The Prognostic Value of the Advanced Lung Cancer Inflammation Index on Disease-Free Survival in Patients with Gastric Cancer Receiving Neoadjuvant Chemotherapy


Kara M., Ürün M., Ebinç S., Sezgin Y., Yılmaz Ürün Y., Aldemir M. N.

Journal of Clinical Medicine, cilt.15, sa.17, 2026 (SCI-Expanded, Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 15 Sayı: 17
  • Basım Tarihi: 2026
  • Doi Numarası: 10.3390/jcm15176806
  • Dergi Adı: Journal of Clinical Medicine
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Chemical Abstracts Core, EMBASE, Academic Search Ultimate (EBSCO), Health Research Premium Collection (ProQuest)
  • Anahtar Kelimeler: Advanced Lung Cancer Inflammation Index (ALI), disease-free survival, gastric cancer, neoadjuvant chemotherapy
  • Van Yüzüncü Yıl Üniversitesi Adresli: Evet

Özet

Objectives: The present study investigated whether the pre-treatment Advanced Lung Cancer Inflammation Index (ALI) could serve as a prognostic indicator of disease-free survival (DFS) in patients with locally advanced gastric cancer treated with neoadjuvant chemotherapy followed by curative D2 gastrectomy. Methods: We retrospectively analyzed 157 patients with gastric adenocarcinoma who received treatment between 2016 and 2025. The pre-treatment ALI was derived from body mass index, serum albumin concentration, and the neutrophil-to-lymphocyte ratio. The association of clinical and laboratory variables with DFS was assessed using Kaplan–Meier survival analysis and Cox proportional hazards regression. Results: Median patient age was 63.6 years (61.1% male). Overall, 50.3% of patients experienced recurrence. Multivariate analysis demonstrated that ALI is an independent prognostic factor for DFS (HR = 0.867; 95% CI: 0.768–0.978; p = 0.020). Advanced age (p = 0.040), advanced clinical N stage (p < 0.001), and non-FLOT regimens (p = 0.003) also significantly predicted poorer DFS. Kaplan–Meier analysis confirmed that median DFS was significantly shorter in the low ALI group (38.9 months) compared to the high ALI group (52.0 months; p = 0.029). Conclusions: A low pre-treatment ALI score independently predicts shorter DFS in locally advanced gastric cancer patients treated with neoadjuvant chemotherapy and surgery. ALI serves as an accessible, low-cost biomarker to identify high-risk patients, warranting further prospective validation.