Prognostic significance of preoperative systemic immune-inflammation index in combined hepatocellular-cholangiocarcinoma

Abstract

BACKGROUND: Inflammation-based prognostic scores have been increasingly used for prognosis prediction in malignant tumors. However, no existing study has comprehensively evaluated these scores in combined hepatocellular-cholangiocarcinoma (cHCC-CCA). OBJECTIVE: This study aimed to identify a robust inflammation-based prognostic predictor for cHCC-CCA. METHODS: We retrospectively analyzed 220 patients pathologically confirmed as Allen type C cHCC-CCA. The univariate and multivariate analyses were used to explore the associations between clinical variables and prognosis of cHCC-CCA. The propensity score-matching (PSM) was performed to reduce the effects of potential cofounders and selection bias. Finally, the predictive values of different inflammation-based indices were compared by using time-dependent receiver operating characteristic (ROC) curves. RESULTS: The systemic immune-inflammation index (SII) and aspartate aminotransferase to platelet ratio index (APRI) were identified as independent prognostic predictors in multivariate analysis. After PSM, the survival differences were still significant between SII-high group and SII-low group (P= 0.016 for RFS and P= 0.001 for OS). Further ROC analysis showed that the SII harbored the largest 1-, 3- and 5-year area under the curves (AUC) values as compared with other scores. CONCLUSIONS: The SII may serve as a preferable predictor of both recurrence-free survival (RFS) and overall survival (OS) in patients with cHCC-CCA.

Prognostic and Clinical Value of the Systemic Immune-Inflammation Index in Biliary Tract Cancer: A Meta-Analysis

“…After screening titles and abstracts, 18 studies were excluded. Finally, 10 studies comprising 2,508 patients were included in the meta-analysis [15][16][17][18][19][20][21][22][23][24].…”

“…All 10 identified studies were retrospective cohorts, and the number of patients in each study ranged from 28 to 691. The included studies were published between 1993 and 2021 and were conducted in seven countries, including one multiinstitution (USA, Italy, Australia, China, France, the Netherlands, and Japan) [16], one in Japan [17], and eight in China [14,[18][19][20][21][22][23][24]. All studies provided information on the relationship between the SII and OS [15][16][17][18][19][20][21][22][23][24], three on RFS [22][23][24] and seven on clinicopathological features [17][18][19][20][21][22][23].…”

“…The SII has been a significant prognostic factor in patients with BTC [15][16][17][18][19][20][21][22][23][24]. However, the association between SII and survival in BTC is still controversial.…”

Use of the Advanced Lung Cancer Inflammation Index as a Prognostic Indicator for Patients With Cholangiocarcinoma

“…Systemic inflammation is vital in tumor development and progress in several cancers (6), including CCA (7). Previous studies have demonstrated that serum systemic inflammatory markers, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and can help predict the survival of CCA patients (8)(9)(10). In addition, nutritional status is also helpful for predicting the prognosis of CCA (11).…”

Prognostic significance of gamma‐glutamyl transpeptidase to albumin ratio in patients with intrahepatic cholangiocarcinoma after hepatectomy

“… 10 Currently, accumulating evidence has shown that inflammation‐based scores, such as systemic immune‐inflammation index (SII), platelet‐to‐lymphocyte ratio (PLR), neutrophil‐to‐lymphocyte ratio (NLR), lymphocyte‐to‐monocyte ratio (LMR), prognostic nutritional index (PNI), aspartate aminotransferase/platelet count ratio index (APRI), aspartate aminotransferase (AST) to neutrophil ratio index (ANRI), and AST to lymphocyte ratio index (ALRI) could be used as the prognostic markers for cholangiocarcinoma. 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 Gamma‐glutamyl transpeptidase (GGT) to albumin ratio (GAR) was a newly identified inflammation‐based score. Initially, GAR was pointed out to be useful for stratification of patients with chronic hepatitis B.…”