Clinical significance of advanced lung cancer inflammation index, a nutritional and inflammation index, in gastric cancer patients after surgical resection: A propensity score matching analysis

概要

Background.
The advanced lung cancer inflammation index (ALI) has recently been shown as a prognostic marker for several cancers. However, the potential of ALI for predicting perioperative risk and oncological outcome in gastric cancer (GC) patients has never been clarified.

Objective.
The aim of our study is to investigate the predictive value of ALI in patients with GC who undergo surgical resection, and to clarify its predictive value for short-term (perioperative surgical site infection (SSI)) and long-term outcome (recurrence and prognosis).

Design.
Height, weight, and blood samples from each patient were obtained within 2 weeks prior to surgery for the resection of the primary tumor, and total protein and albumin (Alb) levels were analyzed in a routine blood test from patients to calculate the ALI. ALI was calculated as follows: ALI= Body Mass Index (BMI) X Alb/neutrolphil to lymphocyte ratio (NLR), where BMI = weight in kilograms/(height in meters)汽Alb= serum albumin in grams per decaliter, and NLR is derived using the= absolute neutrophil count/absolute lymphocyte count. Propensity score matching (PSM) analysis was also conducted to certify these potentials of preoperative ALI.

Patients.
A total of 620 patients who underwent gastrectomy for primary GC at Mie university hospital between 1992 and 2011 were enrolled in this observational retrospective study.

Main outcome measures.
The primary outcome measured was the prognostic value for overall survival (OS) and disease-free survival (DFS) and to clarify predictive value for perioperative risk of surgical site infection (SSI) in GC patients.

Results.
Preoperative low ALI was significantly correlated with advanced tumor-node-metastasis stage classification. Patients with low ALI showed poorer OS (p

Limitations.
The present study had several limitations, including retrospective observational and single institutional study from Japanese patients.

Conclusions.
This study provides new evidence for the clinical significance of preoperative ALI for predicting short-term and longterm outcomes in GC patients receiving a gastrectomy. Preoperative quantification of ALI may help surgeons and oncologists design more effective perioperative management and postoperative oncological follow-up strategies in GC patients.