Prognostic and clinicopathological significance of systemic immune-inflammation index in colorectal cancer: a meta-analysis

Abstract

<jats:sec><jats:title>Background:</jats:title><jats:p> Previous studies on the systemic immune-inflammation index (SII), which is based on platelet, neutrophil and lymphocyte counts, as a prognostic marker in patients with colorectal cancer (CRC) yielded inconsistent results. The aim of this study was to evaluate the prognostic and clinicopathological role of SII in CRC via meta-analysis. </jats:p></jats:sec><jats:sec><jats:title>Methods:</jats:title><jats:p> A comprehensive literature survey was performed on PubMed, Web of Science, Embase and the Cochrane Library databases to include studies published up to 6 April 2020. Pooled hazard ratios (HRs) and odds ratios (ORs) with 95% confidence intervals (CIs) were computed to estimate the prognostic and clinicopathological value of SII in CRC. </jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p> A total of 12 studies published between 2016 and 2019 were included in our meta-analysis. The combined analysis showed that high SII levels were significantly associated with worse overall survival (OS; HR = 1.61, 95% CI = 1.21–2.13, p = 0.001) and progression-free survival (HR = 1.74, 95% CI = 1.26–2.39, p = 0.001) in CRC. Moreover, elevated SII was also correlated with poor tumor differentiation (OR = 1.60, 95% CI = 1.27–2.02, p &lt; 0.001), presence of distant metastasis (OR = 2.27, 95% CI = 1.10–4.67, p = 0.026), ECOG PS of 1–2 (OR = 1.98, 95% CI = 1.39–2.84, p &lt; 0.001) and tumor size ⩾5 cm (OR = 1.49, 95% CI = 1.18–1.88, p = 0.001). However, high SII was not significantly associated with sex, tumor location, lymph node metastasis, or age in patients with CRC. </jats:p></jats:sec><jats:sec><jats:title>Conclusion:</jats:title><jats:p> Our meta-analysis indicated that high SII levels predicted poor prognosis in CRC. In addition, an elevated SII was also associated with clinical factors, implying higher malignancy of the disease. </jats:p></jats:sec>

Systemic Immune-inflammation Index (SII) Predicts Pathological Complete Response to Neoadjuvant Chemoradiotherapy in Locally Advanced Rectal Cancer

“…17 Many studies have demonstrated that there is a close relationship between high SII and increased risk of distant metastasis, poor survival and poor prognosis in patients with colorectal cancer. 8,[18][19][20][21] Chen et al reported that high preoperative NLR (>2.7), PLR (>210) and SII (>340) were associated with poor OS in a study on 1,383 patients with stage I-IV colorectal cancer, who had undergone radical surgery. 22 In a multivariate Cox regression analysis in the same study, inflammatory markers SII (HR: 3.163, 95% CI: 2.616-3.824) and PLR (HR: 1.294 95% CI: 1.123-1.492) were found to be independent predictive factors of OS; and SII (HR: 2.717, 95% CI: 2.287-3.228) was found to be an independent predictive factor of DFS.…”

“…7 Although contradictory results have been reported regarding the prognostic significance of systemic immune-inflammation index (SII), which is calculated on the basis of neutrophil, platelet and lymphocyte counts, and is defined as a novel marker compared to other inflammatory markers, a recent meta-analysis reported a relationship between high SII and poor prognosis. 8 Another marker reported to be useful in predicting the prognosis of patients with colorectal cancer is the prognostic nutritional index (PNI), which is calculated on the basis of inflammatory parameters and albumin value. 9 It has been reported that inflammatory markers and the changes observed in them during nCRT can predict pCR in patients with LARC.…”

The Change of Systemic Immune-Inflammation Index Independently Predicts Survival of Colorectal Cancer Patients after Curative Resection

“…However, most previous studies only indicated the preoperative value and the results were not consistent. Some studies indicate that SII was proposed as a significant prognostic factor in CRC [ 21 , 22 , 30 ], whereas other studies were not significant [ 23 , 31 ]. Few studies focused on the changes of inflammatory markers before and after treatment, which might reflect the correlation between the host's inherent inflammatory state and immune response.…”

Prognostic Value of Postoperative Neutrophil and Albumin: Reassessment One Month After Gastric Cancer Surgery

“…There is little previous evidence regarding the prognostic value of neutrophil counts, as most studies have not evaluated neutrophil count as a single independent factor. Its prognostic value has primarily been evaluated using neutrophil-containing parameters, such as NLR, SII, or neutrophil–albumin ratio (NAR) ( 3 , 13 , 14 ). Our previous study demonstrated that preoperative neutrophil count was a strong independent prognostic factor for OS and RFS after adjusting for clinical and pathologic characteristics.…”