Zhang L, Wang Z, Xiao J, et al. - Among 247 advanced unresectable gastric cancer (GC) patients treated with first-line chemotherapy, this investigation was carried out to examine the association between pretreatment albumin to D-dimer ratio (ADR) and prognosis. As determined by the receiver operating characteristic (ROC) curve, the ADR had a cut-off value of 41.64. Relative to albumin and D-dimer alone, ADR was shown to have the highest area under curve (AUC) value (AUC = 0.730), followed by albumin (AUC = 0.659) and D-dimer (AUC = 0.719). A lower disease control rate, shorter overall survival (OS), and shorter progression-free survival (PFS) was seen in patients with a low ADR (<41.64) vs those with a high ADR (≥41.64). A correlation of low ADR with poor therapeutic impacts of chemotherapy and shortened OS and PFS, was revealed. Thus, experts suggest the likely usefulness of pretreatment ADR as an instrument to predict the impact of chemotherapy as well as prognosis in advanced GC patients managed with first-line chemotherapy.