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Meta-Analysis
. 2024 May 13;24(1):583.
doi: 10.1186/s12885-024-12349-9.

Prognostic value of the advanced lung cancer inflammation index in patients with gastric cancer after radical gastrectomy: a propensity-score matching cohort study and meta-analysis

Huayang Pang  1   2 , Lingyan Dai  1   3 , Lihui Chen  1 , Xiufeng Chen  1 , Zhixiong Chen  1 , Shouru Zhang  4 , Hao Sun  5
Affiliations
Meta-Analysis

Prognostic value of the advanced lung cancer inflammation index in patients with gastric cancer after radical gastrectomy: a propensity-score matching cohort study and meta-analysis

Huayang Pang et al. BMC Cancer. .

Abstract

Background: Insufficient evidence existed about the prognostic role of the advanced lung cancer inflammation index (ALI) for gastric cancer patients who underwent curative resection. The aim of this study was to identify the predictive ability of ALI for survival after curative gastrectomy.

Methods: We retrospectively analyzed 328 gastric cancer patients who received curative gastrectomy from the database of Chongqing University Cancer Hospital, and investigated the prognostic role of the preoperative ALI compared with clinicopathological variables and other serum biomarkers, such as preoperative neutrophil-to-lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and Lymphocyte-monocyte ratio (LMR). To minimize intergroup differences, propensity score matching (PSM) analysis was employed. Additionally, we performed a meta-analysis of four cohort studies published up to October 2023 following the PRISMA guidelines.

Results: In the overall cohort, patients in the low ALI group had a significantly worse overall survival compared to those in the high ALI group (P < 0.0001). Subgroup analysis identified that ALI maintained its prognostic significance across different subgroups. In addition, ROC analysis showed that ALI had a higher AUC value for 3-year overall survival compared to NLR, PLR, and LMR (0.576 vs. 0.573 vs. 0.557 vs. 0.557). Multivariate analysis indicated that ALI, other than other serum biomarkers, was an independent risk factor for decreased overall survival in GC patients following curative surgery (HR = 1.449; 95%CI: 1.028-2.045; P = 0.034). Consistently, PSM analysis supported all of these findings. The meta-analysis including 4 studies evaluating 2542 patients, confirmed the association between the low ALI and poor survival outcomes.

Conclusion: The preoperative ALI was an independent prognostic factor for survival in gastric cancer patients who underwent curative gastrectomy.

Keywords: Advanced lung cancer inflammation index; Gastric cancer; Meta-analysis; Prognostic value; Propensity-score matched analysis.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The flow chart of patients with gastric cancer enrolled in this study
Fig. 2
Fig. 2
Kapan-Meier curves of ALI in the overall (A) and PSM (B) cohorts
Fig. 3
Fig. 3
Subgroup analyses of ALI for overall survival in the overall (A) and PSM (B) cohorts
Fig. 4
Fig. 4
Predictive abilities of ALI and other hematological indices for 3-year overall survival examined using t-ROC curves in the overall (A) and PSM (B) cohorts
Fig. 5
Fig. 5
Forest plots of overall survival (A) and progression-free survival (B) between the low ALI and high ALI groups
See this image and copyright information in PMC

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