Predictive value of the systemic immune-inflammation index for the efficacy of neoadjuvant chemotherapy and prognosis in patients with stage III ovarian cancer—a retrospective cohort study

Abstract

Background: The systemic immune-inflammation index (SII) has been proven to be related to the prognoses of multiple malignant tumors. However, there are still few studies on the relationship between the SII and the effect of neoadjuvant chemotherapy in patients with ovarian cancer. It is of great significance to predict the efficacy of neoadjuvant chemotherapy in patients with ovarian cancer. Our study was aimed at determining the predictive value of the SII for the efficacy of neoadjuvant chemotherapy and prognosis in patients with stage III ovarian cancer.Methods: A total of 102 patients with stage III ovarian cancer treated in Tongji Hospital of Tongji University from January 2017 to January 2019 were retrospectively collected. According to the level of the SII before neoadjuvant chemotherapy, patients were divided into the high SII group and low SII group. We compared the effect of neoadjuvant chemotherapy between the 2 groups, and observed the progression-free survival and mortality of patients in the 2 groups after 3 years follow-up.Results: Compared with patients in the low SII group, the complete response rate of patients in the high SII group decreased significantly after neoadjuvant chemotherapy (13.73% vs. 45.10%, P=0.001), and the progressive disease rate increased (19.61% vs. 1.96%, P=0.011). The SII had certain value in predicting the inefficacy of neoadjuvant chemotherapy in patients with stage III ovarian cancer, and the area under the curve was 0.655 (95% CI: 0.548-0.762, P=0.007). The progression-free survival of patients in the high SII group was shorter than that of patients in the low SII group (P<0.001), and the overall survival rate of patients in the high SII group was lower (47.06% vs. 70.59%, P=0.016). The SII had predicting value for the postoperative death of ovarian cancer patients after neoadjuvant chemotherapy, and the area under the curve was 0.646 (95% CI: 0.537-0.756, P=0.012). Multivariate regression analysis showed that higher SII was a risk factor for death in ovarian cancer patients after neoadjuvant chemotherapy (OR: 2.700, P=0.017).Conclusions: A high SII was a predictor of inefficacy of neoadjuvant chemotherapy in patients with stage III ovarian cancer and was related to poor prognosis.

Prognostic significance of systemic immune-inflammation index in patients with ovarian cancer: a meta-analysis

“…Five articles were published in English ( 21 , 22 , 24 – 26 ) and one in Chinese ( 23 ). Three studies were conducted in China ( 21 , 23 , 25 ), two in Italy ( 22 , 26 ), and one in India ( 24 ). The sample sizes were 49–553 (median, 233.5).…”

“…The sample sizes were 49–553 (median, 233.5). Three studies included patients with OC who underwent chemotherapy ( 22 – 24 ), two studies included patients treated surgically ( 21 , 26 ), and one study included patients treated using surgery and chemotherapy ( 25 ). The SII threshold was 612–1000 (median: 715.5).…”

“…The disease stages in the included studies were also not uniform ( 21 – 26 ). One study examined early-stage OC ( 25 ), whereas the other four studies examined recurrent/relapsed OC ( 21 – 24 ). We combined these studies for the following reasons: first, all eligible studies were selected based on the same inclusion and exclusion criteria; therefore, they were comparable.…”

“…However, their results remain conflicting ( 21 – 26 ). Few studies have identified high SII as a significant prognostic factor for survival in OC ( 21 , 25 , 26 ). In contrast, other studies have found an insignificant relationship between the SII and prognostic outcomes of OC ( 22 ).…”

Association between the systemic immune inflammation index and recurrence or metastasis after interventional therapy in patients with primary liver cancer- a retrospective cohort study

“…The study of biological indicators related to the prognosis of different diseases is a research hotspot (28)(29)(30)(31)(32)(33). The elevated systemic immune inflammation index is associated with recurrence and metastasis after interventional therapy in patients with PLC, and treatment should be intensified in patients with elevated systemic immune inflammation index, which may help reduce the risk of recurrence or metastasis.…”