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Systemic Immune-Inflammation Index as a Prognostic Marker of Late Recurrence in Operable Gastric Cancer: a Dual-Center Study

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Abstract

Aim

To evaluate the prognostic role of the systemic immune-inflammation index (SII) in patients with operable gastric cancer.

Methods

We assessed 354 patients with operable gastric cancer from tertiary centers in Turkey. SII was calculated by following formula: [neutrophil (cells × 109/L) × platelet (cells × 109/L)]/lymphocyte (cells × 109/L). The best cut-off value for SII was determined by using “receiver operating characteristics (ROC)” analysis. We used log-rank and Cox-regression analysis for survival analyses.

Results

One hundred twenty patients were in the late recurrence group (recurrences have developed 36 months after the surgery). SII was not a prognostic factor in the early recurrence group. However, relapse-free survival (RFS) was longer in SII-low patients than SII-high patients in the late recurrence group. In multivariable analysis, SII was the only independent prognostic factor for RFS in the late recurrence group (hazard ratio (HR): 5.42, 95% CI: 1.18–24.82, p = 0.03).

Conclusion

SII was an independent prognostic factor for RFS in GC patients with late recurrence. Late recurrence risk was higher in SII-high patients than SII-low patients. Inflammation contributes to tumor progression, invasion, and metastasis. Prolonged exposure to chronic inflammation could explain the results of this study.

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Authors and Affiliations

  1. Department of Medical Oncology, Faculty of Medicine, Ankara University, Ankara, Turkey

    Emre Yekedüz, Güngör Utkan, Hakan Akbulut & Yüksel Ürün

  2. Ankara University Cancer Research Institute, Ankara, Turkey

    Emre Yekedüz, Güngör Utkan, Salim Demirci, Hakan Akbulut & Yüksel Ürün

  3. Department of Medical Oncology, Istanbul University Institute of Oncology, Istanbul, Turkey

    İzzet Dogan & Sezai Vatansever

  4. Hatay State Hospital Medical Oncology Clinic, Hatay, Turkey

    Dılşa Mızrak Kaya

  5. Department of General Surgery, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey

    İlker Özgür

  6. Department of Surgical Oncology, Faculty of Medicine, Ankara University, Ankara, Turkey

    Salim Demirci

  7. Ankara Üniversitesi Tıp Fakültesi, Tıbbi Onkoloji Bilim Dalı Cebeci Hastanesi, 06590, Cebeci, Ankara, Turkey

    Emre Yekedüz

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  1. Emre Yekedüz
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  2. İzzet Dogan
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Correspondence to Emre Yekedüz.

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Yekedüz, E., Dogan, İ., Kaya, D.M. et al. Systemic Immune-Inflammation Index as a Prognostic Marker of Late Recurrence in Operable Gastric Cancer: a Dual-Center Study. J Gastrointest Canc 53, 870–879 (2022). https://doi.org/10.1007/s12029-021-00769-w

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  • DOI: https://doi.org/10.1007/s12029-021-00769-w

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