Preoperative systemic immune-inflammation index predicts survival and recurrence in patients with resected primary pulmonary sarcomatoid carcinoma

Abstract

Background: Pulmonary sarcomatoid carcinoma (PSC) is a rare lung cancer subtype. Studies concerning PSC are limited and controversial; therefore, we analyzed the treatment and outcomes of PSC utilizing a relatively large single-institution database. Methods: From January 2003 to December 2018, 262 consecutive PSC patients treated at our institution were retrospectively reviewed. The clinical characteristics, treatments, and outcomes were analyzed. Results: The median survival time (MST) was 22.0 months, with 1-, 3-, and 5-year overall survival (OS) rates of 59.9%, 40.1%, and 36.1%, respectively. Patients who underwent surgery had a significantly better prognosis than patients who received nonsurgical treatment (MST, 23.0 vs. 11.0 months, P=0.016). The use of surgery followed by adjuvant therapy significantly prolonged survival in stage III patients (MST, 17.0 vs. 8.0 months, P=0.003) but not in stage I and II patients. Multivariate analysis showed that a systemic inflammation-immune index (SII) value >430.8, TNM stage and necrosis were independent prognostic predictors of OS and disease-free survival (DFS) in radically resected PSC patients (P<0.05). In addition, SII and necrosis were independent risk factors for recurrence after the radical resection of PSC (P<0.05).Conclusions: PSC is aggressive and has a poor prognosis. Surgery should be the mainstay treatment for operable cases, and adjuvant therapy is recommended for locally advanced disease. A novel potential biomarker, SII, which is an integrated parameter based on preoperative lymphocyte, neutrophil, and platelet counts, may be useful for prognostic prediction and the identification of resected PSC patients at high risk for recurrence.

Pre-radiotherapy systemic immune inflammation index associated with overall survival in patients with advanced EGFR mutant non-small cell lung cancer receiving thoracic radiotherapy

“…It was reported that high systemic immune inflammation index (SII) value was related to poor prognosis in a variety of cancers. Some studies showed that SII can be used to predict the survival of patients with Intrahepatic Cholangiocarcinoma (ICCA)、pulmonary sarcomatoid carcinoma (PSC)、resectable gastroesophageal adenocarcinomas and anal cancer [12][13][14][15]. The results showed that the overall survival of the high SII group was significantly more worsen than that of the low SII group.…”

Pretreatment Systemic Immune-Inflammation Index Can Predict Response to Neoadjuvant Chemotherapy in Cervical Cancer at Stages IB2-IIB

“…Jomrich et al [ 27 ] studied 320 consecutive patients undergoing esophagectomy and found that in patients with gastroesophageal junction adenocarcinoma, a high SII was associated significantly with lower survival in patients undergoing neoadjuvant treatment. Zeng et al [ 28 ] revealed that the SII is an important independent prognostic index for pulmonary sarcomatoid carcinoma. Aziz et al [ 29 ] assessed 590 patients with resectable pancreatic ductal adenocarcinoma (PDAC) retrospectively and identified an SII >900 as an independent predictor of cancer-specific survival and recurrence.…”

Factors Associated With Lymph Node Yield and Effects of Lymph Node Density on Survival of Patients With Pulmonary Sarcomatoid Carcinoma

“…However, there is no consensus on the standard treatment for PSC 18. Fortunately, there is abundant evidence of the survival benefits for patients with early-stage PSC undergoing surgery 8,19,20. Surgical resection is the preferred treatment for early-stage PSC and is also the basis of comprehensive treatment according to the 2021 National Comprehensive Cancer Network guidelines 5.…”