Preoperative systemic immune-inflammation index-based nomogram for lung carcinoma following microwave ablation -a real world single center study

Abstract

Background: The preoperative inflammatory condition significantly influences the prognosis of malignancies. We aimed to investigate the potential significance of preoperative inflammatory biomarkers in forecasting the long-term results of lung carcinoma after microwave ablation (MWA).

Method: This study included patients who received MWA treatment for lung carcinoma from Jan. 2012 to Dec. 2020. We collected demographic, clinical, laboratory, and outcome information. To assess the predictive capacity of inflammatory biomarkers, we utilized the area under the receiver operating characteristic curve (AUC-ROC) and assessed the predictive potential of inflammatory biomarkers in forecasting outcomes through both univariate and multivariate Cox proportional hazard analyses.

Results: A total of 354 individuals underwent MWA treatment, of which 265 cases were included in this study, whose average age was 69.1 ± 9.7 years. The AUC values for the Systemic Inflammatory Response Index (SIRI) to overall survival (OS) and disease-free survival (DFS) were 0.796 and 0.716, respectively. The Cox proportional hazards model demonstrated a significant independent association between a high SIRI and a decreased overall survival (hazard ratio [HR]=2.583, P<0.001). Furthermore, a high SIRI independently correlated with a lower DFS (HR=2.391, P<0.001). We developed nomograms utilizing various independent factors to forecast the extended prognosis of patients. These nomograms exhibited AUC of 0.900, 0.849, and 0.862 for predicting 1-year, 3-year, and 5-year OS, respectively. Additionally, the AUC values for predicting 1-year, 3-year, and 5-year DFS were 0.851, 0.873, and 0.883, respectively.

Conclusion: SIRI has shown promise as a valuable long-term prognostic indicator for forecasting the outcomes of lung carcinoma patients following MWA.

Keywords: biomarkers; lung carcinoma; microwave ablation; prognosis; systemic inflammatory response index.

Figure 1

Flowchart depicting the composition of the study group. MWA, microwave ablation.

Figure 2

Survival analysis using Kaplan-Meier curves based on SIRI for long-term prognosis: (A) Kaplan-Meier survival curves based on SIRI for assessing overall survival. (B) Kaplan-Meier survival curves based on SIRI for assessing disease-free survival.

Figure 3

Nomogram for the long-term prognosis of lung cancer patients undergoing MWA: (A) Nomogram based on independent related factors for assessing overall survival. (B) Nomogram based on independent related factors for assessing disease-free survival. In “Power”, “1” represents the low power group, and “2” represents the high power group. In “Differentiation”, “0” represents the well differentiation group, and “1” represents the poor differentiation group. In “Gene”, “0” represents no gene mutation group and ALK mutation, and “1” represents EGFR mutation group. In “SIRI”, “0” represents the low SIRI group, and “1” represents the high SIRI group.

Figure 4

ROC curve of the nomogram for lung cancer patients undergoing MWA: (A) ROC curves of the nomogram for 1, 2, and 3-year overall survival. (B) ROC curves of the nomogram for 1, 2, and 3-year disease-free survival.