Significance of a preoperative systemic immune-inflammation index as a predictor of postoperative survival outcomes in gastric cancer
Abstract Background Since inflammation and the immune system contribute to the development and progression of malignancies, parameters that reflect a host’s immune-inflammatory status may be useful prognostic indicators of gastric cancer (GC). The present study examined the clinical significance of...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-06-01
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| Series: | World Journal of Surgical Oncology |
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| Online Access: | https://doi.org/10.1186/s12957-021-02286-3 |
| _version_ | 1819088890992001024 |
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| author | Hiroyuki Inoue Toshiyuki Kosuga Takeshi Kubota Hirotaka Konishi Atsushi Shiozaki Kazuma Okamoto Hitoshi Fujiwara Eigo Otsuji |
| author_facet | Hiroyuki Inoue Toshiyuki Kosuga Takeshi Kubota Hirotaka Konishi Atsushi Shiozaki Kazuma Okamoto Hitoshi Fujiwara Eigo Otsuji |
| author_sort | Hiroyuki Inoue |
| collection | DOAJ |
| description | Abstract Background Since inflammation and the immune system contribute to the development and progression of malignancies, parameters that reflect a host’s immune-inflammatory status may be useful prognostic indicators of gastric cancer (GC). The present study examined the clinical significance of a preoperative systemic immune-inflammation index (SII) for predicting postoperative survival outcomes in GC. Methods A total of 447 patients who underwent curative gastrectomy for GC were included in the present study. SII was calculated as platelet count × neutrophil count/lymphocyte count. The prognostic impact of preoperative SII was examined using univariate and multivariate analyses. Results Preoperative SII ranged between 105 and 4455 (median 474), and the optimal cutoff value for predicting overall survival (OS) was 395 based on a receiver operating characteristic curve. The 5-year OS rate of the SII ≥ 395 group was 80.0%, which was significantly worse than that (92.7%) of the SII < 395 group (p < 0.001). The multivariate analysis identified SII ≥ 395 (hazard ratio [HR] 2.95; 95% confidence interval [CI] 1.49–6.39; p = 0.001), heart disease (HR 2.14, 95% CI 1.07–4.07), C-reactive protein ≥ 0.5 (HR 2.45, 95% CI 1.15–4.94), pT4 (HR 4.46, 95% CI 2.44–8.14), and pN+ (HR 4.02, 95% CI 2.10–7.93) as independent predictors of worse OS. Peritoneal recurrence was more frequent in the high SII group than in the low SII group (p = 0.028). Conclusion Preoperative SII may be a useful predictor of postoperative survival outcomes in GC. The meticulous surveillance of GC relapse, particularly peritoneal dissemination, is necessary for patients with SII ≥ 395 even after curative gastrectomy. |
| first_indexed | 2024-12-21T21:59:14Z |
| format | Article |
| id | doaj.art-4b019ffa03054e57b9644adae5525dbc |
| institution | Directory Open Access Journal |
| issn | 1477-7819 |
| language | English |
| last_indexed | 2024-12-21T21:59:14Z |
| publishDate | 2021-06-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj.art-4b019ffa03054e57b9644adae5525dbc2022-12-21T18:48:53ZengBMCWorld Journal of Surgical Oncology1477-78192021-06-0119111010.1186/s12957-021-02286-3Significance of a preoperative systemic immune-inflammation index as a predictor of postoperative survival outcomes in gastric cancerHiroyuki Inoue0Toshiyuki Kosuga1Takeshi Kubota2Hirotaka Konishi3Atsushi Shiozaki4Kazuma Okamoto5Hitoshi Fujiwara6Eigo Otsuji7Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of MedicineDivision of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of MedicineDivision of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of MedicineDivision of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of MedicineDivision of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of MedicineDivision of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of MedicineDivision of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of MedicineDivision of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of MedicineAbstract Background Since inflammation and the immune system contribute to the development and progression of malignancies, parameters that reflect a host’s immune-inflammatory status may be useful prognostic indicators of gastric cancer (GC). The present study examined the clinical significance of a preoperative systemic immune-inflammation index (SII) for predicting postoperative survival outcomes in GC. Methods A total of 447 patients who underwent curative gastrectomy for GC were included in the present study. SII was calculated as platelet count × neutrophil count/lymphocyte count. The prognostic impact of preoperative SII was examined using univariate and multivariate analyses. Results Preoperative SII ranged between 105 and 4455 (median 474), and the optimal cutoff value for predicting overall survival (OS) was 395 based on a receiver operating characteristic curve. The 5-year OS rate of the SII ≥ 395 group was 80.0%, which was significantly worse than that (92.7%) of the SII < 395 group (p < 0.001). The multivariate analysis identified SII ≥ 395 (hazard ratio [HR] 2.95; 95% confidence interval [CI] 1.49–6.39; p = 0.001), heart disease (HR 2.14, 95% CI 1.07–4.07), C-reactive protein ≥ 0.5 (HR 2.45, 95% CI 1.15–4.94), pT4 (HR 4.46, 95% CI 2.44–8.14), and pN+ (HR 4.02, 95% CI 2.10–7.93) as independent predictors of worse OS. Peritoneal recurrence was more frequent in the high SII group than in the low SII group (p = 0.028). Conclusion Preoperative SII may be a useful predictor of postoperative survival outcomes in GC. The meticulous surveillance of GC relapse, particularly peritoneal dissemination, is necessary for patients with SII ≥ 395 even after curative gastrectomy.https://doi.org/10.1186/s12957-021-02286-3Gastric cancerSystemic immune-inflammation indexGastrectomyPrognosis |
| spellingShingle | Hiroyuki Inoue Toshiyuki Kosuga Takeshi Kubota Hirotaka Konishi Atsushi Shiozaki Kazuma Okamoto Hitoshi Fujiwara Eigo Otsuji Significance of a preoperative systemic immune-inflammation index as a predictor of postoperative survival outcomes in gastric cancer World Journal of Surgical Oncology Gastric cancer Systemic immune-inflammation index Gastrectomy Prognosis |
| title | Significance of a preoperative systemic immune-inflammation index as a predictor of postoperative survival outcomes in gastric cancer |
| title_full | Significance of a preoperative systemic immune-inflammation index as a predictor of postoperative survival outcomes in gastric cancer |
| title_fullStr | Significance of a preoperative systemic immune-inflammation index as a predictor of postoperative survival outcomes in gastric cancer |
| title_full_unstemmed | Significance of a preoperative systemic immune-inflammation index as a predictor of postoperative survival outcomes in gastric cancer |
| title_short | Significance of a preoperative systemic immune-inflammation index as a predictor of postoperative survival outcomes in gastric cancer |
| title_sort | significance of a preoperative systemic immune inflammation index as a predictor of postoperative survival outcomes in gastric cancer |
| topic | Gastric cancer Systemic immune-inflammation index Gastrectomy Prognosis |
| url | https://doi.org/10.1186/s12957-021-02286-3 |
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