Advanced Lung Cancer Inflammation Index Predicts Outcomes of Patients with Pathological Stage IA Lung Adenocarcinoma Following Surgical Resection

Ann Thorac Cardiovasc Surg. 2019 Apr 20;25(2):87-94. doi: 10.5761/atcs.oa.18-00158. Epub 2018 Oct 17.


Purpose: The correlation of advanced cancer with inflammation and/or nutrition factors is well known. Recently, the advanced lung cancer inflammation index (ALI) was developed as a new prognostic tool for patients with advanced lung cancer. In this study, we examined whether ALI results are correlated with prognosis of patients with early stage lung adenocarcinoma who undergo lung resection.

Methods: From January 2009 to December 2014, 544 patients underwent lung resection due to primary lung cancer at Dokkyo Medical University Hospital, of whom 166 with pathological stage IA lung adenocarcinoma were retrospectively investigated in this study. ALI was calculated as follows: Body Mass Index (BMI; kg/m2) × albumin (g/dL)/neutrophil-to-lymphocyte ratio (NLR).

Results: Multivariate analysis revealed that gender, red cell distribution width (RDW), NLR, and ALI were parameters significantly correlated with overall survival (OS). Patients with an ALI value less than 22.2 had an inferior 5-year OS rate as compared to those with a value of 22.2 or higher (p <0.001) as well as an inferior 5-year recurrence-free survival (RFS) rate (p <0.001).

Conclusion: Low ALI was correlated with poor prognosis in patients with stage IA lung adenocarcinoma. Those with an ALI value less than 22.2 should be carefully followed regardless of cancer stage.

Keywords: nutrition; outcome; thoracic.

MeSH terms

  • Adenocarcinoma of Lung / mortality
  • Adenocarcinoma of Lung / secondary
  • Adenocarcinoma of Lung / surgery*
  • Aged
  • Body Mass Index
  • Disease Progression
  • Erythrocyte Indices
  • Female
  • Health Status Indicators*
  • Health Status*
  • Humans
  • Japan
  • Lung Neoplasms / mortality
  • Lung Neoplasms / pathology
  • Lung Neoplasms / surgery*
  • Lymphocyte Count
  • Lymphocytes
  • Male
  • Neoplasm Recurrence, Local
  • Neoplasm Staging
  • Neutrophils
  • Nutritional Status
  • Pneumonectomy* / adverse effects
  • Pneumonectomy* / mortality
  • Pneumonia / blood
  • Pneumonia / diagnosis*
  • Pneumonia / mortality
  • Predictive Value of Tests
  • Progression-Free Survival
  • Retrospective Studies
  • Risk Factors
  • Serum Albumin, Human / analysis
  • Time Factors


  • Serum Albumin, Human