Systemic Immune-Inflammation Index as a Prognostic Marker of Late Recurrence in Operable Gastric Cancer: a Dual-Center Study


Yekeduz E., Dogan I., Kaya D. M., Ozgur I., UTKAN G., Vatansever S., ...More

JOURNAL OF GASTROINTESTINAL CANCER, vol.53, no.4, pp.870-879, 2022 (ESCI) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 53 Issue: 4
  • Publication Date: 2022
  • Doi Number: 10.1007/s12029-021-00769-w
  • Journal Name: JOURNAL OF GASTROINTESTINAL CANCER
  • Journal Indexes: Emerging Sources Citation Index (ESCI), Scopus, EMBASE, MEDLINE
  • Page Numbers: pp.870-879
  • Keywords: Gastric cancer, Prognosis, Systemic immune-inflammation index, CURATIVE SURGERY, SURVIVAL, ROLES, SII
  • Istanbul University Affiliated: Yes

Abstract

Aim To evaluate the prognostic role of the systemic immune-inflammation index (SII) in patients with operable gastric cancer. Methods We assessed 354 patients with operable gastric cancer from tertiary centers in Turkey. SII was calculated by following formula: [neutrophil (cells x 10(9)/L) x platelet (cells x 10(9)/L)]/lymphocyte (cells x 10(9)/L). The best cut-off value for SII was determined by using "receiver operating characteristics (ROC)" analysis. We used log-rank and Cox-regression analysis for survival analyses. Results One hundred twenty patients were in the late recurrence group (recurrences have developed 36 months after the surgery). SII was not a prognostic factor in the early recurrence group. However, relapse-free survival (RFS) was longer in SII-low patients than SII-high patients in the late recurrence group. In multivariable analysis, SII was the only independent prognostic factor for RFS in the late recurrence group (hazard ratio (HR): 5.42, 95% CI: 1.18-24.82, p = 0.03). Conclusion SII was an independent prognostic factor for RFS in GC patients with late recurrence. Late recurrence risk was higher in SII-high patients than SII-low patients. Inflammation contributes to tumor progression, invasion, and metastasis. Prolonged exposure to chronic inflammation could explain the results of this study.