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Preoperative Neutrophil-to-Albumin Ratio as a Prognostic Indicator in Advanced Gastric Cancer Undergoing Radical Gastrectomy

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Název: Preoperative Neutrophil-to-Albumin Ratio as a Prognostic Indicator in Advanced Gastric Cancer Undergoing Radical Gastrectomy
Autoři: Huaping Ye, Rong Kang, Mao Chen, Si Zhang, Jinfeng Yang
Zdroj: Ther Clin Risk Manag
Therapeutics and Clinical Risk Management, Vol Volume 21, Iss Issue 1, Pp 1107-1119 (2025)
Informace o vydavateli: Informa UK Limited, 2025.
Rok vydání: 2025
Témata: Prognostic biomarker, Radical gastrectomy, Systemic inflammation, Neutrophil-to-albumin ratio, Therapeutics. Pharmacology, RM1-950, Gastric cancer, Original Research
Popis: OBJECTIVE: This study aimed to evaluate the prognostic significance of the preoperative neutrophil-to-albumin ratio (NAR) in patients with advanced gastric cancer undergoing radical gastrectomy. METHODS: A retrospective analysis was conducted involving 526 patients diagnosed with locally advanced gastric adenocarcinoma who underwent radical gastrectomy between January 2017 and December 2019. Preoperative NAR values were calculated using neutrophil count and serum albumin levels obtained within 24 hours of admission. Patients were stratified into high-NAR and low-NAR groups using an optimal cut-off value determined by receiver operating characteristic analysis. Kaplan-Meier curves, univariate, and multivariate Cox regression analyses were used to evaluate overall survival and recurrence-free survival. RESULTS: The optimal NAR cut-off value was identified as 2.8. Patients with high NAR exhibited significantly worse overall survival and recurrence-free survival compared to the low-NAR group. High NAR was significantly associated with advanced tumor stage, incomplete resection status, administration of chemotherapy and radiotherapy, and poor histological differentiation (all P < 0.0001). Multivariate analyses confirmed NAR as an independent prognostic factor for both overall survival (HR=2.67; 95% CI, 1.97–4.25; p = 0.002) and recurrence-free survival (HR=3.51; 95% CI, 1.58–5.26; p = 0.003). CONCLUSION: The preoperative neutrophil-to-albumin ratio is an independent and reliable prognostic biomarker for overall and recurrence-free survival in patients with advanced gastric cancer undergoing radical gastrectomy. Due to its accessibility, simplicity, and predictive value, the neutrophil-to-albumin ratio can effectively facilitate risk stratification, personalized clinical decision-making, and targeted interventions to improve patient outcomes.
Druh dokumentu: Article
Other literature type
Jazyk: English
ISSN: 1178-203X
DOI: 10.2147/tcrm.s532863
Přístupová URL adresa: https://doaj.org/article/32e62a7c8ee445cf8279b25a6a7eeef8
Rights: CC BY NC
URL: http://creativecommons.org/licenses/by-nc/4.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at http://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v4.0) License (http://creativecommons.org/licenses/by-nc/4.0/ (http://creativecommons.org/licenses/by-nc/4.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (http://www.dovepress.com/terms.php).
Přístupové číslo: edsair.doi.dedup.....ea4ffb7a89bf87d04278643600ac0a16
Databáze: OpenAIRE
Popis
Abstrakt:OBJECTIVE: This study aimed to evaluate the prognostic significance of the preoperative neutrophil-to-albumin ratio (NAR) in patients with advanced gastric cancer undergoing radical gastrectomy. METHODS: A retrospective analysis was conducted involving 526 patients diagnosed with locally advanced gastric adenocarcinoma who underwent radical gastrectomy between January 2017 and December 2019. Preoperative NAR values were calculated using neutrophil count and serum albumin levels obtained within 24 hours of admission. Patients were stratified into high-NAR and low-NAR groups using an optimal cut-off value determined by receiver operating characteristic analysis. Kaplan-Meier curves, univariate, and multivariate Cox regression analyses were used to evaluate overall survival and recurrence-free survival. RESULTS: The optimal NAR cut-off value was identified as 2.8. Patients with high NAR exhibited significantly worse overall survival and recurrence-free survival compared to the low-NAR group. High NAR was significantly associated with advanced tumor stage, incomplete resection status, administration of chemotherapy and radiotherapy, and poor histological differentiation (all P < 0.0001). Multivariate analyses confirmed NAR as an independent prognostic factor for both overall survival (HR=2.67; 95% CI, 1.97–4.25; p = 0.002) and recurrence-free survival (HR=3.51; 95% CI, 1.58–5.26; p = 0.003). CONCLUSION: The preoperative neutrophil-to-albumin ratio is an independent and reliable prognostic biomarker for overall and recurrence-free survival in patients with advanced gastric cancer undergoing radical gastrectomy. Due to its accessibility, simplicity, and predictive value, the neutrophil-to-albumin ratio can effectively facilitate risk stratification, personalized clinical decision-making, and targeted interventions to improve patient outcomes.
ISSN:1178203X
DOI:10.2147/tcrm.s532863