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. 2021 Jan 23:2021:6688138.
doi: 10.1155/2021/6688138. eCollection 2021.

Prechemoradiotherapy Systemic Inflammation Response Index Stratifies Stage IIIB/C Non-Small-Cell Lung Cancer Patients into Three Prognostic Groups: A Propensity Score-Matching Analysis

Erkan Topkan  1 , Ugur Selek  2   3 , Ahmet Kucuk  4 , Veysel Haksoyler  5 , Yurday Ozdemir  1 , Duygu Sezen  2 , Huseyin Mertsoylu  6 , Ali Ayberk Besen  6 , Yasemin Bolukbasi  2   3 , Ozgur Ozyilkan  5 , Berrin Pehlivan  7
Affiliations

Prechemoradiotherapy Systemic Inflammation Response Index Stratifies Stage IIIB/C Non-Small-Cell Lung Cancer Patients into Three Prognostic Groups: A Propensity Score-Matching Analysis

Erkan Topkan et al. J Oncol. .

Abstract

Purpose: We explored the prognostic influence of the systemic inflammation response index (SIRI) on the survival outcomes of stage IIIB/C non-small-cell lung cancer (NSCLC) patients who underwent concurrent chemoradiotherapy.

Methods: Present propensity score-matching (PSM) analysis comprised 876 stage IIIB/C NSCLC patients who received 1-3 cycles of platinum-based doublets concurrent with thoracic radiotherapy from 2007 to 2017. The primary and secondary objectives were the relationships between the SIRI values and overall (OS) and progression-free survival, respectively. Propensity scores were calculated for SIRI groups to adjust for confounders and to facilitate well-balanced comparability between the SIRI groups by creating 1 : 1 matched study groups.

Results: The receiver operating characteristic curve analysis identified an optimal SIRI cutoff at 1.9 for OS (AUC: 78.8%; sensitivity: 73.7%; specificity: 70.7%) and PFS (AUC: 80.5%; sensitivity: 75.8%; specificity: 72.9%) and we grouped the patients into two PSM cohorts: SIRI < 1.9 (N = 304) and SIRI ≥ 1.9 (N = 304), respectively. The SIRI ≥ 1.9 cohort had significantly worse median OS (P < 0.001) and PFS (P < 0.001) than their SIRI < 1.9 companions. The further combination of SIRI with disease stage exhibited that the SIRI-1 (IIIB and SIRI < 1.9) and SIRI-3 (IIIC and SIRI ≥ 1.9) cohorts had the best and worst outcomes, respectively, with SIRI-2 cohort (IIIB and SIRI ≥ 1.9 or IIIC and SIRI < 1.9) being remained in between (P < 0.001 for OS and PFS, separately). In multivariate analysis, the two- and three-laddered stratifications per the 1.9 cutoffs and SIRI groups retained their independent significance, individually.

Conclusions: The SIRI ≥ 1.9 independently prognosticated significantly worse OS and PFS results and plated the stage IIIB/C patients into three fundamentally distinct prognostic groups.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Results of receiver operating characteristic curve analyses: (a) progression-free survival; (b) overall survival.
Figure 2
Figure 2
Comparative survival outcomes according to pretreatment SIRI groups (red line: SIRI < 1.9 and dark blue line: SIRI ≥ 1.9): (a) progression-free survival; (b) overall survival.
Figure 3
Figure 3
Comparative survival outcomes according to grouping composite disease stage and pretreatment SIRI groups (red line: Group 1, IIIB and SIRI < 1.9; dark blue line: Group 2, IIIB and SIRI ≥ 1.9; green line: Group 3, IIIC and SIRI < 1.9; and orange line: Group 4, IIIC and SIRI ≥ 1.9): (a) progression-free survival; (b) overall survival.
Figure 4
Figure 4
Comparative survival outcomes according to three-laddered pretreatment SIRI groups (red line: SIRI-1, IIIB and SIRI < 1.9; dark blue line: SIRI-2, IIIB and SIRI ≥ 1.9 or IIIC and SIRI < 1.9; and green line: SIRI-3, IIIC and SIRI ≥ 1.9): (a) progression-free survival; (b) overall survival.
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