Prognostic Significance Of Preoperative Serum Uric Acid To Lymphocyte Ratio In Advanced Gastric Cancer: A Propensity Score-matched Analysis

Purpose: Gastric cancer ranks fifth and forth in incidence and mortality among all cancer.The purpose of our research was to evaluate the prognostic value of uric acid to lymphocyte ratio(ULR)for advanced gastric cancer(AGC)patients after gastrectomy with D2 lymphadenectomy.Methods: In this research,we included 287 AGC patients underwent gastrectomy with D2 lymphadenectomy,and collected their clinicopathological data.All patients were divided into two groups based on the preoperative ULR level,the clinicopathological data and prognosis data between the two groups were compared.Then we established the propensity score matching(PSM)cohort to confirm our results.Finally,the prognostic values of ULR,uric acid,lymphocytes and albumin were compared by using the Receiver operating characteristic(ROC)curve.Results : We found that age(P<0.01)and gender(P<0.01)were significantly correlated with the ULR level.Survival analysis showed that the overall survival(OS)and Disease-free survival(DFS)in the high level ULR group were significantly shorter than in the low level ULR group(log-rank P < 0.001).Multivariate analysis showed that high levels of ULR,poor differentiation,postoperative pathology of T4 stage,and regional lymph node metastasis were independent prediction factors for poor outcomes of OS and DFS in patients with AGC after gastrectomy with D2 lymphadenectomy.Finally,ROC curve analysis showed that compared with a single serological index,ULR had better prognostic value and higher sensitivity and specificity.Conclusion: High level ULR is a poor predictive factor for patients with advanced gastric cancer underwent gastrectomy with D2 lymphadenectomy,and predict shorter overall survival and disease-free survival.