The Prognostic Value of the New Combined Hemo-Eosinophil Inflammation Index (HEI Index): A Multicenter Analysis of Anal Cancer Patients Treated with Concurrent Chemo-Radiation

Abstract

Anal squamous cell carcinoma (SCC) is a rare tumor, and bio-humoral predictors of response to chemo-radiation (CT-RT) are lacking. We developed a prognostic score system based on laboratory inflammation parameters. We investigated the correlation between baseline clinical and laboratory variables and disease-free (DFS) and overall (OS) survival in anal SCC patients treated with CT-RT in five institutions. The bio-humoral parameters of significance were included in a new scoring system, which was tested with other significant variables in a Cox’s proportional hazard model. A total of 308 patients was included. We devised a prognostic model by combining baseline hemoglobin level, SII, and eosinophil count: the Hemo-Eosinophils Inflammation (HEI) Index. We stratified patients according to the HEI index into low- and high-risk groups. Median DFS for low-risk patients was not reached, and it was found to be 79.5 months for high-risk cases (Hazard Ratio 3.22; 95% CI: 2.04–5.10; p < 0.0001). Following adjustment for clinical covariates found significant at univariate analysis, multivariate analysis confirmed the HEI index as an independent prognostic factor for DFS and OS. The HEI index was shown to be a prognostic parameter for DFS and OS in anal cancer patients treated with CT-RT. An external validation of the HEI index is mandatory for its use in clinical practice.

Evaluation of prognostic factors after primary chemoradiotherapy of anal cancer: A multicenter study of the German Cancer Consortium-Radiation Oncology Group (DKTK-ROG)

“…Nevertheless, the combined influence of these parameters on outcome have not been assessed. Other composite blood based markers that have been reported to be associated with impaired prognosis are the systemic inflammatory index consisting of platelets, neutrophils and lymphocytes and the Hemo-Eosinophil-Inflammatory index consisting of hemoglobin and eosinophil levels [24,25].…”

A Machine-Learning-Based Bibliometric Analysis of the Scientific Literature on Anal Cancer

“…Biomarkers and patient-reported outcomes also emerged as recent trend topics in ASCC. The HPV/p16 status, tumor-infiltrating lymphocytes (TILs) rate, Epidermal Growth Factor Receptor (EGFR) overexpression, circulating HPV-DNA and blood biomarkers [Neutrophil-to-lymphocyte ratio (NLR), Systemic Index of Inflammation (SII), absolute number of leukocytes and neutrophils, hemoglobin level] were the most frequently studied biomarkers [ 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 ].…”

Impact of preoperative white blood cell count on long-term outcome in patients undergoing surgery for colorectal cancer: A retrospective observational study of Chinese patients

“…Some studies have demonstrated that peripheral blood leukocytosis and neutrophilia re ected cancerrelated in ammation and has been proposed as prognostic immunological biomarkers for various malignancies 11,21 . A study validated leukocytosis as an independent prognostic factor in CRC, which provided for the rst-time vital insight on the correlation of peripheral pretreatment leukocytosis with the tumor-in ltrating cells contexture and might be relevant for future risk strati cation 22 .…”