{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T05:21:27Z","timestamp":1763529687143,"version":"3.45.0"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T00:00:00Z","timestamp":1763510400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the prognostic significance of inflammatory and nutrition-related indexes in patients with cardia cancer prior to treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 229 patients with cardia cancer, diagnosed pathologically and admitted to Shanxi Cancer Hospital between January 2017 and December 2018, were included. Statistical analysis was conducted using SPSS 26.0, and the optimal cut-off values for body mass index (BMI), peripheral blood platelet-to-lymphocyte ratio (PLR), hemoglobin-to-erythrocyte distribution width ratio (HRR), prognostic nutritional index (PNI), and integrating hemoglobin, albumin, lymphocyte, and platelets (HALP) score were determined with X-tile 3.6.1 software. Survival analysis was performed using the Kaplan\u2013Meier method, with variability assessed by the Log-rank test. Univariate and multivariate Cox proportional hazards regression analyses were used to evaluate the prognostic value of the variables. A prognostic risk stratification model was developed, incorporating age, tumor node metastasis classification (TNM), treatment options, HRR, and PNI, to classify patients into low-risk, intermediate-risk, high-risk, and very high-risk groups. The predictive value of the model was assessed using receiver operating characteristic (ROC) curves.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The optimal critical values of BMI, PLR, HRR, PNI, and HALP score were 20.43\u202fkg\/m\n                      <jats:sup>2<\/jats:sup>\n                      , 140.59, 2.85, 49.98, and 28.23, respectively. Cox univariate analysis showed that age, TNM stage, treatment regimen, BMI, PLR, HRR, PNI, and HALP score were correlated with the prognosis of patients with cardia cancer (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05). The results of Cox multifactorial analysis showed that age, TNM stage, treatment regimen, HRR, and PNI were independent factors affecting the prognosis of patients with cardia cancer (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05). Age \u2265 60\u202fyears, TNM stage III\/IV, treatment regimen without surgical involvement, HRR\u202f&amp;lt;\u202f2.85, and PNI\u202f&amp;lt;\u202f49.98 were considered as risk factors. These five variables were assigned points based on their HRs. The patients were categorized as low-risk (0\u20136 points), intermediate-risk (7\u20138 points), high-risk (9 points), and very-high-risk (10\u201311 points) groups. The median survival times were undefined, 18.05\u202fmonths, 15.63\u202fmonths, and 9.10\u202fmonths, respectively, with statistically significant differences among the four groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05). ROC curve analysis, the area under the curve (AUC) of the prognostic risk stratification model was 0.80, which was higher than those for age (0.56), TNM stage (0.63), treatment regimen (0.73), HRR (0.57), and PNI (0.63).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Pre-treatment inflammatory and nutrition-related indexes, HRR and PNI, were closely associated with the prognosis of patients with cardia cancer. Combining age, TNM stage, treatment regimen, HRR, and PNI for prognostic risk stratification could significantly enhance the accuracy of prognostic predictions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2025.1559892","type":"journal-article","created":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T05:18:31Z","timestamp":1763529511000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The prognostic value of pretreatment inflammatory and nutrition-related indices in patients with cardia cancer"],"prefix":"10.3389","volume":"12","author":[{"given":"Wenjuan","family":"Guo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinwei","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ning","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,19]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"674","DOI":"10.1111\/1751-2980.12945","article-title":"Unraveling the identity of gastric cardiac cancer","volume":"21","author":"Huang","year":"2020","journal-title":"J Dig Dis"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1043550","DOI":"10.3389\/fnut.2023.1043550","article-title":"Value of a preoperative prognostic nutritional index for the prognostic evaluation of gastric neuroendocrine carcinoma patients","volume":"10","author":"Wei","year":"2023","journal-title":"Front Nutr"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1016\/j.ygyno.2021.11.009","article-title":"Pre-treatment inflammatory parameters predict survival from endometrial cancer: A