The Advanced Lung Cancer Inflammation Index: A Powerful and Independent Prognostic Factor in Metastatic Gastric Cancer

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Background and Objectives: The Advanced Lung Cancer Inflammation Index (ALI), a composite marker integrating body mass index (BMI), serum albumin, and neutrophil-to-lymphocyte ratio (NLR), has demonstrated prognostic value in various cancers. However, its role in metastatic gastric cancer (mGC) remains unexplored. This study aimed to investigate the prognostic significance of the ALI in patients with mGC. Materials and Methods: This retrospective study included 206 patients with de novo or recurrent metastatic gastric cancer treated at Manisa Celal Bayar University between September 2009 and 2024. The ALI was calculated as “BMI × serum albumin (g/dL)/NLR”. A cut-off value of 20.8 was determined using Receiver Operating Characteristic (ROC) curve analysis. Patients were stratified into high (ALI > 20.8) and low (ALI ≤ 20.8) groups. Survival outcomes were evaluated using Kaplan–Meier analysis, and prognostic factors were examined with Cox regression models. Results: The median overall survival (OS) was significantly longer in the high-ALI group compared to the low-ALI group (11.4 months vs. 5.2 months, p < 0.001). The 1-year and 2-year OS rates were 42.9% and 11.3% for the high-ALI group, versus 11.6% and 2.1% for the low-ALI group, respectively. Multivariate Cox regression analysis confirmed that a low ALI was an independent predictor of poorer survival (HR: 2.07, 95% CI: 1.47–2.92, p < 0.001). The low-ALI group also had a higher prevalence of peritoneal metastases and a lower likelihood of receiving first- and second-line chemotherapy. Conclusions: The ALI is a strong and independent prognostic factor for survival in patients with metastatic gastric cancer. As an easily calculable and cost-effective index derived from routine parameters, it shows significant potential for risk stratification and treatment planning in clinical practice. Prospective, multi-centre studies are warranted to validate these findings.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.