Systemic inflammatory response activity in a variety of conditions, including cancer, can affect different organs of the body. The most important parameter to measure inflammation is the counts of white blood cells and acute-phase proteins. Specifically, white blood cell count such as neutrophils, lymphocytes and platelets, and blood CRP levels and albumin as well as NLR and PLR have been used as inflammation parameters . In the present study, the relationship of two prognostic factors NLR and PLR to survival in gastric cancer patients diagnosed before surgery in Shahrekord was investigated. The mean age of the studied patients was 63.79 ± 15.03 (range: 10–92) years. 76% of patients were male and the rest were female. In the study of Biglarian et al. (2009) on postoperative survival in patients with gastric cancer, it was reported that 71.6% of patients were male with the mean age of 59.39 years and the rest (28.6%) were female with the mean age of 56.22 years . In the study of Moghimi Dehkordi et al. entitled Modeling Survival Analysis Using Cox Model in Gastric Cancer Patients, 68.6% of patients were male. The mean age of the patients was 58.4 years . The results of the present study are consistent with the above studies regarding gender and age distribution in gastric cancer patients. In the study of Biglari et al. (2009), the mean and median survival of patients with gastric cancer were 32.56 and 28.3 months, respectively, and one, two, three, four and five-year survival rates were obtained 0.78, 0.53, 0.40, 0.32 and 0.15, respectively. Cox proportional hazard showed that age at diagnosis, family history, and tumor size were significantly correlated with patients' longevity . In this study, Cox regression model showed no relationship between age, gender, smoking, education, place of residence, duration of chronic gastrointestinal disease and survival of patients. The mean NLR and PLR were 3.37 ± 2.78 and 147.13 ± 78.93, respectively. The correlation coefficient (r) between NLR and PLR was 0.556 (P < 0.001), indicating a significant and direct correlation between the two indices. In evaluating the factors affecting survival in patients in univariate model, the Cox proportional hazard of both NLR and PLR were found to have a significant effect on survival. In the present study, 54% of the studied patients had no gastrointestinal disease and 46% had gastrointestinal disease. The maximum duration of the disease was 3 years (n = 15), followed by 2 years (n = 10) and 4 years (n = 9). Patient survival after surgery until death or last follow-up ranged from 14 days to 1892 days (mean: 548.56 ± 405.90 days). The mean survival in the survived and died patients was 506.57 ± 343.29 days and 559.72 ± 422.28 days, respectively. After inclusion of both NLR and PLR, only NLR was found to have a significant effect on patient survival. The results indicated that in the presence of NLR, PLR had no effect on survival. In other words, the main variable affecting survival of patients was NLR. With an increase in NLR by one point, the risk of death in gastric cancer patients increased by 18%. In other words, with an increase in NLR, the survival rate of gastric cancer patients after surgery significantly decreased. Various studies have reported that NLR in patients with gastric cancer is prognostically valuable before surgery and higher preoperative NLR, as a strong independent factor, is associated with poorer prognosis in gastric cancer patients [15, 20]. Other studies have also reported that comparably higher NLR was associated with lower survival in patients with malignant pleural mesothelioma . There are many reports that high density of neutrophils may stimulate tumor growth and metastasis and impair the immune system's antitumor response by suppressing lymphocytes. These observations suggest that high NLR in peripheral blood of cancer patients may lead to tumor progression [8–10]. Regarding studies on the prognostic importance of PLR in cancer patients, Smith et al. (2008) in a study in patients with pancreatic adenocarcinoma reported that the PLR ratio was prognostically important before surgery,and is a more reliable marker for prognosis of cancer than lymphocyte count alone . Gu et al., (2017) also reported that a high PLR was significantly associated with overall survival but not with disease-free survival. High PLR also significantly predicted a poor and low overall survival in whites, chemotherapy recipients, and Patients with advanced cancer. In addition, the PLR over 160 was prognostically appropriate. High PLR was also associated with lymph node metastasis and CEA levels in gastric cancer . In other studies, increased PLR has been reported as an independent factor for reduced longevity of patients with colon and pancreatic cancer [13, 14]. However, a study by Matowicka-Karna et al. (2013) showed that gastric cancer progression was associated with a decrease in the levels of IL-6 and IL-23, with no association with platelet count or morphological features . It is suggested to investigate the relationship of the levels of the two ILs to NLR and PLR with respect to survival in gastric cancer patients in additional studies. Dogan et al. (2015) reported that in patients with metastatic gastric cancer, PLR > 160 or NLR ≥ 2.5 was significantly associated with poorer survival in these patients . He et al. also comparatively studied NLR and PLR and reported that NLR was more efficient than PLR as a prognostic marker for colon cancer [25_ENREF_25]. The results of the present study also showed that NLR, as compared to PLR, was the main factor associated with the survival of gastric cancer patients. Therefore, according to the results of this study, the main variable affecting the survival of gastric cancer patients is NLR that can be used as a prognostic factor related to the survival of these patients.