Systemic immune‐inflammation index (SII) is useful to predict survival outcomes in patients with surgically resected non‐small cell lung cancer

Abstract

Background The systemic immune‐inflammation index (SII) is correlated with patient survival in various types of solid tumors. However, only a few studies have focused on the prognostic value of the SII in patients with surgically resected non‐small cell lung cancer (NSCLC). Methods This study was a single center retrospective analysis of 569 NSCLC patients who underwent curative lobectomy at the Department of Thoracic Surgery, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College between 2006 and 2012. A receiver operating characteristic curve was plotted to compare the discriminatory ability of the SII for overall survival (OS). A Cox proportional hazards regression model was used to perform univariate and multivariate analyses. Results The SII, neutrophil‐lymphocyte ratio (NLR), and platelet‐lymphocyte ratio (PLR) all correlated with OS in NSCLC patients, and the SII was an independent prognostic factor for OS (hazard ratio 1.256, 95% confidence interval 1.018–1.551; P = 0.034). The area under the receiver operating characteristic curve of the SII (0.547) was larger than the NLR (0.541) and PLR (0.531). Furthermore, the SII retained prognostic significance in the lung adenocarcinoma subgroup. Conclusion The SII is a promising prognostic predictor for patients with surgically resected NSCLC and retained prognostic significance in the lung adenocarcinoma subgroup. The prognostic value of the SII is superior to the NLR and PLR.

Preoperative systemic immune-inflammation index predicts prognosis and guides clinical treatment in patients with non-small cell lung cancer

“…In the further univariate and multivariate analyses, preoperative SII was an independent prognostic factor for OS in patients with surgically resectable NSCLC. These results were consistent with previous investigations on NSCLC [13,27]. Furthermore, our study was the first to analyze the relationship between preoperative SII and DFS in patients with surgically resectable NSCLC.…”

“…SII, initially reported by Hu et al [26], was defined as neutrophil × platelet/lymphocyte and seemed to be a stronger prognostic predictor. Indeed, Guo et al [27] demonstrated that SII may have a better prognostic ability when compared with NLR and PLR in patients with NSCLC. In the present study, we focused on the prognostic value of SII in patients with NSCLC.…”

Predicting 5-Year Progression and Survival Outcomes for Early Stage Non-small Cell Lung Cancer Treated with Stereotactic Ablative Radiation Therapy: Development and Validation of Robust Prognostic Nomograms

“…In addition, our study is novel in its incorporation of SII, a comprehensive hematological index based on the peripheral platelet, neutrophil, and lymphocyte counts, with prognostic significance. SII has already been demonstrated as a strong prognostic predictor in a variety of malignant tumors, [28][29][30][31] including NSCLC managed with chemoradiotherapy or surgery, [12][13][14][15] and our study is the first to date evaluating its predictive value in the setting of SABR for ES-NSCLC, confirming SII to be significantly associated with survival. SII, which incorporates 3 hematological items, was also superior to NLR and PLR as a survival predictor, consistent with a prior study of esophageal cancer.…”

“…8 For example, neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been demonstrated to be independent prognostic factors for survival in ES-NSCLC patients treated with SABR. [9][10][11] In particular, systemic immune-inflammation index (SII; calculated as platelet counts  neutrophil counts/lymphocyte counts) was identified to be independently associated with survival for patients with surgically resected and advanced NSCLC [12][13][14] and for stage III patients undergoing chemoradiotherapy. 15 Given the expanding corroborating evidence, these readily available and low-cost inflammatory biomarkers merit further investigation, and inclusion of these factors in nomogram models could perhaps improve the precision and accuracy of prognostic prediction.…”

Systemic immune-inflammation index predicts mortality in infective endocarditis

“…According to a study of Nie et al, SII was an independent prognostic factor for poor prognosis and correlated with decreased survival in patients with epithelial ovarian cancer [ 32 ]. Guo et al found that, higher SII may be associated with tumor angiogenesis, invasion, and metastasis, thus leading to poor survival in patients with lung cancer and also showed better prognostic ability than the NLR and PLR [ 33 ].…”