Prognostic value of preoperative L3 SMI, AGR, and PNI in the overall survival of patients after radical gastric cancer surgery

We collected baseline data from patients who underwent radical gastrectomy without receiving neoadjuvant chemotherapy between 2011 and 2018. Additionally, we gathered various preoperative test indicators and monitored the survival status of the patients. The L3 SMI values of patients were assessed using preoperative CT scans, and eight nutritional inflammatory markers were calculated, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), pan-immune-inflammation value (PIV), albumin-to-globulin ratio (AGR), and prognostic nutritional index (PNI). Subsequently, these patients were followed up. The critical values of each indicator were calculated using receiver operating characteristic (ROC) curve analysis, and the L3 SMI values were categorized into low, normal, and high groups using X-tiler software. Survival outcomes among groups were compared using the Kaplan-Meier method, while both univariate and multivariate Cox proportional hazards models were employed to analyze the relationship between each indicator and survival. The C-index was calculated to evaluate the predictive ability of the indicators, and subgroup analyses were conducted to explore the consistency of the relevant indicators across different subgroups.