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

doi:10.29271/jcpsp.2021.04.399

Cited by 26 publications

(21 citation statements)

References 8 publications

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“…Meanwhile, LMR and PLR at post-treatment in the third period seemed to have a more balanced prediction probability for ESCC patients who had responded or no response; thus, there was a more ideal prediction probability in combining LMR with PLR at post-treatment in the third period. Prior studies reported that SII at baseline might predict pCR status for neoadjuvant chemoradiotherapy in patients with locally advanced rectal cancer [ 33 ], and non-small cell lung cancer patients with preoperative high SII levels benefit from adjuvant chemotherapy [ 34 ], which suggests a certain degree of consistency with our results. However, we attempted to combine these inflammation indices to determine whether they could predict the efficacy, instead of using a single or dual biomarkers.…”

Section: Discussionsupporting

confidence: 84%

Combining serum inflammation indexes at baseline and post treatment could predict pathological efficacy to anti‑PD‑1 combined with neoadjuvant chemotherapy in esophageal squamous cell carcinoma

Zhang

Gari

et al. 2022

J Transl Med

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Background The neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) have been used to predict therapeutic response in different tumors. However, no assessments of their usefulness have been performed in esophageal squamous cell carcinoma (ESCC) patients receiving anti‑PD‑1 combined with neoadjuvant chemotherapy. Methods The respective data of 64 ESCC patients receiving anti‑PD‑1 combined with neoadjuvant chemotherapy were analyzed. Whether NLR, LMR, PLR, and SII at baseline and post-treatment might predict pathological response to anti‑PD‑1 plus neoadjuvant chemotherapy, and cutoff values of these parameters were all determined by ROC curve analysis. Results NLR (cutoff = 3.173, AUC = 0.644, 95% CI 0.500–0.788, P = 0.124, sensitivity = 1.000, specificity = 0.373), LMR (cutoff = 1.622, AUC = 0.631, 95% CI 0.477–0.784, P = 0.161, sensitivity = 0.917, specificity = 0.137), PLR (cutoff = 71.108, AUC = 0.712, 95% CI 0.575–0.849, P = 0.023, sensitivity = 1.000, specificity = 0.059), and SII at baseline (cutoff = 559.266, AUC = 0.681, 95% CI 0.533–0.830, P = 0.052, sensitivity = 0.373, specificity = 1.000) seemed to be a useful predictor for distinguishing responders from non-responders. Combining NLR with SII at baseline (AUC = 0.729, 95% CI 0.600–0.858, P = 0.014, sensitivity = 0.917, specificity = 0.510), LMR and SII at baseline (AUC = 0.735, 95% CI 0.609–0.861, P = 0.012, sensitivity = 1.000 specificity = 0.471), PLR and SII at baseline (AUC = 0.716, 95% CI 0.584–0.847, P = 0.021, sensitivity = 1.000 specificity = 0.431), and LMR and PLR at post-treatment in the third period (AUC = 0.761, 95% CI 0.605–0.917, P = 0.010, sensitivity = 0.800, specificity = 0.696) might slightly increase the prediction ability to determine patients who have response or no response. Finally, combining LMR at baseline, SII at post-treatment in the second period with PLR at post-treatment in the third period could be considered a better predictor for discriminating responders and non-responders than single or dual biomarkers (AUC = 0.879, 95% CI 0.788–0.969, P = 0.0001, sensitivity = 0.909, specificity = 0.800). Conclusions The models we constructed allowed for the accurate and efficient stratification of ESCC patients receiving anti-PD-1 plus chemotherapy and are easily applicable for clinical practice at no additional cost.

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Section: Discussionsupporting

confidence: 84%

Combining serum inflammation indexes at baseline and post treatment could predict pathological efficacy to anti‑PD‑1 combined with neoadjuvant chemotherapy in esophageal squamous cell carcinoma

Zhang

Gari

et al. 2022

J Transl Med

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“…In the presented study, unlike other studies, it has been shown that lymphocyte level can also be a marker in predicting pCR [24]. From our point of view, the high number of patients in this study may have made a difference in obtaining this result [24]. Moreover, in our study, similar to other studies, NLR and PLR were independent predictive factors after adjustment for confounding factors [15,16].…”

Section: Discussionsupporting

confidence: 66%

“…There are several other studies suggesting that systemic inflammatory indices such as NLR and PLR are predictors of the pathological response to neoadjuvant CRT [ 15 - 16 , 28 - 29 ]. In the presented study, unlike other studies, it has been shown that lymphocyte level can also be a marker in predicting pCR [ 24 ]. From our point of view, the high number of patients in this study may have made a difference in obtaining this result [ 24 ].…”

Section: Discussionmentioning

confidence: 63%

“…Various factors have been investigated as potential predictors of response to neoadjuvant concurrent CRT in locally advanced rectal cancer. However, the number of studies on the prediction of treatment response is limited [21][22][23][24]. Inflammatory response is closely associated with the development of tumors, and increased inflammatory response is associated with poor prognosis in many cancers [25].…”

