Introduction: Plasma brain natriuretic peptide (BNP) is a biomarker of heart failure and associated with inflammation in patients with cancer. We investigated the clinicopathological and prognostic significance of preoperative BNP and C-reactive protein (CRP) levels in patients with gastric cancer.

Methods: We analyzed the data of 537 patients with gastric cancer who underwent surgery between 2011 and 2020. The cut-off values of BNP (48.4 pg/mL) and CRP (0.1 mg/dL) were determined using a receiver operating characteristic curve for overall survival. Clinicopathological factors were compared between the high and low BNP groups. The prognostic significance of BNP and CRP levels was investigated by univariate and multivariate analyses.

Results: Deep tumors (p <0.01) and positive lymph nodes (p <0.01) were significantly associated with high BNP levels. Overall survival and relapse-free survival of the high BNP group (p <0.01) and the high CRP group (p <0.01) were significantly worse than those of the other groups. Although high BNP levels (p <0.01) and deep tumors (p <0.01) were independent prognostic risk factors, high CRP levels were not (p = 0.10). Among the four groups classified according to BNP and CRP status, the high BNP/high CRP group exhibited the worst overall survival.

Conclusions: High preoperative BNP levels were associated with deep tumors and lymph node metastases. A high preoperative BNP level was an independent poor prognostic factor. The high BNP/high CRP group exhibited the worst prognosis among the four subgroups of patients with gastric cancer.

A 51-year-old woman presented with Stanford type B communicating aortic dissection accompanied by bowel ischemia. Stenosis of the superior mesenteric artery (SMA) caused by dissection was observed. Frozen elephant trunk (FET) repair was performed, and SMA stenosis improved with only primary entry tear closure, without stent insertion into the SMA. We report the good outcomes obtained by FET repair of complicated Stanford type B aortic dissection.