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Fang KH, Lo SW, Kudva A, De Vito A, Tsai YH, Hsu CM, Chang GH, Huang EI, Tsai MS, Lai CH, Tsai MH, Liao CT, Kang CJ, Tsai YT. Prognostic Utility of the Modified Systemic Inflammation Score for Patients Undergoing Oral Cavity Cancer Surgery. Diagnostics (Basel) 2024; 14:2856. [PMID: 39767217 PMCID: PMC11674824 DOI: 10.3390/diagnostics14242856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2024] [Revised: 12/12/2024] [Accepted: 12/18/2024] [Indexed: 01/11/2025] Open
Abstract
BACKGROUND/OBJECTIVES Chronic inflammation significantly contributes to human malignancies. We investigated the prognostic significance of the preoperative modified systemic inflammation score (mSIS) in patients with primary oral cavity squamous cell carcinoma (OCSCC). METHODS We retrospectively reviewed data from 320 OCSCC patients who underwent curative surgery between 2007 and 2017. Based on preoperative lymphocyte-to-monocyte ratio (LMR) and serum albumin levels, patients were classified into three groups: mSIS = 2 (LMR < 3.4 and albumin < 4.0 g/dL), mSIS = 1 (LMR < 3.4 or albumin < 4.0 g/dL), and mSIS = 0 (LMR ≥ 3.4 and albumin ≥ 4.0 g/dL). We explored the associations between the preoperative mSIS and overall survival (OS) and disease-free survival (DFS). We developed a nomogram based on mSIS for OS prediction. RESULTS The distribution was mSIS = 0 (n = 197, 61.6%), mSIS = 1 (n = 99, 30.9%), and mSIS = 2 (n = 24, 7.5%). Kaplan-Meier estimated OS and DFS for the mSIS = 0, mSIS = 1, and mSIS = 2 groups demonstrated a sequential decrease (both p < 0.001). The prognostic significance of mSIS was consistent across subgroup analyses. Multivariable analysis revealed that mSIS = 1 and mSIS = 2 were independent negative prognostic indicators. The mSIS-based nomogram effectively predicted OS (concordance index: 0.755). CONCLUSIONS The mSIS reliably predicts OS and DFS in OCSCC patients undergoing surgery, with the nomogram providing individualized OS estimates, enhancing mSIS's clinical utility.
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Affiliation(s)
- Ku-Hao Fang
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan 333423, Taiwan; (K.-H.F.); (C.-T.L.); (C.-J.K.)
- College of Medicine, Chang Gung University, Taoyuan 330036, Taiwan; (Y.-H.T.); (C.-M.H.); (G.-H.C.); (E.I.H.); (M.-S.T.); (C.-H.L.); (M.-H.T.)
| | - Sheng-Wei Lo
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi 613016, Taiwan;
| | - Adarsh Kudva
- Department of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal 576104, India;
| | - Andrea De Vito
- Ear Nose Throat (ENT) Unit, Department of Surgery, Forlì Hospital Health Local Agency of Romagna, 47121 Forlì, Italy;
| | - Yuan-Hsiung Tsai
- College of Medicine, Chang Gung University, Taoyuan 330036, Taiwan; (Y.-H.T.); (C.-M.H.); (G.-H.C.); (E.I.H.); (M.-S.T.); (C.-H.L.); (M.-H.T.)
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Chiayi 613016, Taiwan
| | - Cheng-Ming Hsu
- College of Medicine, Chang Gung University, Taoyuan 330036, Taiwan; (Y.-H.T.); (C.-M.H.); (G.-H.C.); (E.I.H.); (M.-S.T.); (C.-H.L.); (M.-H.T.)
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi 613016, Taiwan;
| | - Geng-He Chang
- College of Medicine, Chang Gung University, Taoyuan 330036, Taiwan; (Y.-H.T.); (C.-M.H.); (G.-H.C.); (E.I.H.); (M.-S.T.); (C.-H.L.); (M.-H.T.)
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi 613016, Taiwan;
| | - Ethan I. Huang
- College of Medicine, Chang Gung University, Taoyuan 330036, Taiwan; (Y.-H.T.); (C.-M.H.); (G.-H.C.); (E.I.H.); (M.-S.T.); (C.-H.L.); (M.-H.T.)
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi 613016, Taiwan;
| | - Ming-Shao Tsai
- College of Medicine, Chang Gung University, Taoyuan 330036, Taiwan; (Y.-H.T.); (C.-M.H.); (G.-H.C.); (E.I.H.); (M.-S.T.); (C.-H.L.); (M.-H.T.)
