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.