Abstract
BackgroundA novel systemic immune-inflammation index (SII), based on the neutrophils, lymphocytes and platelet counts, is associated with the prognosis of several cancers. The present study evaluates the prognostic significance of SII in non-metastatic renal cell carcinoma (RCC).MethodThe present study retrospectively reviewed the medical record of patients with non-metastatic RCC who underwent nephrectomy between 2010 and 2013. Receiver operating characteristic (ROC) curve analysis was performed to identify the optimal cut-off value. In addition, the propensity score matching (PSM) was performed with a matching ratio of 1:1. Univariate and multivariate Cox proportional hazards models were used to identify the prognostic factors. The results were reported by hazard ratio (HR) with 95% confidence interval (95% CI).ResultsA total of 646 patients were included in the final analysis. High SII group (> 529) was significantly associated with older age (P = 0.014), larger tumor (P < 0.001), higher pathological T stage (P < 0.001), higher tumor grade (P < 0.001) and more tumor necrosis (P < 0.001). Multivariate Cox regression analysis demonstrated that the higher preoperative SII was significantly associated with worse overall survival (OS) (HR = 2.26; 95% CI 1.44–3.54; P < 0.001) and cancer-specific survival (CSS) (HR = 2.17; 95% CI 1.33–3.55; P = 0.002). After PSM, elevated preoperative SII was an independent predictor of poor OS (HR = 1.78; 95% CI 1.1–2.87; P = 0.018) and CSS (HR = 1.8; 95% CI 1.07–3.03; P = 0.027).ConclusionIn conclusion, preoperative SII is associated with adverse factors for RCC. Furthermore, higher preoperative SII is an independent predictor of poor OS and CSS in surgically treated patients with non-metastatic RCC. More prospective and large scale studies are warranted to validate our findings.
Highlights
A novel systemic immune-inflammation index (SII), based on the neutrophils, lymphocytes and plate‐ let counts, is associated with the prognosis of several cancers
Multivariate Cox regression analysis demonstrated that the higher pre‐ operative SII was significantly associated with worse overall survival (OS) (HR = 2.26; 95% Confidence interval (CI) 1.44–3.54; P < 0.001) and cancer-specific survival (CSS) (HR = 2.17; 95% confidence interval (95% CI) 1.33–3.55; P = 0.002)
After propensity score matching (PSM), elevated preoperative SII was an inde‐ pendent predictor of poor OS (HR = 1.78; 95% CI 1.1–2.87; P = 0.018) and CSS (HR = 1.8; 95% CI 1.07–3.03; P = 0.027)
Summary
A novel systemic immune-inflammation index (SII), based on the neutrophils, lymphocytes and plate‐ let counts, is associated with the prognosis of several cancers. The present study evaluates the prognostic significance of SII in non-metastatic renal cell carcinoma (RCC). Renal cell carcinoma (RCC) is one of the most common urological cancers and represents an increased global burden on human healthcare [1]. About 20–30% of patients will develop recurrence [4, Hu et al Cancer Cell Int (2020) 20:222. Several treatment strategies have developed well, such as immunotherapy, radiotherapy and molecular target drugs, and the clinical outcomes of the advanced disease have been improved [3, 6, 7]. The clinical outcomes remain not encouraging due to the low objective response rate, local recurrence or distant metastases. Identifying the prognostic factors of patients would be of great value to patients’ risk stratification, treatment selection, and long-term outcomes
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