Purpose: Gastric cancer ranks sixth and second in incidence and mortality among all cancer. The purpose of our research was to evaluate the prognostic value of uric acid to lymphocyte ratio (ULR) for advanced gastric cancer (AGC) patients after gastrectomy with D2 lymphadenectomy.Methods: In this research, we included 287 AGC patients underwent gastrectomy with D2 lymphadenectomy. These patients were followed up for 5 years, and their clinicopathological data were collected. All patients were divided into two groups based on the preoperative ULR level. Then we established the propensity score matching (PSM) cohort to confirm our results. Finally, The clinical characteristics and survival indexes of the two groups in the PSM cohort and the entire cohort were compared. Results:We found that age and gender were significantly correlated with the ULR level. Multivariate analysis for the entire cohort and PSM cohort showed that high levels of ULR, poor differentiation, postoperative pathology of T4 stage, and regional lymph node metastasis were independent prediction factors for poor outcomes of overall survival (OS) and Disease-free survival (DFS) in patients with AGC after gastrectomy with D2 lymphadenectomy. Survival analysis showed that the OS and DFS in the high level ULR group were significantly shorter than in the low level ULR group (log-rank P < 0.001). Conclusion: High level ULR is a poor predictive factor for patients with AGC underwent gastrectomy with D2 lymphadenectomy, and high levels of ULR predict shorter OS and DFS.
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