Systemic immune-inflammation index predicting chemoradiation resistance and poor outcome in patients with stage III non-small cell lung cancer

Abstract

BackgroundThere is increasing evidence that the existence of systemic inflammation response is correlated with poor prognosis in several solid tumors. The aim of this retrospective study was to investigate the association between systemic immune-inflammation index (SII) and therapy response and overall survival in patients with stage III non-small cell lung cancer (NSCLC). The prognostic values of neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and prognostic nutritional index (PNI) were also evaluated.MethodsIn total, 332 patients with new diagnosis of stage III NSCLC were included in this retrospective analysis. SII was defined as platelet counts × neutrophil counts/lymphocyte counts. Receiver operating characteristic (ROC) curve was used to evaluate the optimal cut-off value for SII, NLR, PLR and PNI. Univariate and multivariate survival analysis were performed to identify the factors correlated with overall survival.ResultsApplying cut-offs of ≥ 660 (SII), ≥ 3.57 (NLR), ≥ 147 (PLR), ≤ 52.95 (PNI), SII ≥ 660 was significantly correlated with worse ECOG PS (< 0.001), higher T stage (< 0.001), advanced clinical stage (p = 0.019), and lower response rate (p = 0.018). In univariate analysis, SII ≥ 660, NLR ≥ 3.57, PLR ≥ 147, and PNI ≤ 52.95 were significantly associated with worse overall survival (p all < 0.001). Patients with SII ≥ 660 had a median overall survival of 10 months, and patients with SII < 660 showed a median overall survival of 30 months. In multivariate analysis only ECOG PS (HR, 1.744; 95% CI 1.158–2.626; p = 0.008), T stage (HR, 1.332; 95% CI 1.032–1.718; p = 0.028), N stage (HR, 1.848; 95% CI 1.113–3.068; p = 0.018), SII (HR, 2.105; 95% CI 1.481–2.741; p < 0.001) and NLR ≥ 3.57 (HR, 1.934; 95% CI 1.448–2.585; p < 0.001) were independently correlated with overall survival.ConclusionsThis study demonstrates that the SII is an independent prognostic indicator of poor outcomes for patients with stage III NSCLC and is superior to other inflammation-based factors in terms of prognostic ability.

Pre‐treatment systemic immune‐inflammation index is a useful prognostic indicator in patients with breast cancer undergoing neoadjuvant chemotherapy

“…However, SII based on three inflammatory cells, including neutrophil, platelet and lymphocyte and can fully reflect the balance between host immune and inflammatory status. SII has been investigated in some malignancies, such as gastric cancer, prostate cancer, lung cancer and pancreatic cancer, and SII has been proved to be an independent predictor of malignant tumours . In our study, we confirmed that the SII was the significant prognostic factor by univariate and multivariate analyses and could predict survival in breast cancer patients receiving NACT.…”

Nomogram Based on Systemic Immune-Inflammation Index to Predict Survival of Tongue Cancer Patients Who Underwent Cervical Dissection

“…Recently, the systemic immune-inflammation index (SII), based on a combination of peripheral lymphocytes, neutrophils, and platelet count, was hypothesized to better reflect the balance between host inflammation and immune status. Its prognostic value in hepatocellular carcinoma (15), gastric cancer (16), colorectal cancer (17), and small cell lung cancer (18) has been confirmed, but few studies have focused on the importance of SII in TSCC.…”

Preoperative systemic immune-inflammation index predicts prognosis and guides clinical treatment in patients with non-small cell lung cancer

“…However, these genomic technologies are expensive at present and more genomic information needs to be integrated due to the biological complexity of NSCLC [7]. Recently, systemic inflammatory response indicators, such as peripheral neutrophils, lymphocytes and platelets, play important roles in the progression and prognosis of various cancers, including lung cancer [8,9], breast cancer [10] and gastric cancer [11]. Moreover, these peripheral markers can be detected with an easy, convenient method, and its application in prognosis prediction deserves attention.…”