Prognostic role of systemic immune-inflammation index in patients with nasopharyngeal cancer

Abstract

Aim: This study aimed to evaluate the prognostic significance of the systemic immune-inflammation index (SII) in patients with nasopharyngeal carcinoma (NPC). Material and Methods: This retrospective study included 42 patients diagnosed with NPC between January 2014 and January 2020. Clinical data, hematological parameters, and survival outcomes were collected. Disease stage was classified using the 8th edition of the American Joint Committee on Cancer (AJCC) Staging System. Pre-treatment SII values were calculated using complete blood count data (platelets × neutrophils / lymphocytes). Results: The mean patient age was 54.0 ± 13.8 years, with a male predominance (66.7%). Most patients presented with advanced disease (AJCC Stage III–IV). Higher pre-treatment SII values were significantly associated with poorer overall survival (OS) and progression-free survival (PFS). Multivariate Cox regression analysis confirmed that elevated SII independently predicted reduced OS (HR: 1.06; 95% CI: 1.02–1.09; p < 0.001). ROC analysis identified optimal SII cut-off values of >610 for OS (sensitivity: 73.9%, specificity: 60.0%) and >580 for PFS (sensitivity: 75.0%, specificity: 57.1%). Kaplan–Meier analysis demonstrated significantly lower OS and PFS in patients with elevated SII (log-rank p < 0.001). Conclusion: Elevated SII is a strong and independent prognostic marker for poor outcomes in NPC patients and may guide personalized clinical management.

Keywords

• nasopharyngeal carcinoma
• systemic immune-inflammation index
• prognosis
• survival analysis
• inflammation

Nazofarenks kanserli hastalarda sistemik immün-inflamasyon indeksinin prognostik rolü

Abstract

Amaç: Bu çalışmanın amacı, nazofarenks karsinomlu (NPC) hastalarda sistemik immün-inflamasyon indeksinin (SII) prognostik önemini değerlendirmektir. Gereç ve Yöntemler: Bu retrospektif çalışmaya Ocak 2014 ile Ocak 2020 arasında NPC tanısı alan 42 hasta dahil edildi. Klinik veriler, hematolojik parametreler ve sağkalım sonuçları toplandı. Hastalığın evresi, Amerikan Kanser Ortak Komitesi (AJCC) Evreleme Sisteminin 8. baskısı kullanılarak sınıflandırıldı. Tedavi öncesi SII değerleri, tam kan sayımı verileri (trombositler × nötrofiller / lenfositler) kullanılarak hesaplandı. Bulgular: Hastaların ortalama yaşı 54,0 ± 13,8 yıl olup, erkek hastalar çoğunluktaydı (%66,7). Hastaların çoğunluğu ileri evrede (AJCC Evre III-IV) tanı aldı. Yüksek tedavi öncesi SII değerleri, anlamlı olarak daha kötü genel sağkalım (OS) ve progresyonsuz sağkalım (PFS) ile ilişkili bulundu. Çok değişkenli Cox regresyon analizinde, artmış SII’nin bağımsız olarak azalmış OS’yi öngördüğü gösterildi (HR: 1,06; %95 GA: 1,02–1,09; p < 0,001). ROC analizi ile OS için optimal SII eşik değeri >610 (%73,9 sensitivite, %60,0 spesifisite), PFS için >580 (%75,0 sensitivite, %57,1 spesifisite) olarak belirlendi. Kaplan-Meier analizinde yüksek SII olan hastaların OS ve PFS süreleri anlamlı derecede düşük bulundu (log-rank p < 0,001). Sonuç: Artmış SII, NPC hastalarında kötü prognozun güçlü ve bağımsız bir belirtecidir ve kişiselleştirilmiş klinik tedavi yönetiminde yol gösterici olabilir.

Keywords

• nazofarenks karsinomu
• sistemik immün-inflamasyon indeksi
• prognoz
• sağkalım analizi
• inflamasyon

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