The Prediction Value of the Systemic Inflammation Score for Oral Cavity Squamous Cell Carcinoma

Abstract

Objectives This study aimed to investigate the potential prognostic role of the oral cancer systemic inflammation score (SIS) based on serum albumin levels and the lymphocyte-to-monocyte ratio in patients with oral squamous cell carcinoma (OSCC) after treatment. Study Design A retrospective cohort study. Setting Tertiary care center. Subjects and Methods The study involved 613 patients who were treated for OSCC between September 2005 and December 2014. The association of the oral cancer SIS with various clinicopathological features was investigated. A nomogram based on different clinicopathological features and SIS was established to predict prognosis. Results Higher SIS was significantly associated with older age ( P = .0013), advanced tumor status ( P < .0001), tumor depth ( P < .0001), advanced overall pathologic stage ( P < .0001), and extranodal extension ( P = .0045), as well as the presence of perineural invasion ( P = .0341). Higher SIS, older age, overall stage, and extranodal extension were demonstrated to be independent prognostic indicators for shorter overall survival ( P < .0001). A nomogram comprising SIS, TNM stage, and the degree of cell differentiation, as well as perineural invasion and extranodal extension, was developed to predict the prognosis of these patients. The c-index of the nomogram model based on TNM staging only was 0.688 and could be increased to 0.752 if SIS and several other clinicopathological parameters were incorporated. Conclusions Higher SIS is associated with many poor prognosticators, and the nomogram that was established and based on the incorporation of SIS might strengthen the prediction of prognosis in patients with OSCC.

The prognostic value of the systemic inflammatory score in patients with unresectable metastatic colorectal cancer

“…Both the serum albumin concentration and the LMR, which are components of the SIS, are markers related to inflammation, but their severity is not always correlated with each other (11). Therefore, the combination of these two markers enables a more detailed stratification.…”

“…Inflammation is known to contribute to cancer progression (1,2), and several inflammatory markers, such as the neutrophil-to-lymphocyte ratio (NLR), the lymphocyte-to-monocyte ratio (LMR) and the Glasgow prognostic score (GPS) have been reported to be associated with clinical outcomes in patients with various types of cancer, including colorectal cancer (3)(4)(5)(6)(7)(8). Recently, a new inflammatory marker, the systemic inflammatory score (SIS), based on the combination of the LMR and the serum albumin concentration has been reported to be a useful prognostic marker in patients with clear-cell renal cell carcinoma, colorectal cancer and oral cavity squamous cell carcinoma (9)(10)(11).…”

Personalized prognostication in head and neck cancer: A systematic review of nomograms according to the AJCC precision medicine core (PMC) criteria

“…These updated prognostic variables would not be available for the older AJCC staging systems. However, we found several studies using older editions of the AJCC staging, which also feature “contemporary” prognostic variables such as HPV or ENE as components of their nomograms. The c‐indexes of these studies (maximum 0.83) were just as high as the c‐indexes of studies using the 8th AJCC edition (maximum 0.76).…”

“…The level of agreement for the second phase was 88% with a kappa of 0.77. A total of 44 studies remained for the final analysis . The list of excluded papers with the reasons for exclusion can be found in the Supporting Information S3.…”

Hallmarks of Cancer-Related Newly Prognostic Factors of Oral Squamous Cell Carcinoma

“…In addition, stromal fibroblasts may play a vital role in the desmoplastic reaction to cancer by secreting the extracellular matrix. Eltohami et al [43] reported that the systemic inflammatory score (SIS), which is based on the sum of albumin and the lymphocyte-to-monocyte ratio, is closely associated with local progression (T grade), clinical stage, tumor depth, perineural invasion, extranodal extension, and poor survival. Cyclooxygenase-2 (COX-2) is a pro-inflammatory enzyme that converts arachidonic acid to prostaglandins, promoting invasion and OSCC cell metastasis [44].…”