Prognostic Value of the Systemic Immune-Inflammation Index and Prognostic Nutritional Index in Patients With Medulloblastoma Undergoing Surgical Resection

Abstract

Background: The progression and metastasis of cancers are associated with systematic immune inflammation and nutritional dysfunction. The systemic immune-inflammation index and prognostic nutritional index (PNI) have shown a prognostic impact in several malignancies. Therefore, our study aimed to evaluate immune inflammation and nutritional index prognostic significance in patients with medulloblastoma (MB).Methods: We retrospectively analyzed 111 patients with MB between 2001 and 2021 at our institution. The optimal cutoff values for systemic immune-inflammation index (SII), neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte counts ration (MLR), and PNI were evaluated with receiver operating characteristic (ROC) curve analysis. Clinical characteristics and SII, NLR, MLR, and PNI were tested with the Pearson's chi-squared test. The Kaplan–Meier survival curves and the Cox proportional hazards model were used to evaluate the effects of immune inflammation and nutritional index on overall survival (OS).Results: Receiver operating characteristic curve analysis determined the optimal SII, NLR, MLR, and PNI cutoff values of 2,278, 14.83, 0.219, and 56.5 that significantly interacts with OS and divided the patients into two groups. Comparative survival analysis exhibited that the high-SII cohort had significantly shorter OS (p = 0.0048) than the low-SII cohort. For the univariate analysis, the results revealed that preoperative hydrocephalus (p = 0.01), SII (p = 0.006), albumin–bilirubin score (ALBI) (p = 0.04), and coSII–PNI were predictors of OS. In the multivariate analysis, preoperative hydrocephalus (p < 0.001), ALBI (p = 0.010), SII (p < 0.001), and coSII–PNI as independent prognostic factors were significantly correlated with OS.Conclusion: The preoperative SII, ALBI, and coSII–PNI serve as robust prognostic biomarkers for patients with MB undergoing surgical resection.

Prognostic role of the pretreatment systemic immune-inflammation index in patients with glioma: A meta-analysis

“…To be specific, articles enrolled in this meta-analysis were published between 2019 and 2022 and were all in English ( 15 – 22 ). A total of four studies were performed in China ( 15 , 16 , 19 , 22 ), two studies were carried out in Turkey ( 17 , 18 ), and one each in Italy ( 21 ) and Poland ( 20 ), respectively. A sample size of 77 to 358 was obtained, with 168 representing the median.…”

“…SII has also been investigated in numerous studies to be the prognosis prediction biomarker for glioma cases; however, results have been inconsistent ( 15 – 22 ). For example, some researchers reported elevated SII as the important biomarker to predict the prognosis of glioma cases ( 17 , 19 , 20 ), whereas some other scholars found no evident relation of SII with glioma prognosis ( 18 ). These conflicting results confuse the application of SII in the clinical management of patients with glioma.…”

The ALBI score: From liver function in patients with HCC to a general measure of liver function

“…For example, ALBI has been shown to be prognostic in cancers other than HCC, including pancreatic, colon and gastric cancer, intrahepatic cholangiocarcinoma, extrahepatic bile duct cancer, and even brain cancer (glioma and medulloblastoma). [114] , [115] , [116] , [117] , [118] , [119] , [120] , [121] , [122] , [123] , [124] , [125] , [126] , [127] , [128] , [129] , [130] , [131] , [132] , [133] , [134] , [135] , [136] ALBI is likely to be reflective of liver dysfunction in patients undergoing hepatic resection for intrahepatic tumours, such as intrahepatic cholangiocarcinoma or metastatic liver tumours, and tolerance for those undergoing systemic therapy, including chemotherapies, molecular-targeted drugs and immune checkpoint inhibitors. 118 , 123 , [126] , [127] , [128] , 131 , 133 , 134 Although most authors have attempted to link the association of ALBI with a particular cancer to liver function, we should consider whether its association with mortality is actually through some aspect of liver dysfunction or whether it simply reflects the prognostic power of serum albumin and bilirubin levels, independent of liver function.…”

“… Zhu et al. 136 Retrospective 111 Medulloblastoma ALBI score was a prognostic biomarker for overall survival in patients undergoing surgical resection as well as systemic immune-inflammation index and prognostic nutritional index. Ieda et al.…”

The Association of Albumin-Bilirubin (ALBI) Grade with Mortality Risk in Trauma Patients with Liver Injuries

“…[21][22][23][24][25][26][27] Patients with cholangiocarcinoma, 28 intrahepatic cholangiocarcinoma, 29 pancreatic cancer with liver metastases, 30 colorectal cancer with liver metastases, 31 and primary biliary cholangitis 32 can all benefit from knowing their ALBI grade as a prognostic indicator. Additionally, other non-hepatological disorders, including aortic dissection, 33 heart failure, 34,35 acute pancreatitis, 36 lung cancer, 24,37,38 esophageal cancer, 39 gastric cancer, 40 lung cancer, 41 and medulloblastoma, 42 have shown a high correlation between ALBI and death.…”