Prognostic Value of the Systemic Immune-Inflammation Index (SII) After Neoadjuvant Therapy for Patients with Resected Pancreatic Cancer

Murthy, Pranav; Zenati, Mazen S.; Abbas, Amr I. Al; Rieser, Caroline; Bahary, Nathan; Lotze, Michael T.; Zeh, Herbert J.; Zureikat, Amer H.; Boone, Brian A.

doi:10.1245/s10434-019-08094-0

Cited by 62 publications

(55 citation statements)

References 54 publications

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“…The SII is an index that is calculated on the basis of the platelet, neutrophil, and lymphocyte counts. The SII has been used to evaluate the pretreatment balance between inflammatory factors and immune status of patients with cancer [5][6][7][8]. The SII is associated with the prognosis of patients with breast cancer, although the results are controversial [9][10][11][12][13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Prognostic value of the systemic immune-inflammation index in patients with breast cancer: a meta-analysis

2020

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Background: Although previous studies have evaluated the prognostic role of the systemic immune-inflammation index (SII) in patients with breast cancer, the results were inconsistent. Therefore, in this context, we aimed to identify the prognostic and clinicopathological value of the SII in patients with breast cancer by performing a meta-analysis. Methods: A literature search was using PubMed, Web of Science, EMBASE, and Cochrane Library databases for relevant articles, from their inception to May 12, 2020. The prognostic value of the SII in breast cancer was assessed by pooling the hazard ratios (HRs) with 95% confidence intervals (CIs). The clinical outcomes included the overall survival (OS), disease-free survival (DFS), recurrence-free survival (RFS), and distant metastasis-free survival (DMFS). The methodological quality of all the included studies was evaluated using the Newcastle-Ottawa quality assessment scale. The odds ratios (ORs) with 95% CIs were combined to evaluate the correlation between the SII and clinicopathological characteristics of patients with breast cancer. Publication bias was evaluated using the Begg funnel plot and the Egger linear regression test. All statistical analyses were performed using Stata software, version 12.0 (Stata Corporation, College Station, TX, USA). A p value of < 0.05 was considered statistically significant. Results: Eight studies involving 2642 patients were included in the current meta-analysis. The combined data showed that patients with a high SII had worse OS (HR = 1.79, 95% CI 1.33-2.42, p < 0.001), poorer DFS/RFS (HR = 1.79, 95% CI 1.31-2.46, p < 0.001), and inferior DMFS (HR = 1.64, 95% CI 1.32-2.03, p < 0.001) than patients with a low SII. In addition, a high SII was correlated with the presence of lymph node metastasis (OR = 1.38, 95% CI 1.12-1.69, p = 0.002), higher T stage (OR = 1.49, 95% CI 1.17-1.89, p < 0.001), advanced TNM stage (OR = 1.37, 95% CI 1.07-1.77, p = 0.014), and higher histological grade (OR = 3.71, 95% CI 1.00-13.73, p = 0.049). However, there was no significant association between the SII and the pathological type (OR = 0.82, 95% CI 0.55-1.23, p = 0.345) or lymphatic invasion (OR = 1.30, 95% CI 0.82-2.08, p = 0.266). Conclusions: The results of our meta-analysis suggest that an elevated SII predicts poor survival outcomes and is associated with clinicopathological features that indicate tumor progression of breast cancer.

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Section: Introductionmentioning

confidence: 99%

Prognostic value of the systemic immune-inflammation index in patients with breast cancer: a meta-analysis

2020

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“…There are contradictory results as to whether baseline pretreatment SII can predict clinical outcome for pancreatic ductal adenocarcinoma (9,20). Our study demonstrated that NLR and SII were predictors of poor OS in GBC patients, whereas LMR was a protective prognostic factor in univariate analysis.…”

Section: Discussionmentioning

confidence: 51%

The Impacts of Systemic Immune-Inflammation Index on Clinical Outcomes in Gallbladder Carcinoma

Sun

Jin

et al. 2020

Front. Oncol.

