Prognostic value of the lung immune prognostic index in metastatic gastric cancer: a single-center retrospective cohort study

Aims To evaluate the prognostic significance of the Lung Immune Prognostic Index (LIPI) in patients with metastatic gastric cancer (mGC).Patients and methods We retrospectively analyzed 177 patients with mGC. Patients were stratified into three groups (good, intermediate, and poor) based on the LIPI score, which was calculated using a derived neutrophil-to-lymphocyte ratio (dNLR) >3 and lactate dehydrogenase (LDH) >upper limit of normal (ULN). Survival outcomes were analyzed using Kaplan–Meier and Cox regression models.Results In univariate analyses, intermediate and poor LIPI, elevated dNLR and LDH, ECOG performance status ≥1, low albumin, and high CRP were significantly associated with overall survival. In multivariate analysis, poor LIPI remained an independent prognostic factor (HR: 3.43; 95% CI: 1.30–9.05; p = 0.013). ECOG performance status and C-reactive protein (CRP) were also independently associated with survival. Subgroup analysis showed a more pronounced prognostic impact of LIPI in Human Epidermal Growth Factor Receptor 2 (HER2)-negative patients.Conclusions The LIPI is a simple, noninvasive, and inexpensive tool that provides strong prognostic information for patients with mGC, potentially aiding in better risk stratification in clinical practice.