Postoperative ratio of the maximum C-reactive protein level to the minimum peripheral lymphocyte count as a prognostic indicator for gastric cancer patients

Purpose: Inflammation, together with immune and nutritional status, are associated with the progression of various cancer types. We evaluated the prognostic significance of the postoperative ratio (post-CLR) of the maximum C-reactive protein value (post-CRP ^Max ) to the minimum peripheral lymphocyte count (post-LC ^Min ) in patients with gastric cancer (GC). Methods: The subjects of this retrospective study were 227 patients who underwent curative surgery for histopathologically diagnosed gastric adenocarcinoma. Results: The 5-year overall survival (OS) rates differed significantly between the post-CLR ^High (≥ 152.6) group and the post-CLR ^Low (< 152.6) group for all patients (45.0% vs. 68.4%, respectively; P < 0.001). The 5-year disease-specific survival (DSS) rates were also significantly related to post-CLR for all patients, (80.6% vs. 64.3% for the post-CLR ^Low and the post-CLR ^High groups, respectively; P = 0.002). Among patients without infectious complications, the CLR affected both the 5-year OS rate (48.4% vs. 69.2% for the post-CLR ^High and the post-CLR ^Low groups, respectively; P = 0.006) and the 5-year DSS rate (80.2% vs. 67.0% for the post-CLR ^Low and the post-CLR ^High groups, respectively; P = 0.027). Multivariate analysis revealed that post-CLR was an independent prognostic indicator for both the OS and DSS of all patients. Conclusions: Our finding show that the post-CLR can help predict the prognosis of GC patients.