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Background: There is good evidence that both local (Klintrup criteria) and systemic (Glasgow Prognostic Score, mGPS) inflammatory responses are independent predictors of cancer-specific survival in colorectal cancer. There is also some evidence that the systemic inflammatory response predicts cancer survival in gastro-esophageal cancer. However, it is unclear whether the local inflammatory response has predictive value in these patients. The aim of the present study was to compare the prognostic value of tumour inflammatory infiltrate and systemic inflammation in operable gastro-oesophageal cancer.Patient and Methods: One hundred and ninety six patients had undergone potentially curative surgery for gastro-oesophageal cancer between January 1996 and August 2007. The positive to total lymph node ratio (LNR) was calculated in these patients. In addition tumour specimens were scored with Klintrup’s criteria for peri-tumoral infiltrate1 and mGPS was constructed from the pre-operative blood results. Results: The median follow up for survivors was 49 months. 84 patients died of cancer and median survival was 16 months (range 1 to 90 months). On multivariate analysis only positive to total lymph node ratio (LNR) (HR 2.11, 95% CI 1.57-2.83, P<0.001), tumour differentiation (HR 0.63, 95% CI 0.41-0.98, p<0.05), Klintrup’s criteria (HR 1.97, 95% CI 1.04-3.74, p<0.05) and pre-operative mGPS (HR 2.06, 95% CI 1.3-3.28, P=0.002) were independently associated with cancer-specific survival. Median survival for high-grade infiltrate was 46.5 months in contrast to 23 months in low-grade ones. In node negative patients (n=79) only resection margin (HR 3.88, 95% CI 1.08-13.94, p<0.05) and mGPS (HR 5.88, 95% CI 2.41-14.35, P<0.001) were independent predictors of cancer specific survival. Conclusion: The present study indicates that, in patients with gastro-oesophageal cancer, both systemic inflammatory score, the mGPS and tumour infiltrate (Klintrup’s score) provides independent prognostic information. In node negative cancer mGPS appears to be a superior predictor of cancer survival. Reference: 1. Klintrup K, Makinen JM, Kauppila S, et al. Inflammation and prognosis in colorectal cancer. Eur J Cancer 2005;41:2645-54.