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. 2022 Oct 3;12(1):16559.
doi: 10.1038/s41598-022-20056-3.

The relationship between systemic immune inflammation index and survival in patients with metastatic renal cell carcinomatreated withtyrosine kinase inhibitors

Kadriye Bir Yücel  1 , Emre Yekedüz  2   3 , Serdar Karakaya  4 , Deniz Tural  5 , İsmail Ertürk  6 , Cihan Erol  7 , Özlem Ercelep  8 , Nihan Şentürk Öztaş  9 , Çağatay Arslan  10 , Gökhan Uçar  11 , Ahmet Küçükarda  12 , Özlem Nuray Sever  13 , Saadettin Kılıçkap  14   15 , Orçun Can  16 , Satı Coşkun Yazgan  1 , Berna Öksüzoğlu  4 , Nuri Karadurmuş  6 , Mehmet Ali Şendur  7 , Yüksel Ürün  17   18
Affiliations

The relationship between systemic immune inflammation index and survival in patients with metastatic renal cell carcinomatreated withtyrosine kinase inhibitors

Kadriye Bir Yücel et al. Sci Rep. .

Abstract

This study aims to investigate the prognostic value of the systemic immune-inflammation index (SII)and its impact on survival in patients with metastatic renal cell carcinoma (mRCC). A total of 706patients with mRCC treated with tyrosine kinase inhibitors (TKIs)between January 2007 and June 2020 (i.e., sunitinib, pazopanib) were included in this study. SII was calculated in 621 patients with the following formula:[neutrophil (cellsx109/L) x platelet (cellsx109/L)] / lymphocyte (cellsx109/L).All patients were classified into SII-high and SII-low groups based on the cut-off value of SII at 756, which was the median SII level of our study group. The minimal follow-up duration was 10 months in all cohorts. The median age of patients was 60 (interquartile range (IQR):53-67) years. Three out of four patients were male. The majority of patients (85.7%) had clear cell histology, and sarcomatoid differentiation was observed in 16.9% of all patients. There were 311 and 310 patients in the SII-low and SII-high groups, respectively. In general, baseline characteristics were similar in each group. However, the rate of patients treated with sunitinib (63.3% vs. 49.0%, p < 0.001) and those who underwent nephrectomy (83.6% vs. 64.2%, p < 0.001) was higher in the SII-low group than in the SII-high group. On the other hand, patients with the IMDC poorrisk (31.6% vs. 8.0%, p < 0.001), those with bone (51.8% vs. 32.2%, p < 0.001) or central nervous system (12.9% vs. 5.8%, p = 0.026) metastasis, and those with Eastern Cooperative Oncology Group(ECOG) 2-4 performance score (28.1% vs.17.7%, p = 0.002) were more common in the SII-high group than in the SII-low group. The median overall survival (OS) was longer in the SII-low group than in the SII-high group (34.6 months vs. 14.5 months, p < 0.001). Similarly, the median progression-free survival (PFS) was longer in the SII-low group than in the SII-high group (18.0 months vs. 7.7 months, p < 0.001).In multivariableanalysis, SII was an independent prognostic factor for OS (hazard ratio (HR):1.39, 95% confidence interval (CI):1.05-1.85, p = 0.01) and PFS (HR:1.60, 95% CI:1.24-2.05, p < 0.001).Pre-treatment level of high SII might be considered a predictor of poor prognosisin patients with mRCC treated with TKIs.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Kaplan-Meier estimates of overall survival (OS). SII  systemic immune inflammation index.
Figure 2
Figure 2
Kaplan-Meier estimates of progression-free survival (PFS). SII   systemic immune inflammation index.
See this image and copyright information in PMC

References

    1. Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA a cancer j clin. 2021;71(3):209–249. doi: 10.3322/caac.21660. - DOI - PubMed
    1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA a cancer j. clin. 2019;69:7–34. doi: 10.3322/caac.21551. - DOI - PubMed
    1. Lam JS, Shvarts O, Leppert JT, et al. Renal cell carcinoma 2005: New frontiers in staging, prognostication and targeted molecular therapy. J. Urol. 2005;173:1853–1862. doi: 10.1097/01.ju.0000165693.68449.c3. - DOI - PubMed
    1. Tannir, N.M., Frontera, O.A., Hammers, H.J., et al. Thirty-month follow-up of the phase III CheckMate 214 trial of first-line nivolumab+ ipilimumab (N+ I) or sunitinib (S) in patients (pts) with advanced renal cell carcinoma (aRCC). Am. Soc. Clin. Oncol. (2019).
    1. Rini BI, Plimack ER, Stus V, et al. Pembrolizumab plus axitinib versus sunitinib for advanced renal-cell carcinoma. N. Engl. J. Med. 2019;380:1116–1127. doi: 10.1056/NEJMoa1816714. - DOI - PubMed