Prognostic significance of the preoperative systemic immune‐inflammation index in patients with oral cavity squamous cell carcinoma treated with curative surgery and adjuvant therapy

Hung, Sheng-Ping; Chen, Pei-Rung; Ho, Tsung-Ying; Chang, Kai‐Ping; Chou, Wen‐Chi; Lee, Ching-Hsin; Wu, Yao-Yu; Chen, Po-Jui; Lin, Cen-Hung; Chou, Yi–Hong; Fan, Kang‐Hsing; Lin, Chien‐Yu; Huang, Bing‐Shen; Chang, Joseph Tung-Chieh; Wang, Chun‐Chieh; Tsang, Ngan‐Ming

doi:10.1002/cam4.3650

Cited by 14 publications

(19 citation statements)

References 33 publications

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“…Many reports, including systematic reviews, have shown the usefulness of NLR, PLR, and MLR as prognostic predictors in the eld of head and neck cancer (13,14,15). Conversely, few studies have reported the usefulness of SIRI and SII in this eld, and the usefulness of SIRI in nasopharyngeal cancer and SII in oral cancer has been reported (16,17). Neutrophils participate in various processes of tumor growth through cytokine production (18) and promote tumor angiogenesis by releasing angiogenic factors (19,20).…”

Section: Discussionmentioning

confidence: 99%

Predictive Value of Combined Peripheral Inflammatory Markers in Patients with Head and Neck Cancers

Iuchi

Ohori

Haraguchi

et al. 2023

Preprint

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Background Head and neck squamous cell carcinoma (HNSCC) is one of the most common malignancies worldwide, and patients have low survival and poor quality of life. Combined peripheral inflammatory markers are associated with poor outcomes in patients with malignancies. This study aimed to investigate the prognostic significance of combined peripheral inflammatory markers in patients with HNSCC. Methods Records of 531 patients with histologically confirmed HNSCC between January 2009 and January 2021 were reviewed. The optimal cutoff values of peripheral inflammatory markers were determined by the receiver operating characteristic curve analysis and the Youden test. The neutrophil-to-lymphocyte ratio (NLR)–platelet-to-lymphocyte ratio (PLR) score, NLR–monocyte-to-lymphocyte ratio (MLR) sore, and PLR-MLR score ranged from low to high, i.e., a high score indicated that both inflammation markers are high; mid score, either inflammation marker is high; and low score, both inflammation markers are low. The overall survival (OS) and disease-free survival (DFS) were evaluated. Univariate and multivariate analyses were performed. Results The median follow-up time was 55 (range, 3–148) months. The optimal cutoff values for pretreatment NLR, PLR, MLR, systemic inflammation response index (SIRI), and systemic immune inflammation index (SII) were 2.21, 214.24, 0.33, 0.86, and 472.44, respectively. Univariate analyses revealed that smoking status (P = 0.021), drinking status (P = 0.033), tumor stage (P < 0.001), nodal stage (P < 0.001), tumor node metastasis (TNM) stage (P < 0.001), SIRI (P = 0.031), NLR-PLR score (P = 0.007), NLR-MLR score (P = 0.004), and PLR-MLR score (P < 0.001) were significantly associated with OS. Independent prognostic factors for OS were smoking status, drinking status, tumor stage, and PLR-MLR score. Univariate analyses revealed that smoking status (P = 0.008), tumor stage (P < 0.001), nodal stage (P < 0.001), TNM stage (P < 0.001), SIRI (P = 0.003), SII (P = 0.010), NLR-PLR score (P = 0.002), NLR-MLR score (P = 0.002), and PLR-MLR score (P < 0.001) were significantly associated with DFS. Independent prognostic factors for DFS were smoking status and PLR-MLR score. Conclusions PLR-MLR score may be a valuable inflammatory marker for the prediction of survival in patients with HNSCC.

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Section: Discussionmentioning

confidence: 99%

Predictive Value of Combined Peripheral Inflammatory Markers in Patients with Head and Neck Cancers

Iuchi

Ohori

Haraguchi

et al. 2023

Preprint

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“…This biomarker is used as a prognostic factor in diseases with inflammation-related causes . The SII has also recently been highlighted as a predictor of mortality for head and neck as well as other cancers …”

Section: Introductionmentioning

confidence: 99%

Depressive Symptoms, Systemic Inflammation, and Survival Among Patients With Head and Neck Cancer

