Prognostic value of the advanced lung cancer inflammation index in early-stage non-small cell lung cancer patients undergoing video-assisted thoracoscopic pulmonary resection

Background: The aim of this study was to assess the prognostic value of the preoperative advanced lung cancer inflammation index (ALI) in early stage non-small lung cancer (NSCLC) patients who received video-assisted thoracoscopic surgery (VATS) pulmonary surgery as their only therapy. Methods: We retrospectively reviewed the medical records of patients who were diagnosed with early-stage NSCLC and received a VATS pulmonary resection from January 2014 to June 2016 in the Department of Thoracic Surgery, West China Hospital. A receiver operating characteristic (ROC) curve analysis was conducted to determine the optimal cut-off values, and patients were divided into low and high ALI groups. The Kaplan-Meier method and Cox proportional hazards model were used to evaluate potential predictors of overall survival (OS) and disease-free survival (DFS). Results: A total of 292 patients were enrolled in our analysis. Then, 155 and 137 patients were assigned to the low ALI (ALI <50) and high (ALI >50) groups, respectively. The multivariate analyses revealed that preoperative ALI <50 was an independent prognostic factor for both OS [hazard ratio (HR) =2.603, 95% confidence interval (95% CI): 1.128-6.006, P=0.025] and DFS (HR =2.372, 95% CI: 1.141-4.935, P=0.021), and patients with a low preoperative ALI had worse OS (P<0.001) and DFS (P<0.001) compared with those with a high preoperative ALI. Conclusions: A low preoperative ALI was significantly correlated with poor survival, and the ALI might serve as a promising marker of prognosis in early-stage NSCLC patients who received a VATS pulmonary resection as their only therapy.