RT Journal Article SR Electronic T1 Association of systemic inflammation and body mass index with survival in patients with resectable gastric or gastroesophageal junction adenocarcinomas JF Cancer Biology and Medicine JO Cancer Biol Med FD China Anti-Cancer Association SP 283 OP 297 DO 10.20892/j.issn.2095-3941.2020.0246 VO 18 IS 1 A1 Gao, Xianchun A1 Pan, Yanan A1 Han, Weili A1 Hu, Caie A1 Wang, Chenchen A1 Chen, Ling A1 Guo, Yong A1 Shi, Yupeng A1 Pan, Yan A1 Xie, Huahong A1 Yao, Liping A1 Yang, Jianjun A1 Zheng, Jianyong A1 Li, Xiaohua A1 Liu, Xiaonan A1 Hong, Liu A1 Li, Jipeng A1 Li, Mengbin A1 Ji, Gang A1 Li, Zengshan A1 Xia, Jielai A1 Zhao, Qingchuan A1 Fan, Daiming A1 Wu, Kaichun A1 Nie, Yongzhan YR 2021 UL http://www.cancerbiomed.org/content/18/1/283.abstract 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.