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Review
. 2020 Aug 7;18(1):197.
doi: 10.1186/s12957-020-01974-w.

Prognostic prediction of systemic immune-inflammation index for patients with gynecological and breast cancers: a meta-analysis

Yongfang Ji  1 , Haiyan Wang  2
Affiliations
Review

Prognostic prediction of systemic immune-inflammation index for patients with gynecological and breast cancers: a meta-analysis

Yongfang Ji et al. World J Surg Oncol. .

Abstract

Background: Systemic immune-inflammation index (SII) has been suggested to be effective to reflect the inflammatory status and thus may be an underlying biomarker for prognosis prediction. This hypothesis has been demonstrated in meta-analyses on several cancer types. However, there was no study to confirm the prognostic roles of SII for gynecological and breast cancers, which was the goal of our study.

Methods: PubMed, EMBASE, and Cochrane Library databases were searched to collect the articles exploring the associations of SII with prognostic outcomes [overall survival (OS), disease-free survival (DFS), progression-free survival (PFS), lymph node metastasis (LNM), and lymphovascular invasion (LVI)] in gynecological and breast cancers. The prognostic value of SII was estimated by hazard ratio (HR) or relative risk (RR) with 95% confidence interval (CI).

Results: Nine articles involving 2724 patients in 11 datasets were included. Meta-analysis showed that a high SII index was significantly associated with poor OS (HR = 2.12, 95% CI, 1.61-2.79, P < 0.001), DFS/PFS (HR = 2.28, 95% CI 1.52-3.41, P < 0.001) and an increased risk for LNM (RR = 1.34, 95% CI 1.20-1.50, P < 0.001) in patients with gynecological and breast cancers. Subgroup analysis confirmed the prognostic role of SII for OS was applicable to all cancer types, but the association with DFS/PFS and LNM was only significant for ovarian cancer and breast cancer, especially triple-negative breast cancer. No significant association was detected between SII and LVI.

Conclusion: High SII may be a promising indicator for the prediction of poor prognosis in patients with gynecological and breast cancers, especially ovarian cancer and triple-negative breast cancer.

Keywords: Breast cancer; Gynecological cancer; Prognosis; Systemic immune-inflammation index.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of included studies
Fig. 2
Fig. 2
Forest plots showing the association between SII and overall survival. SII, systemic immune-inflammation index; HR, hazard ratio; CI, confidence interval
Fig. 3
Fig. 3
Forest plots showing the association between SII and disease-free survival/progression-free survival. SII, systemic immune-inflammation index; HR, hazard ratio; CI, confidence interval
Fig. 4
Fig. 4
Forest plots showing the association between SII and lymph node metastasis. SII, systemic immune-inflammation index; HR, hazard ratio; CI, confidence interval
Fig. 5
Fig. 5
Forest plots showing the association between SII and lymphovascular invasion. SII, systemic immune-inflammation index; HR, hazard ratio; CI, confidence interval
Fig. 6
Fig. 6
Sensitivity analysis for disease-free survival/progression-free survival. CI, confidence interval
See this image and copyright information in PMC

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