Clinical Utility of the Systemic Immune-Inflammation Index for Predicting Survival in Esophageal Squamous Cell Carcinoma after Radical Radiotherapy

Abstract

Aim: To explore the clinical utility of the systemic immune-inflammation index (SII) for predicting the prognosis of esophageal squamous cell carcinoma (ESCC). Patients & methods: After calculating the SII in 180 patients with ESCC, the relationship between SII values and the pre-/post-radiotherapy SII ratio and overall survival was determined. Results: The median overall survival was 649 days for the entire group and 909 and 466 days for the high and low pre-/post-radiotherapy SII ratio groups, respectively. Multivariate analysis identified Karnofsky performance status (p = 0.045), lymphatic metastasis (p = 0.032), mid-radiotherapy SII (p < 0.001) and pre-/post-radiotherapy SII ratio (p = 0.003) as independent prognostic factors. Conclusion: The pre-/post-radiotherapy SII ratio and mid-radiotherapy SII are potentially effective markers for predicting ESCC prognosis.

Inflammatory biomarkers as predictors of immune activation to different irradiated sites and short-term efficacy in advanced squamous cell esophageal carcinoma received radioimmunotherapy

“…Contrary to neutrophils and platelets, T-lymphocytes have been shown to inhibit tumor proliferation and metastasis, induce cytotoxic cell death, and foster antitumor immune responses ( 32 ). In recent years, a growing number of studies have demonstrated the predictive value of SII in patients with ESCC undergoing surgery and neoadjuvant therapy ( 33 – 36 ). However, limited studies are available that use delta-SII to predict the efficacy for any tumor.…”

“…Wang et al. found that the pre-/post-RT SII ratio and mid-RT SII ratio were potentially effective markers for predicting ESCC prognosis ( 33 ). Similarly, in this study, an elevated delta-SII, referring to the changes in SII before and during RT, indicated worse short-term efficacy in patients with advanced ESCC who received radioimmunotherapy.…”

Prognostic value of pretreatment systemic immune-inflammation index in Chinese esophageal squamous cell carcinoma patients receiving radical radiotherapy: A meta-analysis

“…Finally, a total of 8 retrospective studies were included in this meta-analysis after reviewing the full texts. [26][27][28][29][30][31][32][33] The detailed literature process was presented in Figure 1.…”

“…All 8 included studies explored the predictive role of pre-radiotherapy SII for OS of Chinese ESCC patients. [26][27][28][29][30][31][32][33] The pooled results demonstrated that elevated SII was significantly associated with worse OS (HR = 1.59, 95% CI: 1.24-2.02, P < .001; I 2 = 75.1%, P < .001) (Fig. 2).…”

“…Wang [26] 2021 180 II-IV 21.6 (2-91) 630.08 OS 7 Xia [27] 2021 221 I-IV 51.8 (4.5-64.7) 617.76 OS 7 Zhang [28] 2021 328 I-III 38 (9-60) 737.65 OS 7 Zhao [29] 2021 106 I-III NR 646.8 OS 7 Du [30] 2022 245 I-III NR 738 OS, PFS 6 Huang [31] 2022 470 II-IV 23.5 (2-98.7) 577.7 OS, PFS 6 Yan [32] 2022 248 I-III SCC 740.80 OS, PFS 6 Zhao [33] 2022 303 I-III NR 648 OS, PFS 8 NOS = Newcastle-Ottawa Scale, NR = not reported, OS = overall survival, PFS = progression-free survival, SCC = squamous cell carcinoma, SII = systemic immune-inflammation index, TNM = tumor-node-metastasis. This meta-analysis has well verified that pretreatment SII could serve as a novel prognostic indicator for Chinese ESCC patients who receive the definitive radiotherapy.…”