The prognostic value of the preoperative inflammatory index on the survival of glioblastoma patients

Abstract

Objectives The growth and development of tumors are closely related to the initiation and amplification of the inflammatory response. Various inflammatory biomarkers had attained growing attention for nearly two decades and were discovered strongly associated with cancer patients’ prognosis, indicating that systemic inflammatory response is possibly essential to cancer progression. However, little was known about the sensitive biomarkers associated with the detection, persistence, treatment, and prognosis of GBM. Hence, the retrospective research endeavored to evaluate the prognostic value of preoperative inflammatory biomarkers in patients with GBM who initially received standardized treatment. Methods The 232 glioblastoma patients eligible who were admitted to Qilu Hospitals in Shandong Province from January 2014 to January 2018 were collected for this analysis. Inflammatory markers, including the systemic immune-inflammation index (SII), systemic immune response index (SIRI), neutrophil–lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocyte-lymphocyte ratio (MLR), and albumin/globulin ratio (AGR), were designed. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan–Meier method, and we calculated the area under the ROC curve to determine the AUC value. Besides, we used the Cox proportional hazard model to estimate the relationship between variables and PFS and OS. The statistical differences between variables and PFS and OS were tested through the log-rank test. What is more, the LR method was used to perform Cox multiple regression analysis. The results were represented by hazard ratio (HR), 95% CI, any 2-tailed P < 0.01 was accepted as statistically different. Results The multivariate Cox proportional hazard model presented that SII ≥ 659.1 was an independent risk factor affecting OS (HR = 2.238, 95% CI = 1.471–3.406, P < 0.001) and postoperative PFS (HR = 2.000, 95% CI = 1.472–2.716, P < 0.001) in GBM patients. The 1-, 3-, and 5-year OS of the SII < 659.1 group was 70.8%, 26.9%, and 14.1%, respectively, while the 1- and 3-year OS of the SII ≥ 659.1 group was 37.5% and 11.5% ( P < 0.001). The 1-, 3-, and 5-year PFS of the SII < 659.1 group was 36.3%, 19.6%, and 13%, respectively, while the 1-year PFS of the SII ≥ 659.1 group was 11.3% ( P < 0.001). Results of patients’ clinical and pathological characteristics paraded that in comparison to the lower SII group, the higher SII group had significantly inferior Karnofsky Performance Scale (KPS) scores ( P < 0.001) and more frequent cystic changes of the tumors ( P < 0.001), whereas the values of SIRI, NLR, PLR, MLR, and AGR were low. Conclusions SII is an independent inflammatory indicator for predicting the prognosis of GBM pa...

Prognostic role of the pretreatment systemic immune-inflammation index in patients with glioma: A meta-analysis

“…In addition, five studies were discarded based on the reasons such as the nonavailability of survival information ( n = 3), no analysis of the SII ( n = 1), and the enrollment of overlapped patients ( n = 1). As a result of this meta-analysis, we enrolled eight articles including 1,426 cases ( 15 – 22 ) ( Figure 1 ).…”

“…In the past, SII has been demonstrated to have a significant prognostic effect in a wide variety of cancers in many studies, including gastric cancer (GC) ( 10 ), cervical cancer (CC) ( 11 ), renal cell carcinoma (RCC) ( 12 ), diffuse large B-cell lymphoma (DLBCL) ( 13 ), and melanoma ( 14 ). SII has also been investigated in numerous studies to be the prognosis prediction biomarker for glioma cases; however, results have been inconsistent ( 15 – 22 ). For example, some researchers reported elevated SII as the important biomarker to predict the prognosis of glioma cases ( 17 , 19 , 20 ), whereas some other scholars found no evident relation of SII with glioma prognosis ( 18 ).…”

Prognostic Value of Systemic Immune-Inflammation Index (SII) in Patients with Glioblastoma: A Comprehensive Study Based on Meta-Analysis and Retrospective Single-Center Analysis

“…Duplicate studies were excluded, and conference abstracts or studies lacking sufficient data were excluded after full-text evaluation. Five studies that enrolled 788 patients were included in the final metaanalysis [20][21][22][23]26]. The selection process of the meta-analysis is shown in Supplementary Figure S1.…”

“…The systemic immune-inflammation index (SII) [17], a novel inflammatory biomarker calculated by platelet count*neutrophil count/lymphocyte count, has been determined to be related to worse outcomes in many cancer patients, including breast cancer [18], hepatocellular carcinoma [19] and glioma [20]. Two recent studies reported that a higher SII was associated with a worse outcome in the GBM cohort [21,22]. However, the prognostic value of the SII is still controversial.…”

Nomogram Based on Inflammatory Biomarkers to Predict the Recurrence of Hepatocellular Carcinoma—A Multicentre Experience

“…They did not assess their prognostic capacity in comparison to the current tumour staging systems. 20,42,43 In our study, by incorporating inflammatory biomarkers and other clinicopathological factors, we built a simple but reproducible model that had higher prognostic power than common staging systems. It is undeniable that our research has some limitations.…”