New index combining multiple inflammation-based prognostic scores for predicting the prognosis of gastric cancer patients

Background and Aim: Several inflammation-based scores have prognostic value for patients diagnosed with various cancers. However, using only a single inflammation-based prognostic score may be unreliable, as the cut-off values and relative usefulness among various inflammation-based prognostic scores vary. We established a new combined index of four inflammation-based prognostic scores, namely the neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, prognostic index, and prognostic nutritional index, and assessed its usefulness to predict the prognosis of gastric cancer. Methods and Results: We reviewed the data of 635 patients who underwent surgical resection for gastric cancer. We calculated the combined index as the total value of each of the four included inflammation-based prognostic scores and analyzed the relationship between the combined index and postoperative prognosis of gastric cancer. The new combined index was represented as a value between 0 and 6 in each patient. The Kaplan-Meier survival curves showed that patients whose combined index was 0 had good long-term outcomes, while the prognosis of patients whose combined index ranged from 4 to 6 was poor. Conclusion: This new combined index was strongly associated with poor prognosis in patients who underwent surgery for gastric cancer. It is inferred that it can predict patient prognosis after surgical resection for gastric cancer with a stronger correlation and clearer stratification than a single inflammation-based prognostic score.