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Background: Systemic immune-inflammation index (SII) is considered to be a prognostic marker in several cancers. However, the prognostic value of baseline pre-operative SII in gallbladder carcinoma (GBC) has not been evaluated. This study aimed to determine the prognostic significance of SII and generate a predictive nomogram. Methods: We retrospectively studied 142 GBC patients who underwent surgical resection at the Peking Union Medical College Hospital between 2003 and 2017. SII, neutrophil-to-lymphocyte ratio (NLR), and lymphocyte-to-monocyte ratio (LMR) were evaluated for their prognostic values. A multivariate Cox proportional hazards model was used for the recognition of significant factors. Then, the cohort was randomly divided into the training and the validation set. A nomogram was constructed using SII and other selected indicators in the training set. C-index, calibration plots, and decision curve analysis were performed to assess the nomogram's clinical utility in both the training and the validation set. Results: The predictive accuracy of SII (Harrell's concordance index [C-index]: 0.624), NLR (C-index: 0.626), and LMR (C-index: 0.622) was evaluated. The multivariate Cox model showed that SII was a superior independent predictor than NLR and LMR. SII level (≥600) (hazard ratio [HR]: 1.694, 95% confidence interval [CI]: 1.069-2.684, p = 0.024), carbohydrate antigen (CA) 19-9 level (≥37 U/ml) (HR: 2.407, 95% CI: 1.472-3.933, p < 0.001), and TNM stage (p = 0.026) were selected to construct a nomogram for predicting overall survival (OS). The predictive ability of this model was assessed by C-index (0.755 in the training set, 0.754 in the validation set). Good performance was demonstrated by the calibration plot. A high net benefit was proven by decision curve analysis (DCA). Conclusion: SII is an independent prognostic indicator in GBC patients after surgical resection, and the nomogram based on it is a useful tool for predicting OS.

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“…1. Finally, a total of four studies [16,[18][19][20] , involving 1749 patients were included in our analysis. Three of the studies reported OS, whereas the remaining one reported CSS and RFS.…”

Section: Search Results and Study Characteristicsmentioning

confidence: 99%

“…Conversely, other research works have reported contradictory results on the prognostic values [14][15][16][17] . Numerous studies have also implicated systemic immune-in ammation index (SII), combining platelet, lymphocyte, and neutrophil counts, as a promising in ammation-based biomarker and a prognostic indicator for clinical outcomes in several malignancies, including pancreatic carcinoma [16,[18][19][20] . Therefore, we sought to comprehensively assess the clinical prognostic effect of SII in pancreatic carcinoma patients using a meta-analysis.…”

Section: Introductionmentioning

confidence: 99%

Systemic immune‐inflammation index has prognostic significance in pancreatic carcinoma patients: a meta-analysis

Li¹,

Lin²,

Ouyang³

et al. 2021

Preprint

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Background Systemic immune-inflammation index (SII) is reportedly a prognostic indicator for several malignancies, including pancreatic carcinoma, although there exists no consensus regarding its significance. In the current study, we used a systematically meta-analysis to evaluate the association between SII and prognosis in pancreatic carcinoma patients. Methods We screened PubMed, Embase and Cochrane Library databases, through May 2020, and retrieved studies describing the prognostic role of SII in pancreatic carcinoma. We calculated pooled hazard ratio (HR) and 95% confidence interval (CI) using a random or fixed effects models to reveal the correlation between SII and prognosis. Results A total of 4 studies, comprising 1,749 patients, met our inclusion criteria and were therefore eligible for inclusion. Our meta-analysis showed that elevated SII indicated significantly worse overall survival in patients with pancreatic carcinoma (HR: 1.43, 95% CI: 1.24–1.65, P < 0.001), with subgroup analyses, stratified by the TNM stage and treatment, further validating these results. In addition, patients with high SII had poorer cancer-specific survival (HR: 2.32, 95% CI: 1.55–3.48, P < 0.001). However, we found no significant associations between SII with disease-free and relapse-free survival. Conclusions These findings indicate that SII is a potential non-invasive and promising tool for predicting clinical outcomes of pancreatic carcinoma patients. However, further studies using adequate designs and larger sample sizes are required to validate our findings.

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Prognostic Value of the Systemic Immune-Inflammation Index (SII) After Neoadjuvant Therapy for Patients with Resected Pancreatic Cancer

Cited by 62 publications

References 54 publications

Prognostic value of the systemic immune-inflammation index in patients with breast cancer: a meta-analysis

Prognostic value of the systemic immune-inflammation index in patients with breast cancer: a meta-analysis

The Impacts of Systemic Immune-Inflammation Index on Clinical Outcomes in Gallbladder Carcinoma

Systemic immune‐inflammation index has prognostic significance in pancreatic carcinoma patients: a meta-analysis

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