Section: Discussionmentioning

confidence: 99%

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High Neutrophil-Lymphocyte Ratio, Platelet-Lymphocyte Ratio and Low Lymphocyte Levels Are Correlated With Worse Pathological Complete Response Rates

Karakaya¹,

Karadağ²,

Yılmaz³

et al. 2022

Cureus

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Objective: To investigate the effect of hemogram parameters on predicting pathological complete response (pCR) in locally advanced rectal cancer.Methodology: A total of 227 patients with rectal cancer treated with neoadjuvant concurrent chemoradiotherapy (CRT) were retrospectively analyzed. All patients were divided into two subgroups as high or low hemogram parameters according to the cut-off value obtained using the receiver operating characteristic (ROC) curve.Results: In patients with low neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) levels, pCR rate was statistically significantly higher than the group with high NLR and PLR levels (for NLR: 39.77% vs. 5.34%; p<0.001, for PLR: 32.38% vs 7.01%; p<0.001 respectively). In addition, the pCR rate was significantly better in patients with high lymphocyte levels compared to the group with low lymphocyte levels (33.33% vs. 7.5%; p<0.001, respectively). According to the multivariate logistic regression analysis result, NLR and PLR levels were considered as independent predictors to predict pathological complete response [p<0.001, HR: 0.128 (95% CI=0.051 -0.322) for NLR; p=0.017, HR: 0.332 (95% CI=0.134 -0.821) for PLR, respectively]. Conclusion:Our study showed that high NLR, PLR, and low lymphocyte levels were correlated with worse pCR rates. In addition to that, NLR and PLR emerged as independent predictive markers.

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“…Jiang et al [ 8 ] retrospectively analyzed 387 female patients with breast cancer who were treated with NACT followed by surgery and determined that the SII was an independent predictor of pCR for patients with breast cancer, with the low-SII group showing the highest pCR rate. Eraslan et al [ 9 ] studied 188 patients diagnosed with locally advanced rectal cancer who received neoadjuvant chemoradiotherapy (NACRT) and found that among several inflammatory indices, including neutrophil-to-lymphocyte ratio (NLR), PLR, and SII, only the SII, at a value of <748, was an independent predictive factor of pCR after NACRT (OR: 0.471, 95% CI: 0.224–0.991, p = 0.047). Murthy et al [ 11 ] found that the SII could reflect treatment response and outcome following NACT for patients with pancreatic adenocarcinoma.…”

Section: Discussionmentioning

confidence: 99%

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

Li¹,

Jiang²,

Zheng³

et al. 2022

Pathol. Oncol. Res.

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Background: The systemic immune-inflammation index (SII) has been identified as a predictor of chemotherapy efficacy for a variety of cancers, and we aimed to determine its ability to predict the response to chemotherapy and its long-term prognosis for patients with cervical squamous cell carcinoma (CSCC) who have underwent platinum-based neoadjuvant chemotherapy (NACT).Methods: The date from 210 patients (133 in the training cohort and 77 in the validation cohort) with CSCC who received NACT were analyzed retrospectively. The association between SII and the pathological complete response (pCR) was determined using Pearson’s chi-square test, receiver operating characteristic (ROC) curve, and Logistic regression analysis. The Kaplan-Meier method and Cox proportional regression model were used to assess the relationship between SII and progression-free survival (PFS) or overall survival (OS).Results: The calculated optimal SII cutoff values for pCR and survival were 568.7051 and 600.5683, respectively, and patients were divided into two groups: a low SII group (≤568.7051 or ≤600.5683) and a high SII group (>568.7051 or >600.5683). A high SII was associated significantly with a lower pCR. Further analysis determined that SII was a more efficient predictor of pCR than the prognostic nutritional index, platelet-to-lymphocyte ratio, and lymphocyte-to-monocyte ratio. Upon multivariate logistic analysis, SII proved to be an independent risk factor to predict the pCR of patients with CSCC. Kaplan-Meier analysis demonstrated that PFS and OS rates were significantly higher in the low-SII group compared with those in the high-SII group. Additional multivariate analysis indicated that the SII is an independent prognostic factor for patients with CSCC treated with NACT.Conclusion: The results confirmed that the pre-treatment SII is not only an independent predictor of pCR but also an independent prognostic factor of CSCC patients treated with platinum based NACT.

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

Abstract: Objective: To determine the relationship between inflammatory markers and pathological complete response (pCR) in patients with locally advanced rectal cancer (LARC), who received neoadjuvant chemoradiotherapy (NACRT).

Cited by 26 publications

References 8 publications

Combining serum inflammation indexes at baseline and post treatment could predict pathological efficacy to anti‑PD‑1 combined with neoadjuvant chemotherapy in esophageal squamous cell carcinoma

Combining serum inflammation indexes at baseline and post treatment could predict pathological efficacy to anti‑PD‑1 combined with neoadjuvant chemotherapy in esophageal squamous cell carcinoma

High Neutrophil-Lymphocyte Ratio, Platelet-Lymphocyte Ratio and Low Lymphocyte Levels Are Correlated With Worse Pathological Complete Response Rates

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

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