Journal of Gastrointestinal & Digestive System
Open Access

Postoperative Systemic Inflammatory Response (SIR) serves as a significant prognostic factor for patients undergoing surgery for gastric cancer. This inflammatory response encompasses various biochemical and cellular changes that occur following surgery, influenced by factors such as surgical trauma, tissue injury, and immune system activation. Understanding the prognostic implications of postoperative SIR is crucial for optimizing patient care and predicting outcomes in gastric cancer management. The postoperative inflammatory response is characterized by the release of pro-inflammatory cytokines, activation of immune cells, and systemic metabolic changes. Elevated levels of inflammatory markers such as C-reactive protein (CRP), interleukin-6 (IL-6), and white blood cell count are commonly observed following surgery and are associated with poor prognosis in gastric cancer patients. These markers reflect the degree of systemic inflammation and correlate with tumor aggressiveness, recurrence risk, and overall survival. Several studies have demonstrated the prognostic significance of postoperative SIR in gastric cancer. Elevated levels of CRP, an acute-phase reactant produced by the liver in response to inflammation, have been consistently associated with adverse outcomes following surgery. High postoperative CRP levels are correlated with increased tumor stage, lymph node involvement, and decreased survival rates in gastric cancer patients. Similarly, elevated IL-6 levels, a key mediator of inflammation, have been linked to tumor progression, metastasis, and poor prognosis in gastric cancer. The systemic inflammatory response following surgery not only influences tumor biology but also affects host immune function and recovery. Excessive inflammation can impair wound healing, increase susceptibility to infection, and contribute to postoperative complications such as anastomotic leakage and surgical site infections. Furthermore, chronic inflammation has been implicated in promoting tumor angiogenesis, immune evasion, and resistance to chemotherapy, thereby exacerbating cancer progression and reducing treatment efficacy. In addition to biochemical markers, the assessment of systemic immune response parameters such as neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) provides valuable prognostic information in gastric cancer. Elevated NLR and PLR have been associated with advanced tumor stage, lymphovascular invasion, and decreased survival in gastric cancer patients undergoing surgery. These ratios reflect the balance between pro-inflammatory and antitumor immune responses and serve as surrogate markers of tumor-host interactions and disease progression. Moreover, the dynamic changes in inflammatory and immune markers during the postoperative period offer insights into disease monitoring and treatment response assessment. Serial measurements of CRP, IL-6, and other inflammatory biomarkers allow clinicians to monitor patients' recovery, detect postoperative complications, and identify individuals at high risk of tumor recurrence or metastasis. Integrating these biomarkers into risk stratification models and treatment algorithms can facilitate personalized therapeutic strategies and improve clinical outcomes in gastric cancer management. Despite the growing body of evidence highlighting the prognostic significance of postoperative SIR in gastric cancer, several challenges remain in its clinical implementation. Standardization of inflammatory biomarker measurements, interpretation of dynamic changes over time, and incorporation into existing prognostic models require further validation and consensus among researchers and clinicians. Elevated levels of inflammatory biomarkers such as CRP, IL-6, NLR, and PLR are associated with adverse clinic-pathological features, decreased survival outcomes, and increased risk of tumor recurrence. Incorporating these biomarkers into clinical practice allows for risk stratification, treatment optimization, and surveillance strategies tailored to individual patient needs. A deeper understanding of the complex interplay between inflammation, immunity, and cancer biology is essential for advancing prognostic assessment and therapeutic interventions in gastric cancer.

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The author has no potential conflicts of interest.