Abstract
BACKGROUND: Patients with gastric cancer (GC) present with chronic inflammation and malnutrition risk. Lymphocyte-to-C-reactive protein ratio (LCR) and food intake are promising indicators for predicting inflammatory and nutritional states. METHODS: This multi-center cohort study included 763 patients with GC. Time-dependent receiver operating characteristic curves were generated to determine the prediction accuracy of 16 systemic inflammatory indicators. Association of the model constructed by LCR and food intake with overall survival (OS) were analyzed using the Kaplan-Meier method and Cox regression model. RESULTS: In this analysis, patients with reduced food intake accounted for 60.4%. The area under the curve and C-index of LCR for all-cause mortality were higher than those of the other indicators in patients with GC and there was a significant inverse relationship between LCR and all-cause mortality (per SD increment HR: 0.79, 95% CI: 0.65-0.96; P = 0.016). Patients with reduced food intake had lower LCR than those patients without reduced food intake. Low LCR had combined effects with reduced food intake on unfavorable OS of patients with GC. CONCLUSIONS: Combined assessment of inflammation and food intake contributes to prognostic stratification of GC. Active therapeutic measures to reduce inflammation and increase nutrition may improve outcomes of affected patients.