Abstract
Background The systemic immune-inflammation index (SII) has an important role in predicting survival in some solid tumors. However, little information is available concerning the change of the SII (∆SII) in colorectal cancer (CRC) after curative resection. This study was designed to evaluate the role of ∆SII in CRC patients who received surgery. Methods A total 206 patients were enrolled in this study. Clinicopathologic characteristics and survival were assessed. The relationships between overall survival (OS), disease-free survival (DFS), and ∆SII were analyzed with both univariate Kaplan-Meier and multivariate Cox regression methods. Results Based on the patient data, the receiver operating characteristic (ROC) optimal cutoff value of ∆SII was 127.7 for OS prediction. The 3-year and 5-year OS rates, respectively, were 60.4% and 36.7% in the high-∆SII group (>127.7) and 87.6% and 79.8% in the low-∆SII group (≤127.7). The 3-year and 5-year DFS rates, respectively, were 54.1% and 34.1% in the high-∆SII group and 80.3% and 78.5% in the low-∆SII group. In the univariate analysis, smoking, pathological stages III-IV, high-middle degree of differentiation, lymphatic invasion, vascular invasion, and the high-ΔSII group were associated with poor OS. Adjuvant therapy, pathological stages III-IV, vascular invasion, and ΔSII were able to predict DFS. Multivariate analysis revealed that pathological stages III-IV (HR = 0.442, 95% CI = 0.236-0.827, p = 0.011), vascular invasion (HR = 2.182, 95% CI = 1.243-3.829, p = 0.007), and the high-ΔSII group (HR = 4.301, 95% CI = 2.517-7.350, p < 0.001) were independent predictors for OS. Adjuvant therapy (HR = 0.415, 95% CI = 0.250-0.687, p = 0.001), vascular invasion (HR = 3.305, 95% CI = 1.944-5.620, p < 0.001), and the high-ΔSII group (HR = 4.924, 95% CI = 2.992-8.102, p < 0.001) were significant prognostic factors for DFS. Conclusions The present study demonstrated that ∆SII was associated with the clinical outcome in CRC patients undergoing curative resection, supporting the role of ∆SII as a prognostic biomarker.
Highlights
Colorectal cancer (CRC) is one of the most common malignant diseases [1, 2]
We attempted to select the optimal cutoff for the ΔSII in our study with receiver operating characteristic (ROC) curve analysis
The patients were divided into two groups, the high ΔSII group (ΔSII > 127:7) or low ΔSII group (ΔSII ≤ 127:7). 74 patients (35.9%) with high ΔSII were considered the high-risk group, and 132 patients (64.1%) with low ΔSII were considered the low-risk group
Summary
Colorectal cancer (CRC) is one of the most common malignant diseases [1, 2]. The clinical outcome of CRC is still unsatisfactory because of recurrence or metastasis. Other conventional prognostic biomarkers, such as tumor differentiation and pathological type, have been used for predicting CRC outcomes [7, 8]. These are tumor tissue dependent and the detections are Mediators of Inflammation usually costly and time-consuming. Pathological stages III-IV, vascular invasion, and ΔSII were able to predict DFS. The present study demonstrated that ΔSII was associated with the clinical outcome in CRC patients undergoing curative resection, supporting the role of ΔSII as a prognostic biomarker
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