prospective database analysis","volume":"164","author":"Njoku","year":"2022","journal-title":"Gynecol Oncol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"2237","DOI":"10.1007\/s00520-021-06612-z","article-title":"Malnutrition risk at solid tumor diagnosis: the malnutrition screening tool in a large US cancer institute","volume":"30","author":"Kadakia","year":"2022","journal-title":"Support Care Cancer"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"360","DOI":"10.1002\/ags3.12351","article-title":"Nutrition update in gastric cancer surgery","volume":"4","author":"Kubota","year":"2020","journal-title":"Ann Gastroenterol Surg"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1187","DOI":"10.1016\/j.clnu.2017.06.017","article-title":"ESPEN expert group recommendations for action against cancer-related malnutrition","volume":"36","author":"Arends","year":"2017","journal-title":"Clin Nutr"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"2540","DOI":"10.1002\/cncr.34218","article-title":"The online Cancer nutrition misinformation: A framework of behavior change based on exposure to cancer nutrition misinformation","volume":"128","author":"Warner","year":"2022","journal-title":"Cancer"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"111492","DOI":"10.1016\/j.nut.2021.111492","article-title":"Perioperative nutrition management for gastric cancer","volume":"93","author":"Xu","year":"2022","journal-title":"Nutrition"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1112473","DOI":"10.3389\/fsurg.2023.1112473","article-title":"Effects of different radical distal gastrectomy on postoperative inflammatory response and nutritional status in patients with gastric cancer","volume":"10","author":"Cheng","year":"2023","journal-title":"Front Surg"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"981533","DOI":"10.3389\/fnut.2022.981533","article-title":"Combined systemic inflammatory immunity index and prognostic nutritional index scores as a screening marker for sarcopenia in patients with locally advanced gastric cancer","volume":"9","author":"Ding","year":"2022","journal-title":"Front Nutr"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"388","DOI":"10.1089\/cbr.2021.0343","article-title":"A novel scoring system in predicting prognosis after adjuvant FOLFOX chemotherapy in gastric Cancer","volume":"38","author":"Ge","year":"2023","journal-title":"Cancer Biother Radiopharm"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"2476729","DOI":"10.1080\/07853890.2025.2476729","article-title":"Association of anti-PD-(L)1 treatment duration to efficacy in advanced solid tumors: a single center retrospective study","volume":"57","author":"Kuusisalo","year":"2025","journal-title":"Ann Med"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"446","DOI":"10.1038\/s41598-024-84890-3","article-title":"Pretreatment neutrophil-to-lymphocyte ratio is associated with immunotherapy efficacy in patients with advanced cancer: a systematic review and meta-analysis","volume":"15","author":"Su","year":"2025","journal-title":"Sci Rep"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1554048","DOI":"10.3389\/fimmu.2025.1554048","article-title":"Prognostic and predictive value of pre-treatment blood-based inflammatory biomarkers in patients with urothelial carcinoma treated with immune checkpoint inhibitors: a systematic review and meta-analysis","volume":"16","author":"Sz\u00e9les","year":"2025","journal-title":"Front Immunol"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"539","DOI":"10.2147\/jir.S395331","article-title":"Clinical significance and diagnostic utility of NLR, LMR, PLR and SII in the course of COVID-19: A literature review","volume":"16","author":"Kosid\u0142o","year":"2023","journal-title":"J Inflamm Res"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1186\/s12943-024-02020-z","article-title":"Aging and cancer","volume":"23","author":"Mont\u00e9gut","year":"2024","journal-title":"Mol Cancer"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1186\/s13062-024-00493-y","article-title":"Genomic characteristics and evolution of multicentric esophageal and gastric cardiac Cancer","volume":"19","author":"Liu","year":"2024","journal-title":"Biol Direct"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"2059","DOI":"10.1245\/s10434-020-08821-y","article-title":"Comparison of inflammation-based prognostic scores associated with the prognostic impact of adenocarcinoma of Esophagogastric junction and upper gastric Cancer","volume":"28","author":"Kudou","year":"2021","journal-title":"Ann Surg Oncol"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"1741","DOI":"10.3390\/cancers16091741","article-title":"Gastric Cancer surgery: balancing oncological efficacy against postoperative morbidity and function