Inflammatory prognostic markers in endometrial carcinoma: Systemic immune-inflammation index and prognostic nutritional index

Abstract

Objective: Systemic inflammatory response markers have prognostic significance in many cancer types. Although the prognostic values of neutrophil/lymphocyte (NLR), and platelet/lymphocyte ratios (PLR) have been shown in patients with Endometrial Cancer (EC) there is no information in the literature about systemic immune-inflammation index (SII) and prognostic nutritional index (PNI). In our study, we aimed to reveal the prognostic role of SII and PNI in EC.
 Material and Methods: Medical data for 101 patients with EC were reviewed retrospectively. NLR, PLR, SII and PNI values were dichotomized based on receiver operating characteristic (ROC) curve analysis (cut-off values: 3.3; 177; 1035.9, and 38, respectively). At the time of diagnosis concentrations of these four serum inflammatory markers were analyzed to determine their potential association with clinicopathologic characteristics and to assess their prognostic values via the Kaplan-Meier method and multivariate Cox regression analysis.
 Results: Patients with higher NLR, PLR, SII, and lower PNI values had shorter progression-free survival (PFS) and overall survival (OS) times. Higher NLR, SII, and lower PNI, were associated with FIGO stages, lymph node involvement, lymphovascular invasion, and cervical stromal invasion while additionally NLR and PNI were associated with worse ECOG performance scores (2-3) and myometrial invasion. In univariate analyses, all these four variables were prognostic for both OS and PFS, whereas in multivariate analyzes only NLR, SII and PNI were found to be independent factors for OS and PFS.
 Conclusion: For the first time in the literature SII and PNI were determined to be independent prognostic factors for both OS and PFS in EC.