Modified Advanced Lung Cancer Inflammation Index Is an Independent Prognostic Factor for Gastric Cancer Patients Who Receive Curative Treatment.

BACKGROUND/AIM: Body composition changes and nutritional status affect the oncological outcomes in various malignancies. Modified advanced lung cancer inflammation index (mALI) evaluates both body composition changes and nutritional status. Herein, we aimed to examine the potential of mALI as a biomarker for gastric cancer (GC).

PATIENTS AND METHODS

The medical records of 327 consecutive patients with gastric cancer who underwent curative resection at Yokohama City University from 2015 to 2022 were retrospectively reviewed. mALI was defined follows: Appendicular skeletal muscle index×Serum albumin/Neutrophil-to-lymphocyte ratio. The clinical impact of the mALI on the short- and long-term oncological outcomes was evaluated using Kaplan-Meier curves and Cox's proportional hazards models.

RESULTS

The 327 patients were classified into the mALI-low (n=121) and mALI-high (n=206) groups, respectively. The 1-, 3-, and 5-year overall survival (OS) rates were 94.0%, 71.4%, and 59.2%, respectively, in the mALI-low group, and 95.5%, 85.0%, and 79.9%, in the mALI-high group. In the multivariable analysis for OS, the mALI was identified as an independent prognostic factor [hazard ratio (HR)=1.794; 95% confidence interval (CI)=1.155-2.786, =0.009]. The 1-, 3-, and 5-year recurrence-free survival (RFS) rates were 79.6%, 66.0%, and 54.3%, respectively, in the mALI-low group, and 90.7%, 79.1%, and 75.5% in the mALI-high group. The multivariable analysis of RFS, identified the mALI as an independent prognostic factor (HR=1.654; 95% CI=1.105-2.477, =0.015). In addition, the mALI status affected short-term oncological outcomes, including the occurrence of postoperative surgical complications and the introduction of postoperative adjuvant chemotherapy.

CONCLUSION

The mALI was an independent prognostic factor for OS and RFS in patients with GC. Our results suggest that the mALI is a promising biomarker for GC and a useful tool for the treatment and management of GC.