detriment","volume":"16","author":"Tsekrekos","year":"2024","journal-title":"Cancers (Basel)"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2019\/7606128","article-title":"Preoperative Anemia or low hemoglobin predicts poor prognosis in gastric Cancer patients: A Meta-analysis","volume":"2019","author":"Huang","year":"2019","journal-title":"Dis Markers"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"473","DOI":"10.2217\/bmm-2021-0577","article-title":"Prognostic value of hemoglobin-to-red cell distribution width ratio in cancer: a systematic review and meta-analysis","volume":"16","author":"Chi","year":"2022","journal-title":"Biomark Med"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"2314","DOI":"10.21873\/invivo.12962","article-title":"The prognostic significance of preoperative Anemia in gastric Cancer patients","volume":"36","author":"Kunishige","year":"2022","journal-title":"In vivo (Athens, Greece)"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"798","DOI":"10.1007\/s10147-019-01417-x","article-title":"A prognostic parameter in advanced non-small cell lung cancer: the ratio of hemoglobin-to-red cell distribution width","volume":"24","author":"Bozkaya","year":"2019","journal-title":"Int J Clin Oncol"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"19","DOI":"10.3233\/cbm-160668","article-title":"The role of red cell distribution width in the prognosis of patients with gastric cancer","volume":"18","author":"Yazici","year":"2017","journal-title":"Cancer Biomark"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"710","DOI":"10.3390\/cancers13040710","article-title":"Prognostic value of the hemoglobin\/red cell distribution width ratio in resected lung adenocarcinoma","volume":"13","author":"Petrella","year":"2021","journal-title":"Cancers (Basel)"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"1010","DOI":"10.1007\/s11605-019-04392-w","article-title":"Prognostic significance of pre- and post-operative red-cell distribution width in patients with gastric Cancer","volume":"24","author":"Shota","year":"2020","journal-title":"J Gastrointest Surg"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"42650","DOI":"10.18632\/oncotarget.9516","article-title":"The ratio of hemoglobin to red cell distribution width as a novel prognostic parameter in esophageal squamous cell carcinoma: a retrospective study from southern China","volume":"7","author":"Sun","year":"2016","journal-title":"Oncotarget"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2022\/3889588","article-title":"The clinical application value of the prognostic nutritional index for the overall survival prognosis of patients with esophageal Cancer: A robust real-world observational study in China","volume":"2022","author":"Kang","year":"2022","journal-title":"Comput Math Methods Med"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"423","DOI":"10.3390\/diagnostics12020423","article-title":"Prognostic nutritional index and lung immune prognostic index as prognostic predictors for combination therapies of immune checkpoint inhibitors and cytotoxic anticancer chemotherapy for patients with advanced non-small cell lung cancer","volume":"12","author":"Tanaka","year":"2022","journal-title":"Diagnostics (Basel, Switzerland)"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"794489","DOI":"10.3389\/fnut.2022.794489","article-title":"Prognostic value of prognostic nutritional index in patients with colorectal Cancer undergoing surgical treatment","volume":"9","author":"Xie","year":"2022","journal-title":"Front Nutr"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"1176","DOI":"10.1016\/j.ejso.2016.05.029","article-title":"The prognostic nutritional index is a predictive indicator of prognosis and postoperative complications in gastric cancer: A meta-analysis","volume":"42","author":"Yang","year":"2016","journal-title":"Eur J Surg Oncol"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"555","DOI":"10.1038\/s41430-019-0502-1","article-title":"Association among the prognostic nutritional index, completion of adjuvant chemotherapy, and cancer-specific survival after curative resection of stage II\/III gastric cancer","volume":"74","author":"Xiao","year":"2020","journal-title":"Eur J Clin Nutr"}],"container-title":["Frontiers in Nutrition"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2025.1559892\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T05:18:31Z","timestamp":1763529511000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2025.1559892\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,19]]},"references-count":32,"alternative-id":["10.3389\/fnut.2025.1559892"],"URL":"https:\/\/doi.org\/10.3389\/fnut.2025.1559892","relation":{},"ISSN":["2296-861X"],"issn-type":[{"value":"2296-861X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,19]]},"article-number":"1559892"}}