Prognostic role of inflammatory response markers in gastric adenocarcinoma

BACKGROUND: Prognostic assessment of survival in patients with cancer is essential for guiding treatment strategies, particularly in gastric cancer, which is associated with high morbidity and mortality. AIM: The study aimed to evaluate the association between inflammatory response markers and survival outcomes in patients with gastric adenocarcinoma. MATERIAL AND METHODS: The study included 152 patients with histologically confirmed gastric adenocarcinoma. Patients were distributed by stage as follows: 25 (16.45%) with stage I, 25 (16.45%) with stage II, 34 (22.4%) with stage III, and 68 (44.7%) with stage IV disease. Inflammatory response parameters were collected, calculated, and evaluated. The resulting data were analyzed and compared to identify statistically significant associations with overall survival. The inflammatory response parameters included the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR), as well as two specific indices, systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI), which reflect the activity of inflammatory response in cancer patients and may serve as additional independent prognostic factors. The Mann–Whitney U test was used for two-group comparisons and the Kruskal–Wallis test for comparisons across more than two groups. Spearman’s rank correlation coefficient was used to assess the relationship between inflammatory markers and overall survival. Statistical analysis was performed using MedCalc version 20.104. RESULTS: No significant associations were observed between inflammatory markers and patients’ age or sex. All inflammatory markers were significantly associated with overall survival (p 0.001 for NLR, PLR, SII, and SIRI; p = 0.013 for MLR). Elevated levels of these markers correlated with shorter overall survival and a higher probability of stage IV disease. CONCLUSION: Changes in hematologic markers reflecting systemic immune inflammation and inflammatory response are significantly correlate with survival outcomes in patients with gastric cancer.