Baş ve boyun kanserinde Sistemik İmmün-İnflamasyon İndeksinin prognostik değeri

Abstract

Amaç: Bu çalışmada, baş ve boyun kanseri hastalarında Sistemik İmmün-İnflamasyon İndeksi’nin (SII) prognostik değeri ile hastalıksız sağkalım (DFS) ve genel sağkalım (OS) gibi sağkalım sonuçlarıyla olan ilişkisi değerlendirildi. Yöntem: Baş ve boyun kanseri tanısı almış hastalar retrospektif olarak analiz edildi. SII cut-off değeri olan 796’ya göre hastalar düşük SII (L-SII) ve yüksek SII (H-SII) olmak üzere iki gruba ayrıldı. Gruplar arasında klinik, demografik ve tedaviye ilişkin parametreler karşılaştırıldı. DFS ve OS analizleri için Kaplan-Meier yöntemine dayalı sağkalım analizleri ve Cox regresyonu kullanılarak univaryant ve multivaryant analizler yapıldı. Bulgular: Toplam 184 hastanın yer aldığı çalışmada, yüksek SII grubundaki (≥796) 67 hastada nüks oranı anlamlı olarak daha yüksek bulundu (%43.3 vs. %8.5, p <0.001) ve ölüm oranı da belirgin şekilde fazlaydı (%26.9 vs. %11.1, p = 0.006). Medyan DFS, H-SII grubunda daha kısa olmasına rağmen (13.7 ay vs. 18.7 ay), bu fark istatistiksel olarak anlamlı değildi (p=0.25). Multivaryant Cox regresyon analizine göre, ileri evre (HR: 3.00, %95 GA: 1.38–6.50, p=0.005), ECOG ≥2 (HR: 3.72, %95 GA: 1.35–10.22, p=0.01) ve yüksek SII (HR: 1.86, %95 GA: 1.01–3.16, p=0.05) bağımsız olarak daha kötü OS ile ilişkili bulundu. Yüksek SII, DFS için bağımsız bir belirleyici olmamakla birlikte, kötü prognoza eğilim gösterdi (HR: 1.56, %95 GA: 0.72–3.34, p=0.25). Sonuç: Yüksek SII düzeyleri, daha kötü klinik sonuçlar ile ve anlamlı düzeyde daha yüksek nüks ve mortalite oranları ile ilişkilendirildi. SII, OS açısından bağımsız bir prognostik faktör olarak saptanırken, DFS üzerindeki etkisi istatistiksel anlamlılığa ulaşmadı. Bu bulgular, SII’nin potansiyel prognostik bir belirteç olarak kullanılabilirliğini desteklemektedir.

Keywords

• Baş ve boyun kanseri
• Sistemik immün-inflamasyon indeksi
• Genel sağkalım
• Progresyonsuz sağkalım
• Hastalıksız sağkalım

Prognostic value of Systemic Immune-Inflammation Index in head and neck cancer

Abstract

Aims: This study aimed to evaluate the prognostic value of the Systemic Immune-Inflammation Index (SII) in patients with head and neck cancer and its association with survival outcomes including disease-free survival (DFS) and overall survival (OS). Methods: The patients diagnosed with head and neck cancer were retrospectively analyzed. Patients were stratified into two groups based on the SII cut-off value (796): low SII (L-SII) and high SII (H-SII). Clinical, demographic, and treatment-related parameters were compared between the groups. Kaplan-Meier survival analysis and Cox regression were used for univariate and multivariate analyses of DFS and OS. Results: Of the total number of patients included in the study (n=184), 67 with high SII (≥796) exhibited significantly higher recurrence rates (43.3% vs. 8.5%, p<0.001) and higher mortality (26.9% vs. 11.1%, p=0.006) compared to those with low SII. Median DFS was shorter in the H-SII group (13.7 vs. 18.7 months), although the difference was not statistically significant (p=0.25). In multivariate Cox analysis, advanced stage (HR: 3.00, 95% CI: 1.38-6.50, p=0.005), ECOG ≥2 (HR: 3.72, 95% CI: 1.35-10.22, p=0.01), and high SII (HR: 1.86, 95% CI: 1.01-3.16, p=0.05) were independently associated with worse OS. Although high SII was not an independent predictor for DFS, it showed a clear trend toward worse outcomes (HR: 1.56, 95% CI: 0.72-3.34, p=0.25). Conclusion: High SII levels were associated with worse clinical outcomes and significantly higher rates of recurrence and mortality. While SII was an independent prognostic factor for OS, its effect on DFS did not reach statistical significance. These findings support the potential utility of SII as a simple, inflammation-based prognostic biomarker in head and neck cancers.

Keywords

• Head and neck cancer
• Systemic Immune-Inflammation Index
• overall survival
• progression-free survival
• disease-free survival

Ethical Statement

The study was approved by the Scientific Research and Ethics Committee of Ankara Etlik City Hospital (Decision no: 2024-432).

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