Gastric cancer with peritoneal metastases is rising, especially in younger patients, highlighting the urgent need for better outcomes.

• Novel therapies like normothermic intraperitoneal and systemic chemotherapy have shown overall survival benefits.
• Patient-reported outcomes remain underreported in major trials, with critical insights missed from studies like Dragon-01.

Incorporating tailored patient-reported measures into clinical trials is essential for improving survivors’ quality of life alongside survival rates.

• Enhanced focus on patient experience will guide effective treatment strategies moving forward.