{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T12:10:50Z","timestamp":1789992650390,"version":"4.0.1"},"reference-count":21,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Gastric cancer is one of the most common malignancies worldwide and continues to be associated with high mortality. The hemoglobin-to-red cell distribution width (HGB\/RDW) ratio has emerged as a promising hematological prognostic biomarker in various cancers. However, its prognostic significance in patients with curative-intent resection of non-metastatic gastric cancer remains insufficiently investigated. This study aimed to evaluate the association between the pretreatment HGB\/RDW ratio and progression-free survival (PFS) as well as overall survival (OS) in patients with non-metastatic gastric cancer. Materials and Methods: In this multicenter study, a total of 175 patients with non-metastatic gastric cancer who received perioperative FLOT chemotherapy (four preoperative and four postoperative cycles) and underwent curative-intent surgical resection were retrospectively analyzed. A cut-off value for the HGB\/RDW ratio was calculated using receiver operating characteristic (ROC) curve analysis. Survival outcomes, including progression-free survival (PFS) and overall survival (OS), were analyzed using the Kaplan\u2013Meier method. Multivariate Cox proportional hazards regression analysis was performed to identify independent prognostic factors. Results: Patients with an HGB\/RDW ratio &gt; 0.85 demonstrated significantly superior 2-year and 5-year OS rates (76.2% vs. 59.6% and 51.6% vs. 27.7%, respectively; p = 0.003) and PFS rates (69.4% vs. 49.6% and 53.7% vs. 36.4%, respectively; p = 0.047) compared to those with HGB\/RDW \u2264 0.85. Multivariate analysis identified HGB\/RDW \u2264 0.85 as an independent predictor of both increased mortality risk (HR: 1.88, 95% CI: 1.16\u20133.06; p = 0.011) and disease progression risk (HR: 1.79, 95% CI: 1.18\u20132.72; p = 0.006). Conclusions: The pretreatment HGB\/RDW ratio is an independent prognostic factor for OS and PFS in patients with curative-intent resection of non-metastatic gastric cancer and may be considered a practical marker that could contribute to treatment planning in this patient population.<\/jats:p>","DOI":"10.3390\/medicina62091797","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T10:25:43Z","timestamp":1789986343000},"page":"1797","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hemoglobin-to-Red Cell Distribution Width Ratio Independently Predicts Survival in Non-Metastatic Gastric Cancer: A Retrospective Cohort Study"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1199-4760","authenticated-orcid":false,"given":"Sevgi","family":"Bilmez Altay","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Gaziantep \u00d6zel Emek Hospital, Gaziantep 27060, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2360-3392","authenticated-orcid":false,"given":"\u0130lker Nihat","family":"\u00d6kten","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, G\u00f6ztepe Prof. Dr. S\u00fcleyman Yal\u00e7\u0131n City Hospital, Istanbul 34722, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6870-1004","authenticated-orcid":false,"given":"\u00c7a\u011flar","family":"K\u00f6seo\u011flu","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Gaziantep City Hospital, Gaziantep 27470, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ert\u00fcrk","family":"Yi\u011fit","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Gaziantep City Hospital, Gaziantep 27470, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8596-4233","authenticated-orcid":false,"given":"Mehmet","family":"Uzun","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, University of Health Sciences, \u0130zmir Tepecik Training and Research Hospital, Izmir 35020, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O\u011fuzhan","family":"Kesen","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Recep Tayyip Erdo\u011fan University, Rize 53100, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,18]]},"reference":[{"key":"ref_1","first-page":"209","article-title":"Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J. 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