The Prognostic Value of Systemic Immune-Inflammation Index (SII) and Red Cell Distribution Width (RDW) in Cervical Cancer Patients Treated with Radiotherapy

Abstract

<h3>Purpose/Objective(s)</h3> To assess the association of pre-treatment systemic immune-inflammation index (SII) and red cell distribution width (RDW) with overall survival (OS) in patients treated for primary localized cervical cancer with radiotherapy. <h3>Materials/Methods</h3> The study cohort includes retrospectively collected data of 249 consecutive cervical cancer patients treated with radical intent between 2011 and 2017. The database was based on medical history of the patients and survival data from National Cancer Registry. The statistical analysis included Kaplan-Meier method, log-rank testing and Cox proportional hazards regression model. The cut-off values for log-rank testing were based on available literature data. <h3>Results</h3> The median age of the patients was 57.2 (IQR 49.2-64.5). The patients undergone a combination of external beam radiotherapy (100%), brachytherapy (98%) and concurrent chemotherapy (90%). The 5-year OS was 69.9% and 60.2% patients were alive at the time of the analysis. The results of the Cox model are presented in Table 1. Both SII and RDW were associated with survival in univariate analysis and remained independent prognostic factors in stepwise selection multivariate analysis. The OS was significantly higher in low SII (≤1000 and >1000; p=0.006) and low RDW (≤14.5% and >14.5%; p=0.002) groups. The 5-year OS was 73.5% and 60.2% for SII, and 74.3%, and 52.7% for RDW respectively. <h3>Conclusion</h3> SII and RDW are significantly associated with overall survival and could be used to improve the accuracy of pre-treatment prognostic assessment, in patients treated with radiotherapy for cervical cancer. Table: Univariate and multivariate Cox Regression analysis of HR for OS in patients with cervical cancer