Cash,

Albert,

Palmer

et al. 2024

JAMA Otolaryngol Head Neck Surg

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ImportancePatients with head and neck cancer experience high rates of depression. Depression and systemic inflammation have been found to be associated in numerous cancer types, often independently from disease status. Depression-related inflammation may elevate the risks for poor tumor response to treatment and early mortality, and comprises a mechanism by which depression is associated with survival in head and neck cancer.ObjectiveTo assess mediation pathways incorporating pretreatment depressive symptoms, pretreatment inflammation, and tumor response posttreatment on overall survival among patients with head and neck cancer.Design, Setting, and ParticipantsThis was a prospective observational cohort study of patients with head and neck cancer treated in a single multidisciplinary head and neck cancer clinic from May 10, 2013, to December 30, 2019, and followed up for 2 years. Data analysis was performed from June 29, 2022, to June 23, 2023.ExposuresPatient-reported depressive symptoms using the Patient Health Questionnaire−9 item (PHQ−9) at treatment planning; pretreatment hematology workup for systemic inflammation index (SII) score; and clinical data review for tumor response (complete vs incomplete) and overall survival.Main OutcomesTwo-year overall survival.ResultsThe total study cohort included 394 patients (mean [SD] age, 62.5 [11.5] years; 277 [70.3%] males) with head and neck cancer. Among 285 patients (72.3%) who scored below the clinical cutoff for depression on the PHQ−9, depressive symptoms were significantly associated with inflammation (partial r, 0.168; 95% CI, 0.007-0.038). In addition, both depression and inflammation were associated with early mortality (PHQ−9: hazard ratio [HR], 1.04; 95% CI, 1.02-1.07; SII: HR, 1.36; 95% CI, 1.08-1.71). The depression-survival association was fully mediated by inflammation (HR, 1.28; 95% CI, 1.00-1.64). Depressive symptoms were also associated with poorer tumor response (odds ratio, 1.05; 95% CI, 1.01-1.08), and the depression-survival association was partially mediated by tumor response (HR, 9.44; 95% CI, 6.23-14.32). Systemic inflammation was not associated with tumor response.ConclusionsIn this cohort study, systemic inflammation emerged as a novel candidate mechanism of the association of depression with mortality. Tumor response partially mediated effects of depression on mortality, replicating prior work. Thus, depression stands out as a highly feasible target for renewed clinical attention. Even mild symptoms of depression during the treatment-planning phase may be associated with higher systemic inflammation in addition to poorer tumor response to treatment and survival outcomes; therefore, depression should be clinically addressed.

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“…Moreover, a number of inflammatory biomarkers (IBs) and their derived ratios have been investigated as prognostic indicators in various cancers. The systemic immune inflammation index (SII), an integrated indicator based on peripheral lymphocyte, neutrophil, and platelet counts, is a strong prognostic indicator for patients with several tumor types ( 13 ). Recent studies have revealed that higher neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are associated with poorer outcomes in ESCC ( 14 , 15 ).…”

Section: Introductionmentioning

confidence: 99%

Inflammatory biomarkers as predictors of immune activation to different irradiated sites and short-term efficacy in advanced squamous cell esophageal carcinoma received radioimmunotherapy

Cai

Gao

et al. 2023

Front. Oncol.

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PurposeThe present study aimed to compare immune activation among different irradiated sites and identify potential short-term efficacy prognostic factors in patients with advanced squamous cell esophageal carcinoma (ESCC) who received radiotherapy (RT) and immunotherapy.Patients and methodsWe recorded the clinical characteristics, blood cell counts, and derived blood index ratios, including neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII), at three time points (before, during, and after RT) in 121 patients with advanced ESCC who had received RT and immunotherapy. Chi-square test and univariate and multivariate logistic regression analyses were used to calculate the relationships among inflammatory biomarkers (IBs), irradiated sites, and short-term efficacy.ResultsDelta-IBs were calculated as (medio-IBs - pre-IBs) ÷ pre-IBs. The medians of delta-LMR, and delta-ALC were the highest, whereas the median of delta-SII was the lowest in patients with brain radiation. Treatment responses were observed within 3 months after RT or until the beginning of the next line therapy, and the disease control rate (DCR) was 75.2%. The areas under the receiver operating characteristic curve (AUCs) for delta-NLR and delta-SII were 0.723 (p = 0.001) and 0.725 (p < 0.001), respectively. Multivariate logistic regression analysis showed that the treatment lines of immunotherapy (odds ratio [OR], 4.852; 95% confidence interval [CI], 1.595-14.759; p = 0.005) and delta-SII (OR, 5.252; 95% CI, 1.048-26.320; p = 0.044) were independent indicators of short-term efficacy.ConclusionIn this study, we found that RT to the brain had a stronger immune activation effect than RT to extracranial organs. We also found that earlier-line immunotherapy plus RT and a decrease in SII during RT may generate better short-term efficacy in advanced ESCC.

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Prognostic significance of the preoperative systemic immune‐inflammation index in patients with oral cavity squamous cell carcinoma treated with curative surgery and adjuvant therapy

Cited by 14 publications

References 33 publications

Predictive Value of Combined Peripheral Inflammatory Markers in Patients with Head and Neck Cancers

Predictive Value of Combined Peripheral Inflammatory Markers in Patients with Head and Neck Cancers

Depressive Symptoms, Systemic Inflammation, and Survival Among Patients With Head and Neck Cancer

Inflammatory biomarkers as predictors of immune activation to different irradiated sites and short-term efficacy in advanced squamous cell esophageal carcinoma received radioimmunotherapy

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