PT - JOURNAL ARTICLE AU - Gao, Xianchun AU - Pan, Yanan AU - Han, Weili AU - Hu, Caie AU - Wang, Chenchen AU - Chen, Ling AU - Guo, Yong AU - Shi, Yupeng AU - Pan, Yan AU - Xie, Huahong AU - Yao, Liping AU - Yang, Jianjun AU - Zheng, Jianyong AU - Li, Xiaohua AU - Liu, Xiaonan AU - Hong, Liu AU - Li, Jipeng AU - Li, Mengbin AU - Ji, Gang AU - Li, Zengshan AU - Xia, Jielai AU - Zhao, Qingchuan AU - Fan, Daiming AU - Wu, Kaichun AU - Nie, Yongzhan TI - Association of systemic inflammation and body mass index with survival in patients with resectable gastric or gastroesophageal junction adenocarcinomas AID - 10.20892/j.issn.2095-3941.2020.0246 DP - 2021 Feb 01 TA - Cancer Biology and Medicine PG - 283--297 VI - 18 IP - 1 4099 - http://www.cancerbiomed.org/content/18/1/283.short 4100 - http://www.cancerbiomed.org/content/18/1/283.full SO - Cancer Biol Med2021 Feb 01; 18 AB - Objective: The systemic inflammation index and body mass index (BMI) are easily accessible markers that can predict mortality. However, the prognostic value of the combined use of these two markers remains unclear. The goal of this study was therefore to evaluate the association of these markers with outcomes based on a large cohort of patients with gastric cancer.Methods A total of 2,542 consecutive patients undergoing radical surgery for gastric or gastroesophageal junction adenocarcinoma between 2009 and 2014 were included. Systemic inflammation was quantified by the preoperative neutrophil-to-lymphocyte ratio (NLR). High systemic inflammation was defined as NLR ≥ 3, and underweight was defined as BMI < 18.5 kg/m2.Results Among 2,542 patients, NLR ≥ 3 and underweight were common [627 (25%) and 349 (14%), respectively]. In the entire cohort, NLR ≥ 3 or underweight independently predicted overall survival (OS) [hazard ratio (HR): 1.236, 95% confidence interval (95% CI): 1.069–1.430; and HR: 1.600, 95% CI: 1.350–1.897, respectively] and recurrence-free survival (RFS) (HR: 1.230, 95% CI: 1.054–1.434; and HR: 1.658, 95% CI: 1.389–1.979, respectively). Patients with both NLR ≥ 3 and underweight (vs. neither) had much worse OS (HR: 2.445, 95% CI: 1.853–3.225) and RFS (HR: 2.405, 95% CI: 1.802–3.209). Furthermore, we observed similar results in subgroup analyses according to pathological stage, age, and postoperative chemotherapy.Conclusions Our results showed that preoperative elevated NLR and decreased BMI had a significant negative effect on survival. Underweight combined with severe inflammation could enhance prognostication. Taking active therapeutic measures to reduce inflammation and increase nutrition may help improve outcomes.