High Systemic Immune-Inflammation Index is an Adverse Prognostic Factor for Patients With Gastroesophageal Adenocarcinoma

Abstract

Objective: The aim of this study was to determine the clinical role of the systemic immune-inflammation index in patients with resectable adenocarcinoma of the gastroesophageal junction treated with or without neoadjuvant therapy. Background: Adenocarcinoma of the gastroesophageal junction is an aggressive disease, with less than 20% of overall patients surviving more than 5 years after diagnosis, while currently available clinical staging for esophageal cancer is lacking necessary accuracy. The systemic immune-inflammation index (SII) based on peripheral neutrophil, lymphocyte, and platelet counts has shown a prognostic impact in various malignancies. Methods: Data of consecutive patients undergoing esophagectomy (n = 320, 1992 to 2016) were abstracted. The cut point for high and low SII before neoadjuvant treatment and before surgery was calculated for illustration of the Kaplan-Meier curves. SII was used for the correlation with patients’ clinicopathological characteristics as a continuous variable. Survival was analyzed with Cox proportional hazards models using clinical or pathological staging, adjusting for other known survival predictors. Results: In both neoadjuvantly treated and primarily resected patients, high SII was significantly associated with diminished overall [hazard ratio (HR) 1.3, 95% confidence interval (95% CI) 1.2–1.4; HR 1.2, 95% CI 1.2–1.3, respectively] and disease-free survival (HR 1.3, 95% CI 1.2–1.3; HR 1.2, 95% CI 1.2–1.3, respectively). In multivariable survival analysis, SII remained an independent prognostic factor for overall survival (HR 1.3, 95% CI 1.2–1.4; HR 1.2, 95% CI 1.2–1.3, respectively) and disease-free survival (HR 1.3, 95% CI 1.2–1.3; HR 1.2, 95% CI 1.2–1.3, respectively) in primarily resected and neoadjuvantly treated patients. Conclusion: Elevated SII is an independent adverse prognostic factor in patients with resectable gastroesophageal adenocarcinomas with and without neoadjuvant treatment.

Association of systemic inflammation and body mass index with survival in patients with resectable gastric or gastroesophageal junction adenocarcinomas

“…Although NLR and BMI have previously been shown to be associated with the prognosis in gastric cancer 12 , 16 , 17 , 25 and many other solid tumors 11 , 19 , 20 , 22 , 26 – 30 , most studies have investigated them individually and in metastatic patients. In the present study, our results confirmed that similar processes occurred in resectable gastric cancer.…”

Impact of perioperative red blood cell transfusion on postoperative recovery and long-term outcome in patients undergoing surgery for ovarian cancer: A propensity score-matched analysis

“…Recent studies showed that the suppression perioperative anti-tumor immune function could facilitate the formation of new metastases and promote postoperative metastasis and recurrence [34,35]. Numerous studies have also shown that some markers of hematological components, such as the NLR, LMR and SII, can comprehensively indicate the balance of the host immune system and have been considered prognosis-related indicators in malignancies [36][37][38]. An increased NLR or SII and a decreased LMR are associated with an adverse prognosis in ovarian cancer [13][14][15].…”

Blood-based Markers in the Prognostic Prediction of Esophagogastric Junction Cancer

“…When combining these three parameters, a systemic immune-inflammation score (SII) has emerged, calculated by using a formula (SII = NE×LY/PLT), first described in 2014 to explore its prognostic value in hepatocellular carcinoma [39]. Jomrich et al also introduced it for EJA and found that a higher SII contributes to poor OS and DFS in EJA patients who underwent esophagectomy with or without receiving neoadjuvant treatment [40].…”