Preoperative systemic inflammatory response index predicts the prognosis of patients with hepatocellular carcinoma after liver transplantation

Abstract

BackgroundPreoperative inflammatory status plays an important role in the prognosis of malignancy. We sought to explore the value of preoperative inflammatory biomarkers in predicting long-term outcomes of liver transplantation (LT) in patients with hepatocellular carcinoma (HCC).MethodPatients who underwent LT for HCC in our hospital between January 2010 and June 2020 were included in this study. Demographic, clinical, laboratory, and outcome data were obtained. The area under the curve (AUC) of the receiver operating characteristic curve was used to evaluate the predictive value of inflammatory biomarkers. The effectiveness of inflammatory biomarkers in predicting outcomes was analyzed by univariate and multivariate Cox proportional hazards analyses.ResultsA total of 218 patients were included in the study, with a mean age of 53.9 ± 8.5 years. The AUC of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune inflammation index (SII), and systemic inflammatory response index (SIRI) for overall survival (OS) were 0.741, 0.731, 0.756, 0.746, and 0.749, respectively. Cox proportional hazards model indicated that SIRI > 1.25 was independently associated with low OS [hazard ratio (HR) = 2.258, P = 0.024]. PLR > 82.15 and SIRI > 0.95 were independently associated with low disease-free survival (HR = 1.492, P = 0.015; and HR = 1.732, P = 0.008, respectively). In the survival analysis, the prognosis of patients with high preoperative SIRI and PLR was significantly worse (P < 0.001).ConclusionSIRI and PLR were useful prognostic markers for predicting patients with HCC after LT.

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

“…We therefore selected 200 for subgroup analysis of sample size. Four studies treated patients with HCC with surgery ( 18 , 21 , 22 , 27 ), two studies used TACE treatment ( 20 , 26 ), and one each used sorafenib ( 19 ), radiofrequency ablation (RFA) ( 23 ), sorafenib/immune checkpoint inhibitors (ICIs) ( 24 ), and LT ( 25 ). Nine studies were single-center studies ( 18 , 19 , 21 – 27 ) and one was a multicenter study ( 20 ).…”

“…Nine articles used the receiver operating characteristic (ROC) curve to determine the best threshold ( 18 – 22 , 24 – 27 ) and one study applied the X-tile software ( 23 ). Six studies reported the significance of SIRI in the OS prediction of HCC ( 18 – 20 , 23 – 25 ) and eight studies reported the association between SIRI and PFS ( 20 – 27 ). Six studies reported HRs and 95%CIs using multivariate analysis ( 18 , 21 , 22 , 25 – 27 ) and four studies used univariate analysis ( 19 , 20 , 23 , 24 ).…”

“…Six studies reported the significance of SIRI in the OS prediction of HCC ( 18 – 20 , 23 – 25 ) and eight studies reported the association between SIRI and PFS ( 20 – 27 ). Six studies reported HRs and 95%CIs using multivariate analysis ( 18 , 21 , 22 , 25 – 27 ) and four studies used univariate analysis ( 19 , 20 , 23 , 24 ). The NOS scores of all eligible studies were 7–9, suggesting a high quality ( Table 1 ).…”

“…The impact of the SIRI on predicting HCC prognosis has also been explored; however, no consistent findings have been found ( 18 – 27 ). In certain studies, elevated SIRI was found to be a significant prognostic marker of HCC ( 23 – 25 ), while other studies have shown no obvious relationship between SIRI and HCC survival ( 21 , 27 ). This meta-analysis aimed to accurately identify the prognostic effects of SIRI in patients with HCC.…”

Combining systemic inflammatory response index and albumin fibrinogen ratio to predict early serious complications and prognosis after resectable gastric cancer

“…Among the above indicators, SIRI, an indicator for assessing a patient’s inflammatory status by integrating multiple inflammatory cells into the assessment, has certain advantages and prospects for application. A significant variety of studies have increasingly reported that SIRI values were strongly associated with the prognosis of patients with many different types of tumors[ 15 - 17 ]. Patients with nasopharyngeal cancer and higher SIRI values had considerably shorter overall survival (OS) compared to those with lower SIRI values[ 18 ].…”