AIM: To investigate the significance of the preoperative neutrophil-to-lymphocyte ratio(NLR) in the prognosis of patients with gastric cancer(GC). METHODS: The clinical data of 291 GC patients were analysed retrospectively; these patients were divided into two groups according to their preoperative NLR: a high-NLR group(NLR ≥ 3.5, 131 cases) and a low-NLR group(NLR < 3.5, 160 cases). The clinicopathological characteristics and five-year survival rates of the two groups were compared. The NLR and other clinicopathological factors were subjected to univariate and multivariate survival analysis to evaluate the effects of the NLR on the prognosis of GC patients. RESULTS: The lowest preoperative NLR among the 291 patients was 0.56, whereas the highest preoperative NLR was 74.5. The mean preoperative NLR was 5.99 ± 8.98. Age, tumour size, T staging, tumour-node-metastasis(TNM) staging and platelet count were significantly different between the highand low-NLR groups(P < 0.05). The five-year survival rate of the high-NLR group was 17.0%, which was significantly lower than that of the low-NLR group(43.6%; 17.0% vs 43.6%, P < 0.05). The univariate analysis results showed that the five-year survival rate was related to age, tumour size, T staging, N staging, TNM staging, carcinoembryonic antigen value and NLR(P < 0.05). Multivariate analysis results showed that the NLR was an independent risk factor that likely affected the five-year survival rate of GC patients(P = 0.003, HR = 0.626, 95%CI: 0.460-0.852). CONCLUSION: The preoperative NLR could be used as a prognostic factor for GC patients; in particular, a high NLR corresponded to poor prognosis of GC patients. AIM: To investigate the significance of the preoperative neutrophil-to-lymphocyte ratio (NLR) in the prognosis of patients with gastric cancer (GC). METHODS: The clinical data of 291 GC patients were analyzed retrospectively; these patients were divided into two groups (NLR ≥ 3.5, 131 cases) and a low-NLR group (NLR <3.5, 160 cases). The clinicopathological characteristics and five-year survival rates of the two groups were compared. The NLR and other clinicopathological factors were subjected to univariate and multivariate survival analysis to evaluate the effects of the NLR on the prognosis of GC patients. RESULTS: The lowest preoperative NLR among the 291 patients was 0.56, and the highest preoperative NLR was 74.5. mean preoperative NLR was 5.99 ± 8.98. Age, tumor size, T staging, tumor-node-metastasis (TNM) staging and platelet count were significantly different between the highand low-NLR groups (P <0.05). The five-ye ar survival rate of the high-NLR group was 17.0%, which was significantly lower than that of the low-NLR group (43.6%; 17.0% vs 43.6%, P <0.05). The univariate analysis results showed that the five-year Multivariate analysis results showed that the the NLR was an independent risk factor that likely affected the five-year survival (P <0.05). The survival rate was related to age, tumor size, T staging, N staging, TNM staging, carcinoembryonic antigen value and NLR rate of GC patients (P = 0.003, HR = 0.626, 95% CI: 0.460-0.852) CONCLUSION: The preoperative NLR could be used as a prognostic factor for GC patients; in particular, a high NLR corresponded to poor prognosis of GC patients.