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The systemic immune-inflammation index is an independent predictor of survival for metastatic colorectal cancer and its association with the lymphocytic response to the tumor.

ABSTRACT: BACKGROUND:Systemic inflammation and immune dysfunction has been proved to be significantly associated with cancer progression and metastasis in many cancer types, including colorectal cancer. We examined the prognostic significance of the systemic immune-inflammation index (SII) in patients with metastatic colorectal cancer (mCRC) and the relationship between the lymphocytic response to the tumor and this index. METHODS:This retrospective study evaluated 240 consecutive patients with newly diagnosed stage IV mCRC who underwent surgical resection. The SII values were calculated based on preoperative laboratory data regarding platelet, neutrophil, and lymphocyte counts. Tumor-infiltrating lymphocytes were evaluated using the surgical specimens. The overall survival and their 95% confidence interval (95% CI) were estimated by regression analyses and the Kaplan-Meier method. RESULTS:After a mean follow-up of 26.7 (1.1-92.4) months, 146 patients (60.8%) died. In the univariate analysis, a high SII was significantly associated with poor overall survival (P?=?0.009). The multivariable analysis also confirmed that a high SII was independently associated with poor overall survival (hazard ratio: 1.462, 95% confidence interval 1.049-2.038, P?=?0.025). The SII value was significantly correlated with the TILs value at the tumor's center (P?=?0.04), but not at the invasive margin (P?=?0.39). When we evaluated overall survival for groupings of the tumor-infiltrating lymphocytes and SII values, we identified three distinct prognostic groups. The group with low tumor-infiltrating lymphocyte values and high SII values had the worst prognosis. CONCLUSIONS:A high SII value independently predicts poor clinical outcomes among patients with mCRC. In addition, combining the lymphocytic response to the tumor and SII could further enhance prognostication for mCRC.

SUBMITTER: Xie QK

PROVIDER: S-EPMC6172841 | biostudies-other | 2018 Oct

REPOSITORIES: biostudies-other

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The systemic immune-inflammation index is an independent predictor of survival for metastatic colorectal cancer and its association with the lymphocytic response to the tumor.

Xie Qian-Kun QK Chen Ping P Hu Wan-Ming WM Sun Peng P He Wen-Zhuo WZ Jiang Chang C Kong Peng-Fei PF Liu Shou-Sheng SS Chen Hai-Tian HT Yang Yuan-Zhong YZ Wang Dan D Yang Lin L Xia Liang-Ping LP

Journal of translational medicine 20181004 1

<h4>Background</h4>Systemic inflammation and immune dysfunction has been proved to be significantly associated with cancer progression and metastasis in many cancer types, including colorectal cancer. We examined the prognostic significance of the systemic immune-inflammation index (SII) in patients with metastatic colorectal cancer (mCRC) and the relationship between the lymphocytic response to the tumor and this index.<h4>Methods</h4>This retrospective study evaluated 240 consecutive patients ...[more]

PMID: 30286769

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Project description:Aim: The aim of this study was to evaluate the prognostic significance of the preoperative systemic immune-inflammation index (SII) and to establish a nomogram for prediction of survival of tongue squamous cell carcinoma (TSCC) patients who underwent primary surgery and cervical dissection. Methods: 120 patients diagnosed with TSCC who underwent primary tumor and neck dissection without preoperative treatment were included to develop the nomogram. This model was externally validated in an independent data cohort of 50 TSCC patients. X-tile software was used to identify the optimal cut-off value. Prognostic factors were identified by Univariate and multivariate analyses. A nomogram based on the multivariate analysis results was built to predict the survival rate and calibration curves and concordance index (C-index) were used to determine predictive and discriminatory capacity. Results: The optimal cut-off value was 569×109/L for SII. In the training cohort, a high preoperative SII (>569) was significantly related to tumor size, histological grade, depth of invasion, lymph node density (LND). A Kaplan-Meier survival analysis showed that patients with a lower SII had a significantly better 5-year overall survival (OS) and disease-free survival (DFS) than patients with high SII (80.8% vs. 43.5% and 72.7% vs. 36.2%, respectively, P<0.001). Univariate analyses of training cohort revealed that age, clinical stage, depth of invasion, LND, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and SII were significant prognostic factors for OS. Moreover, the receiver operating characteristics (ROC) curve showed that SII was superior to NLR and PLR for predicting clinical outcomes. However, multivariate analysis found that age, LND, and SII were independent risk factors for OS. The C-index of the nomograms based on independent prognostic factors was 0.716 for OS and 0.723 for DFS. The C-indexes for external validation of OS and DFS were 0.852 and 0.754, respectively. The calibration curves showed good agreement between predicted and actual observations of OS and DFS. Conclusion: SII can serve as a novel independent prognostic factor for OS and DFS of patients with TSCC. The prognostic nomogram based on SII is a reliable model for predicting survival of patients with TSCC after surgery.

Dataset Information

The systemic immune-inflammation index is an independent predictor of survival for metastatic colorectal cancer and its association with the lymphocytic response to the tumor.

Publications

The systemic immune-inflammation index is an independent predictor of survival for metastatic colorectal cancer and its association with the lymphocytic response to the tumor.

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