The Systemic-immune-inflammation Index Independently Predicts Survival and Recurrence in Resectable Pancreatic Cancer and its Prognostic Value Depends on Bilirubin Levels

Aziz, Moutaz; Sideras, Kostandinos; Aziz, N. Ahmad; Mauff, Katya; Haen, Roel; Roos, Daphne; Saida, Lawlaw; Suker, Mustafa; Harst, Erwin van der; Mieog, J. Sven D.; Bonsing, Bert A.; Klaver, Yarne; Koerkamp, Bas Groot; Eijck, Casper H. van

doi:10.1097/sla.0000000000002660

Cited by 212 publications

(206 citation statements)

References 46 publications

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“…Furthermore, almost all of the SIR markers were significantly correlated with poorer prognosis of DFS in patients with curatively resected CRC (log‐rank test, CRP: P = .0009, serum albumin level: P = .004, NLR: P = .005, PLR: P = .025, SII: P < .0001, LMR: P = .025, NPS: P = .29, and PNI: P = .0006, respectively; Figure S1I–P). Collectively, these findings validated the prognostic impact of SIR markers using optimal cutoff values of these markers established from previous evidence in patients with CRC …”

Section: Resultssupporting

confidence: 70%

“…NPS was calculated as follows: patients with a neutrophil count ≤7 × 10 3 /μL and a platelet count ≤40 × 10 4 /μL scored 0, patients with a neutrophil count >7 × 10 3 /μL or a platelet count of >40 × 10 4 /μL scored 1, and patients with a neutrophil count >7 × 10 3 /μL and a platelet count >40 × 10 4 /μL scored 2, as previously described . The cutoff value of each marker was defined as 0.5 mg/dL, 3.5 g/dL, 3, 150, 900, 3, 45, and score 1 or 2, respectively, based on previous evidence.…”

Section: Methodsmentioning

confidence: 99%

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Close Relationship Between Immunological/Inflammatory Markers and Myopenia and Myosteatosis in Patients With Colorectal Cancer: A Propensity Score Matching Analysis

Okugawa

Toiyama

Yamamoto

et al. 2018

J Parenter Enteral Nutr

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Background The systemic inflammatory response (SIR) via host‐tumor interactions has been termed the seventh hallmark of cancer, and several studies demonstrated that SIR might be a pivotal mediator for progression of cancer cachexia. The objective of this study was to clarify the correlation between sarcopenia and SIR in patients with colorectal cancer (CRC). Methods A total of 308 patients with CRC were enrolled in this study. Preoperative psoas muscle mass index and intramuscular adipose tissue content were evaluated using preoperative computed tomographic images, and the correlation between body composition status and several SIR markers, including C‐reactive protein (CRP), serum albumin level, neutrophil‐lymphocyte ratio, platelet‐lymphocyte ratio, and systemic immune‐inflammation index (SII) was assessed using statistical methods. Results Whereas preoperative myosteatosis was not correlated with clinicopathological factors except for aging and the presence of lymphovascular invasion, preoperative myopenia was significantly associated with well‐established clinicopathological factors. Furthermore, the presence of myopenia was significantly correlated with elevated CRP, SII, and neutrophil‐platelet score, and decreased lymphocyte‐monocyte ratio, prognostic nutrition index, and serum albumin level. Logistic regression analysis revealed that an elevated CRP concentration was an independent risk factor for the presence of preoperative myopenia (odds ratio [OR] 2.49, 95% CI: 1.31–4.72; P = .005). Furthermore, these findings were validated using propensity score matching analysis (OR 2.35, 95% CI: 1.17–4.75; P = .017). Conclusion Quantification of preoperative CRP could identify patients at high risk for development of myopenia who will likely require individualized treatment plans, including postoperative nutrition intervention, rehabilitation, and oncological follow‐up in patients with CRC.

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Section: Resultssupporting

confidence: 70%

Section: Methodsmentioning

confidence: 99%

Close Relationship Between Immunological/Inflammatory Markers and Myopenia and Myosteatosis in Patients With Colorectal Cancer: A Propensity Score Matching Analysis

Okugawa

Toiyama

Yamamoto

et al. 2018

J Parenter Enteral Nutr

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“…(Glasgow Prognostic Score and CA19.9) showed reasonable performance. Recently, the systemic inflammation index has shown to be an independent predictor of cancer‐specific survival and recurrence in resectable pancreatic cancer. As immunotherapy holds promise as treatment for pancreatic cancer, systemic inflammatory scores could assist in patient selection in future.…”

Section: Discussionmentioning

confidence: 99%

Systematic review of clinical prediction models for survival after surgery for resectable pancreatic cancer

