Is Systemic Inflammatory Response Index (SIRI) a Reliable Tool for Prognosis of Gastric Cancer Patients Without Neoadjuvant Therapy?

Abstract

Background: The systemic inflammatory response index (SIRI), which depends on peripheral neutrophil, monocyte, and lymphocyte count, was found as an effective prognostic indicator for various malignancies. This study aims to investigate the predictive value of preoperative SIRI in the prognosis of gastric cancer patients without neoadjuvant therapy.Methods: The patients who underwent gastric cancer surgery in Marmara University Hospital's General Surgery Department between 2019 and 2021 were analyzed retrospectively. SIRI was calculated from preoperative peripheral blood samples' neutrophil, lymphocyte, and monocyte count. The optimal cut-off value for SIRI was calculated by the receiver operating characteristics (ROC) curve and was found to be 1.35. The clinicopathological outcomes and overall survival (OS) were analyzed under two groups according to the SIRI values lower or higher than 1.35.Results: The number of eligible patients was 199. The median follow-up time was 25 (1-56) months. The higher SIRI was associated with male gender (p = 0.044), lower serum albumin (0.002) level, and Clavien-Dindo (CD) Grade III and higher complications (p = 0.018). However, there was no significant difference between the groups regarded pathological tumor, nodes, and metastases (TNM) stages, histological grade, and Lauren Type. In addition, OS and stage-specific OS were similar between the groups.Conclusions: SIRI may be a valuable and effective predictive indicator for postoperative morbidity. The prognostic performance of SIRI on long-term OS is still controversial. Further investigations are needed into this topic.

Construction of a preoperative nomogram model for predicting perineural invasion in advanced gastric cancer

“…SIRI was calculated based on the counts of neutrophils, monocytes, and lymphocytes in peripheral blood, accurately reflecting the tumor’s inflammatory status. Notably, it demonstrated a superior ability to assess the prognosis of gastric cancer patients compared to other traditional inflammatory indicators ( 34 ).…”

Prognostic and clinicopathological value of systemic inflammation response index (SIRI) in patients with breast cancer: a meta-analysis

“…in 2016 for pancreatic cancer prognosis [ 11 ]. Recent studies have reported the prognostic effect of SIRI for various cancers, including nasopharyngeal carcinoma (NPC) [ 12 ], colorectal [ 13 ], ovarian [ 14 ], gastric [ 15 ], and bladder cancers [ 16 ]. Many previous studies have explored the significance of the SIRI in predicting BC prognosis, but no consistent findings have been obtained [ 17–24 ].…”

Prognostic and clinicopathological significance of systemic inflammation response index in patients with hepatocellular carcinoma: a systematic review and meta-analysis

“…The systemic inflammation response index (SIRI) is a novel hematologic parameter that was first proposed in 2016 ( 12 ) and is determined using the following formula: SIRI = (neutrophil × monocyte)/lymphocyte count. SIRI has been widely suggested to exhibit a significant and powerful value in predicting solid tumors such as bladder cancer ( 13 ), non-small cell lung cancer (NSCLC) ( 14 ), gastric cancer ( 15 ), breast cancer ( 16 ), and ovarian cancer ( 17 ). The impact of the SIRI on predicting HCC prognosis has also been explored; however, no consistent findings have been found ( 18 – 27 ).…”