.org/10.17605/OSF.IO/MJAZ3