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. 2022 Apr 28:13:865643.
doi: 10.3389/fimmu.2022.865643. eCollection 2022.

The Prognostic and Clinicopathological Significance of Systemic Immune-Inflammation Index in Bladder Cancer

Jinze Li  1   2 , Dehong Cao  1 , Yin Huang  1   2 , Qiao Xiong  1   2 , Daqing Tan  1   2 , Liangren Liu  1 , Tianhai Lin  1 , Qiang Wei  1
Affiliations

The Prognostic and Clinicopathological Significance of Systemic Immune-Inflammation Index in Bladder Cancer

Jinze Li et al. Front Immunol. .

Abstract

Background: Systemic immune-inflammation index (SII) has recently emerged as a biomarker for the prognosis of a variety of malignant tumors. However, the role of SII in bladder cancer (BC) remains unclear. To this end, we performed a pooled analysis to investigate the prognostic value of preoperative SII in patients with BC.

Methods: A comprehensive search of electronic databases (PubMed/Medline, Web of Science, Scopus, and Cochrane Central Register of Controlled Trials) was conducted to determine the eligible studies that were published until January 2022. Pooled hazard ratios (HRs) and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to evaluate the association between preoperative SII and the prognosis and clinicopathological characteristics of BC.

Results: Ten studies with 7,087 patients were included in this analysis. SII was observed to be correlated with inferior overall survival (HR = 1.22, 95% CI 1.04-1.44, p = 0.013), cancer-specific survival (HR = 1.68, 95% CI 1.14-2.47, p = 0.009), and recurrence-free survival (HR = 1.29, 95% CI 1.03-1.61, p = 0.027). An increased preoperative SII was also associated with poor tumor differentiation, higher tumor stage, presence of lymph node involvement, and tumor size ≥3 cm (all p < 0.05).

Conclusions: An elevated preoperative SII is significantly associated with worse survival outcomes and adverse pathological features in patients with BC. Hence, SII may serve as a strong independent prognostic predictor for patients with BC after surgery.

Keywords: bladder cancer; meta-analysis; prognosis; survival; systemic immune-inflammation index.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram of the study selection process.
Figure 2
Figure 2
Forest plot of the association between systemic immune-inflammation index and overall survival in patients with bladder cancer.
Figure 3
Figure 3
Forest plot of the association between systemic immune-inflammation index and cancer-specific survival in patients with bladder cancer.
Figure 4
Figure 4
Forest plot of the association between systemic immune-inflammation index and recurrence-free survival in patients with bladder cancer.
Figure 5
Figure 5
Forest plots of the association between systemic immune-inflammation index and clinicopathological features in bladder cancer: (A) age (old vs. young); (B) sex (male vs. female); (C) concomitant carcinoma in situ (yes vs. no); (D) lymph node involvement (yes vs. no); (E) lymphovascular invasion (yes vs. no); (F) tumor size (≥3 cm vs. <3 cm); (G) tumor number (unifocal vs. multifocal); (H) tumor differentiation (poor vs. well); (I) tumor stage [muscle-invasive bladder cancer (MIBC): ≥T3 vs. <T3; (J) tumor stage non-muscle-invasive bladder cancer (NMIBC): T1 vs. Tis-Ta].
See this image and copyright information in PMC

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