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. 2018 Sep 7;9(18):3295-3302.
doi: 10.7150/jca.25691. eCollection 2018.

Prognostic value of Systemic immune-inflammation index in cancer: A meta-analysis

Ruonan Yang  1 , Qian Chang  1 , Xianchun Meng  1 , Nan Gao  1 , Wanhai Wang  1
Affiliations

Prognostic value of Systemic immune-inflammation index in cancer: A meta-analysis

Ruonan Yang et al. J Cancer. .

Abstract

Systemic immune-inflammation index (SII), on the basis of lymphocyte, neutrophil and platelet counts had been published to be a good prognostic factor in multiple cancers. Nevertheless, the prognostic value of SII in cancer patients remains inconsistent. Therefore, we carried out a meta-analysis to evaluate the prognostic value of SII in these patients with cancer. A total of 22 articles with 7657 patients enrolled in this meta-analysis. The combined result revealed that a high SII was evidently correlated with poor overall survival (OS) (HR=1.69, 95%CI=1.42-2.01, p<0.001), poor time to recurrent (TTR) (HR=1.87, p<0.001) , poor progress-free survival (PFS) (HR=1.61, p=0.012) ,poor cancer-specific survival (CSS) (HR=1.44, p=0.027) , poor relapse-free survival (RFS) (HR=1.66, p=0.025) and poor disease-free survival (DFS) (HR=2.70, p<0.001) in patients with cancers. Subgroup analysis indicated that SII over the cutoff value could predict worse overall survival in Hepatocellular carcinoma (p<0.001), Gastric cancer (p=0.005), Esophageal Squamous Cell Carcinoma (p=0.013), Urinary system cancer (p<0.001), Small cell lung cancer (p<0.001), Non-Small cell lung cancer (p<0.001) and Acral Melanoma (p<0.001). The largest effect size was observed in the Hepatocellular carcinoma (HR=2.11). In addition, these associations did not vary significantly by the cutoff value, sample size and ethnicity. Therefore, high SII may be a potential prognostic marker in patients with various cancers and associated with the poor overall outcomes.

Keywords: Systemic immune-inflammation index; cancer; meta-analysis; prognosis.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interest exists.

Figures

Figure 1
Figure 1
Flow chat of the study search and selection.
Figure 2
Figure 2
Forest plot of the association between SII and OS.
Figure 3
Figure 3
Funnel plot for detecting publication bias.
Figure 4
Figure 4
Sensitivity analysis on the relationship between SII and OS.
Figure 5
Figure 5
Forest plot of the association between SII and TTR, PFS, CSS, DFS and RFS.
Figure 6
Figure 6
Sensitivity analysis on the relationship between SII and PFS.
See this image and copyright information in PMC

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