OBJECTIVES: Health-state utilities values (HSUVs) are an essential component for cost-utility analysis (CUA). The aim of this review was to systematically identify utility weights associated with advanced gastric (GC), oesophageal (OC), or gastro-oesophageal junction (GEJ) adenocarcinoma. METHODS: Embase, MEDLINE and Cochrane databases (accessed September 2013) were interrogated for relevant studies using a predefined search strategy. Studies eligible for inclusion included those reporting HSUVs using direct (standard gamble [SG] and time-trade-off [TTO]) and indirect methods (such as EuroQol 5D [EQ-5D], short-form 6D [SF-6D] and 15D). RESULTS: A total of 703 publications were identified, of which eight met the inclusion criteria (GC, n=2; mixed population [MP], n=4; OC, n=2). The most commonly used instrument to estimate HSUVs was the EQ-5D (n=7): post-chemotherapy (GC, 0.550 [n=1]; MP, 0.66-0.76 [n=1]); progression-free survival (GC, 0.73 [n=1]); weight loss (MP, 0.52-0.69 [n=2]); patient’s valuation of health state (OC, 0.60-0.93 depending on stage [n=1]); dysphagia-associated (OC, 0.39-0.82, depending on score [n=1]); societal valuation of health state (OC, 0.15-0.77 [n=1]); inoperable OC/GEJ (MP, 0.63 [n=1]). One study derived utilities using the SF-6D and the 15D (post-chemotherapy in GC patients, 0.606 and 0.685, respectively). In two studies the TTO method was used to determine the following HSUVs: patient’s valuation of health state (OC, 0.52-0.80 depending on stage [n=1]); societal valuation of health state (0.15-0.77, [n=1]); dysphagia-associated (OC, 0.25-0.86, depending on score [n=1]); inoperable OC (0.08-0.66, depending on health state [n=1]). Only one study determined HSUVs for inoperable OC according to the SG method (0.08-0.78, depending on health state). CONCLUSIONS: There are limited data estimating HSUVs in patients with advanced GC, OC or GEJ. Comparisons are confounded by heterogeneity across patient and study characteristics in the identified studies. Further research into HSUVs associated with advanced gastric/oesophageal cancers is required in order to improve the evidence available for use in CUAs.