Strijker

Chen

Mungroop

et al. 2019

British Journal of Surgery

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Background: As more therapeutic options for pancreatic cancer are becoming available, there is a need to improve outcome prediction to support shared decision-making. A systematic evaluation of prediction models in resectable pancreatic cancer is lacking.Methods: This systematic review followed the CHARMS and PRISMA guidelines. PubMed, Embase and Cochrane Library databases were searched up to 11 October 2017. Studies reporting development or validation of models predicting survival in resectable pancreatic cancer were included. Models without performance measures, reviews, abstracts or more than 10 per cent of patients not undergoing resection in postoperative models were excluded. Studies were appraised critically.Results: After screening 4403 studies, 22 (44 319 patients) were included. There were 19 model development/update studies and three validation studies, altogether concerning 21 individual models. Two studies were deemed at low risk of bias. Eight models were developed for the preoperative setting and 13 for the postoperative setting. Most frequently included parameters were differentiation grade (11 of 21 models), nodal status (8 of 21) and serum albumin (7 of 21). Treatment-related variables were included in three models. The C-statistic/area under the curve values ranged from 0⋅57 to 0⋅90. Based on study design, validation methods and the availability of web-based calculators, two models were identified as the most promising. Conclusion: Although a large number of prediction models for resectable pancreatic cancer have been reported, most are at high risk of bias and have not been validated externally. This overview of prognostic factors provided practical recommendations that could help in designing easily applicable prediction models to support shared decision-making.Prediction models enable clinicians and patients to calculate the risks of a specific endpoint individualized to a patient, using combinations of predictors. Such models are used widely in some fields, including the CHADS 2 -VASc score for estimation of stroke risk in atrial fibrillation 3 , and the Acute Physiology and Chronic Health Evaluation (APACHE) score 4 for mortality in intensive care. In breast cancer, the PREDICT 5 and Adjuvant! 6 models have been employed in the decision-making process to determine adjuvant treatment administration. Data analysisData extraction was performed independently by two authors. Articles were categorized into development/model update studies and validation studies 12 .

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“…It is an index that incorporates the absolute blood counts of neutrophils, lymphocytes as well as platelets, by multiplying the platelet count by the ratio of neutrophil and lymphocyte counts. Several studies found that the SII is a prognostic factor in patients with solid cancers, such as hepatocellular carcinoma, colorectal and pancreatic cancer . So far, it is unknown whether an increased SII also is a marker for developing incident cancer in healthy individuals.…”

Section: Introductionmentioning

confidence: 99%

“…Several studies found that the SII is a prognostic factor in patients with solid cancers, such as hepatocellular carcinoma, colorectal and pancreatic cancer. [12][13][14] So far, it is unknown whether an increased SII also is a marker for developing incident cancer in healthy individuals.…”

Section: Introductionmentioning

confidence: 99%

The systemic immune‐inflammation index is associated with an increased risk of incident cancer—A population‐based cohort study

Fest

Ruiter

Mulder

et al. 2019

Intl Journal of Cancer

116

103

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Several studies found that the systemic immune‐inflammation index (SII) is a prognostic factor for mortality in patients with solid tumors. It is unknown whether an increased SII in generally healthy individuals reflects a risk for developing cancer. Our objective was to investigate the association between the SII and incident cancers in a prospective cohort study. Data were obtained from the Rotterdam Study; a population‐based study of individuals aged ≥45 years, between 2002 and 2013. The SII at baseline was calculated from absolute blood counts. The association between the SII and the risk of any solid incident cancer during follow‐up was assessed using Cox proportional hazard models. Individuals with a prior cancer diagnosis were excluded. Data of 8,024 individuals were included in the analyses. The mean age at baseline was 65.6 years (SD 10.5 years) and the majority were women. During a maximum follow‐up period of 10.7 years, 733 individuals were diagnosed with cancer. A higher SII at baseline was associated with a 30% higher risk of developing a solid cancer (HR of 1.30 [95% CI; 1.11–1.53]), after adjustment for age, sex, socioeconomic status, smoking, BMI and type 2 diabetes. The absolute cumulative 10‐year cancer risk increased from 9.7% in the lowest quartile of SII to 14.7% in the highest quartile (p‐value = 0.009). The risk of developing cancer was persistent over time and increased for individuals with the longest follow‐up. In conclusion, a high SII is a strong and independent risk indicator for developing a solid cancer.

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The Systemic-immune-inflammation Index Independently Predicts Survival and Recurrence in Resectable Pancreatic Cancer and its Prognostic Value Depends on Bilirubin Levels

Abstract: SIII is an independent predictor of cancer-specific survival and recurrence in patients with resectable PDAC. SIII may lose its prognostic significance in patients with high bilirubin levels. Properly designed prospective studies are needed to further confirm this hypothesis.

Cited by 212 publications

References 46 publications

Close Relationship Between Immunological/Inflammatory Markers and Myopenia and Myosteatosis in Patients With Colorectal Cancer: A Propensity Score Matching Analysis

Close Relationship Between Immunological/Inflammatory Markers and Myopenia and Myosteatosis in Patients With Colorectal Cancer: A Propensity Score Matching Analysis

Systematic review of clinical prediction models for survival after surgery for resectable pancreatic cancer

The systemic immune‐inflammation index is associated with an increased risk of incident cancer—A population‐based cohort study

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