Impact of Serum Albumin Concentration and Neutrophil-lymphocyte Ratio Score on Gastric Cancer Prognosis

Introduction: /AimSerum albumin concentration (COA) and neutrophil-lymphocyte ratio (NLR) could reflect immunological and nutritional status. We aim to evaluate the impact of COA-NLR score on the prognosis of gastric cancer (GC). Material and methodsWe perform a retrospective analysis on a database of 637 GC cases, between January 2010 and December 2017. In 396 patients the inclusion criteria for this study were met (non-resectional or palliative surgery were excluded). Analytic data was only available in 203 patients. COA-NLR score was defined as: COA under 35 g/L and NLR value of 2.585 or higher – score 2; one of these conditions – score 1; and neither – score 0. ResultsIn our population (n=203), 87 patients were classified as score 0, 82 as score 1 and 34 as score 2. COA-NLR score was significantly associated with DFS [HR 1,674; CI95% 1,115 – 2,513; p=0,013) and with OS [HR 2,072; CI95% 1,531 – 2,805; p<0,001]. Kaplan-Meier curves analysis (log-rank test) revealed that a higher score of COA-NLR predicted a worse OS (p<0,001) and DFS (p=0,03). COA-NLR was an independent prognostic factor for OS when adjusted to pStage and age [adjusted HR 1,566; CI95% 1,145 – 2,143; p=0,005]. ConclusionsPreoperative COA-NLR score was significantly associated with worse OS and DFS and, in this way, with worse prognosis on GC patients submitted to curative-intent resectional surgery.