Advanced lung cancer inflammation index predicts survival outcome of cancer patients with diabetes mellitus

Rationale: Patients with cancer and diabetes mellitus (DM) are more likely to develop a proinflammatory or malnourished status. Advanced lung cancer inflammation index (ALI) is a useful indicator of systemic inflammation and nutritional status. However, its association with mortality in patients with cancer and DM has not yet been clarified. Methods: A total of 1466 patients with cancer and DM were included in this study. The association between ALI and overall survival was examined using the Kaplan–Meier method and the Cox model. Results: Among the participants, 878 (59.9%) were men and 588 (40.1%) were women. The area under the curve (AUC) for all-cause mortality was higher for the ALI than the inflammation-based scores. An increase in ALI was inversely associated with all-cause mortality. Low ALI was associated with a worse prognosis in cancer patients with DM (HR, 1.47; 95% CI: 1.23–1.77; P  < 0.01). For specific tumor types, low ALI was independently associated with worse prognosis in patients with lung cancer, upper gastrointestinal cancer, and colorectal cancer. The association between ALI and all-cause mortality was modified by age. Conclusions: Low ALI is associated with an increased risk of all-cause mortality in patients with cancer and DM.