The prognostic value of systemic immune-inflammation index in surgical esophageal cancer patients: An updated meta-analysis

Abstract

PurposeTo identify the prognostic role of systemic immune-inflammation index (SII) in esophageal cancer patients receiving operation.MethodsThe PubMed, EMBASE, Web of Science, Cochrane Library, WanFang and CNKI electronic databases were searched up to February 17, 2022 for relevant studies. The hazard ratios (HRs) and 95% confidence intervals (CIs) were combined to assess the association between SII and prognosis in surgical esophageal cancer patients. The primary outcome was overall survival (OS) and secondary outcomes were progression-free survival (PFS) and cancer-specific survival (CSS). All statistical analyses were conducted by STATA 15.0 software.ResultsA total of nine retrospective studies involving 3,565 participates were included. The pooled results indicated that high SII was significantly related with poor OS (HR = 1.58, 95% CI: 1.23–2.02, P < 0.001). However, subgroup analysis based on pathological type demonstrated that high SII was an independent predictor for poor OS only in esophageal squamous cell carcinoma (ESCC) patients (HR = 1.72, 95% CI: 1.34–2.21, P < 0.001). Besides, SII was also significantly associated with poor PFS (HR = 1.94, 95% CI: 1.61–2.35, P < 0.001) and CSS (HR = 1.44, 95% CI: 1.04–1.99, P = 0.027) in ESCC patients.ConclusionThe SII could serve as an independent prognostic factor in surgical ESCC patients and higher SII was related with worse survival. However, more prospective high-quality studies are still needed to verify above findings.

Prognostic value of pretreatment systemic immune-inflammation index in Chinese esophageal squamous cell carcinoma patients receiving radical radiotherapy: A meta-analysis

“…Actually, the clinical role of pretreatment SII in esophageal cancer has been manifested by several meta-analysis. [21,39,40] Zhang et al included 5 relevant studies involving 2292 cases and revealed that increased SII was associated with shorter OS in esophageal cancer patients after surgery (HR = 1.34, 95% CI: 1.15–1.53, P < .001). [40] Li et al included 9 retrospective studies involving 3565 participants and their results showed that high SII was related to poor OS (HR = 1.58, 95% CI: 1.23–2.02, P < .001) in esophageal cancer.…”

“…[40] Li et al included 9 retrospective studies involving 3565 participants and their results showed that high SII was related to poor OS (HR = 1.58, 95% CI: 1.23–2.02, P < .001) in esophageal cancer. However, their subgroup analysis indicated that elevated preoperative SII was only related to poor OS (HR = 1.72, 95% CI: 1.34–2.21, P < .001), PFS (HR = 1.94, 95% CI: 1.61–2.35, P < .001) and cancer-specific survival (CSS) (HR = 1.44, 95% CI: 1.04–1.99, P = .027) of ESCC patients, [21] which is consistent with the findings in the meta-analysis by Yang et al [39] Radiation could cause a certain amount of inflammation in the body and patients with high basic levels of inflammatory response are suggested to experience more serious side effects of radiotherapy. Thus, ESCC patients with increased pre-radiotherapy SII are more likely to have poorer prognosis.…”

A Novel Predictor of Pathologic Complete Response for Neoadjuvant Immunochemotherapy in Resectable Locally Advanced Esophageal Squamous Cell Carcinoma

“…According to previously published study, variables were calculated by the following formula: aggregate index of systemic inflammation (AISI) = MONO × PLT× NEUT/LY, 26 SII = PLT × NEUT/LY. 27 …”

Prognostic value of systemic immune-inflammation index in head and neck carcinoma patients undergoing definitive radio(chemo)therapy

“…There have been many studies investigating the effects of systemic inflammatory responses such as neutrophil/lymphocyte ratio (NLR), platelet/ lymphocyte ratio (PLR) and monocyte/lymphocyte ratio (MLR) on prognosis. [3] Systemic immune-inflammation index (SII) is an inflammatory response marker calculated based on absolute platelet, neutrophil, and lymphocyte counts. It shows the patient's systemic immune stimulation level and immune response level.…”