Pretreatment C‑reactive protein‑triglyceride‑glucose index predicts survival in patients with FLOT‑treated locally advanced gastric and gastroesophageal junction cancer

The C-reactive protein-triglyceride-glucose index (CTI), integrating C-reactive protein and the triglyceride-glucose index, is a pragmatic biomarker reflecting systemic inflammation and metabolic stress in cancer. Although its prognostic value has been validated in heterogeneous cancer cohorts, data in homogeneous perioperative settings remain limited. The present study retrospectively evaluated 131 patients with locally advanced gastric or gastroesophageal junction adenocarcinoma who received perioperative fluorouracil, leucovorin, oxaliplatin and docetaxel (FLOT) chemotherapy between November 2018 and June 2024 (67 months). CTI was calculated at diagnosis, and patients were stratified using the 4.78 cut-off value previously validated in oncology populations. Associations between CTI and clinicopathological variables, pathological response, progression-free survival (PFS) and overall survival (OS) were analyzed. The results demonstrated that among the 131 patients who underwent curative-intent surgery after neoadjuvant FLOT, 113 (86.3%) had low CTI (