Preoperative systemic immune-inflammation index predicts prognosis of patients with non-metastatic renal cell carcinoma: a propensity score-matched analysis
Background: A novel systemic immune-inflammation index (SII), based on the neutrophils, lymphocytes and platelet counts, is associated with the prognosis of several cancers. The present study evaluates the prognostic significance of SII in non-metastatic renal cell carcinoma (RCC).
Method: The present study retrospectively reviewed the medical record of patients with non-metastatic RCC who underwent nephrectomy between 2010 and 2013. Receiver operating characteristic (ROC) curve analysis was performed to identify the optimal cut-off value. In addition, the propensity score matching (PSM) was performed with a matching ratio of 1:1. Univariate and multivariate Cox proportional hazards models were used to identify the prognostic factors. The results were reported by hazard ratio (HR) with 95% confidence interval (95% CI).
Results: A total of 646 patients were included in the final analysis. High SII group (>529) was significantly associated with older age (P=0.014), larger tumor (P<0.001), higher pathological T stage (P<0.001), higher tumor grade (P<0.001) and more tumor necrosis (P<0.001). Multivariate Cox regression analysis demonstrated that the higher preoperative SII was significantly associated with worse overall survival (OS) (HR=2.26; 95%CI 1.44-3.54; P<0.001) and cancer-specific survival (CSS) (HR=2.17; 95%CI 1.33-3.55; P=0.002). After PSM, elevated preoperative SII was an independent predictor of poor OS (HR=1.78; 95%CI 1.1-2.87; P=0.018) and CSS (HR=1.8; 95%CI 1.07-3.03; P=0.027).
Conclusion: In conclusion, preoperative SII is associated with adverse factors for RCC. Furthermore, higher preoperative SII is an independent predictor of poor OS and CSS in surgically treated patients with non-metastatic RCC. More prospective and large scale studies are warranted to validate our findings.
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Posted 28 May, 2020
Received 02 Jun, 2020
On 27 May, 2020
Invitations sent on 26 May, 2020
On 18 May, 2020
On 17 May, 2020
On 17 May, 2020
Received 13 May, 2020
On 13 May, 2020
Received 28 Apr, 2020
On 15 Apr, 2020
On 14 Apr, 2020
Invitations sent on 13 Apr, 2020
On 11 Apr, 2020
On 10 Apr, 2020
On 03 Apr, 2020
On 01 Apr, 2020
Preoperative systemic immune-inflammation index predicts prognosis of patients with non-metastatic renal cell carcinoma: a propensity score-matched analysis
Posted 28 May, 2020
Received 02 Jun, 2020
On 27 May, 2020
Invitations sent on 26 May, 2020
On 18 May, 2020
On 17 May, 2020
On 17 May, 2020
Received 13 May, 2020
On 13 May, 2020
Received 28 Apr, 2020
On 15 Apr, 2020
On 14 Apr, 2020
Invitations sent on 13 Apr, 2020
On 11 Apr, 2020
On 10 Apr, 2020
On 03 Apr, 2020
On 01 Apr, 2020
Background: A novel systemic immune-inflammation index (SII), based on the neutrophils, lymphocytes and platelet counts, is associated with the prognosis of several cancers. The present study evaluates the prognostic significance of SII in non-metastatic renal cell carcinoma (RCC).
Method: The present study retrospectively reviewed the medical record of patients with non-metastatic RCC who underwent nephrectomy between 2010 and 2013. Receiver operating characteristic (ROC) curve analysis was performed to identify the optimal cut-off value. In addition, the propensity score matching (PSM) was performed with a matching ratio of 1:1. Univariate and multivariate Cox proportional hazards models were used to identify the prognostic factors. The results were reported by hazard ratio (HR) with 95% confidence interval (95% CI).
Results: A total of 646 patients were included in the final analysis. High SII group (>529) was significantly associated with older age (P=0.014), larger tumor (P<0.001), higher pathological T stage (P<0.001), higher tumor grade (P<0.001) and more tumor necrosis (P<0.001). Multivariate Cox regression analysis demonstrated that the higher preoperative SII was significantly associated with worse overall survival (OS) (HR=2.26; 95%CI 1.44-3.54; P<0.001) and cancer-specific survival (CSS) (HR=2.17; 95%CI 1.33-3.55; P=0.002). After PSM, elevated preoperative SII was an independent predictor of poor OS (HR=1.78; 95%CI 1.1-2.87; P=0.018) and CSS (HR=1.8; 95%CI 1.07-3.03; P=0.027).
Conclusion: In conclusion, preoperative SII is associated with adverse factors for RCC. Furthermore, higher preoperative SII is an independent predictor of poor OS and CSS in surgically treated patients with non-metastatic RCC. More prospective and large scale studies are warranted to validate our findings.
Figure 1
Figure 2
Figure 3