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi 613016, Taiwan;
| | - Chia-Hsuan Lai
- College of Medicine, Chang Gung University, Taoyuan 330036, Taiwan; (Y.-H.T.); (C.-M.H.); (G.-H.C.); (E.I.H.); (M.-S.T.); (C.-H.L.); (M.-H.T.)
- Department of Radiation Oncology, Chang Gung Memorial Hospital, Chiayi 613016, Taiwan
| | - Ming-Hsien Tsai
- College of Medicine, Chang Gung University, Taoyuan 330036, Taiwan; (Y.-H.T.); (C.-M.H.); (G.-H.C.); (E.I.H.); (M.-S.T.); (C.-H.L.); (M.-H.T.)
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Kaohsiung 833253, Taiwan
| | - Chun-Ta Liao
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan 333423, Taiwan; (K.-H.F.); (C.-T.L.); (C.-J.K.)
- College of Medicine, Chang Gung University, Taoyuan 330036, Taiwan; (Y.-H.T.); (C.-M.H.); (G.-H.C.); (E.I.H.); (M.-S.T.); (C.-H.L.); (M.-H.T.)
| | - Chung-Jan Kang
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan 333423, Taiwan; (K.-H.F.); (C.-T.L.); (C.-J.K.)
- College of Medicine, Chang Gung University, Taoyuan 330036, Taiwan; (Y.-H.T.); (C.-M.H.); (G.-H.C.); (E.I.H.); (M.-S.T.); (C.-H.L.); (M.-H.T.)
| | - Yao-Te Tsai
- College of Medicine, Chang Gung University, Taoyuan 330036, Taiwan; (Y.-H.T.); (C.-M.H.); (G.-H.C.); (E.I.H.); (M.-S.T.); (C.-H.L.); (M.-H.T.)
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi 613016, Taiwan;
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Shi L, Wang X, Yan C. Prognostic Value of Systemic Inflammation Score for Esophageal Cancer Patients Undergoing Surgery: A Systematic Review and Meta-Analysis. J INVEST SURG 2023; 36:2197058. [PMID: 37068785 DOI: 10.1080/08941939.2023.2197058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
OBJECTIVE The link between inflammation and cancer survival has been the subject of substantial research. The goal of this review is to summarize the evidence on the prognostic value of systemic inflammation score (SIS) in esophageal cancer patients undergoing surgical intervention. METHODS PubMed, Scopus, Embase, and Web of Science were searched for relevant articles published until 30th June 2022. We pooled adjusted data on overall survival (OS) and disease-free survival (DFS) using a random-effects meta-analysis model. The review was pre-registered on PROSPER (No. CRD42022340717). RESULTS Eight studies were included. All studies were conducted either in China or Japan. Six studies showed that patients with SIS of 1-2 had poor OS as compared to those with scores of 0 (HR:1.42 95% CI: 1.24, 1.62 I2=25%). SIS of 1 (HR:1.45 95% CI: 1.18, 1.78 I2=0%) and 2 (HR:1.94 95% CI: 1.49, 2.53 I2=0%) were also associated with poor OS. Two studies compared the SIS score of 2 vs 0-1. Meta-analysis indicated that poor OS was associated with SIS of 2 (HR:1.80 95% CI: 1.25, 2.58). Data from three studies showed that the SIS score did not predict DFS (HR:1.40 95% CI: 0.82, 2.39 I2=91%). CONCLUSION SIS can be a novel prognostic indicator for esophageal cancer patients undergoing surgical intervention. Higher SIS is associated with a poor OS, but it does not predict DFS. Future studies are needed to strengthen the current evidence.
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Affiliation(s)
- Lingfang Shi
- Department of Gastroenterology, Affiliated Hospital of Shaoxing University, Shaoxing City, Zhejiang Province, China
| | - Xiufang Wang
- Department of Gastroenterology, Affiliated Hospital of Shaoxing University, Shaoxing City, Zhejiang Province, China
| | - Chungen Yan
- Department of Gastroenterology, Affiliated Hospital of Shaoxing University, Shaoxing City, Zhejiang Province, China
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Gradel KO. Interpretations of the Role of Plasma Albumin in Prognostic Indices: A Literature Review. J Clin Med 2023; 12:6132. [PMID: 37834777 PMCID: PMC10573484 DOI: 10.3390/jcm12196132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 09/18/2023] [Accepted: 09/21/2023] [Indexed: 10/15/2023] Open
Abstract
This review assesses how publications interpret factors that influence the serum or plasma albumin (PA) level in prognostic indices, focusing on inflammation and nutrition. On PubMed, a search for "albumin AND prognosis" yielded 23,919 results. From these records, prognostic indices were retrieved, and their names were used as search strings on PubMed. Indices found in 10 or more original research articles were included. The same search strings, restricted to "Review" or "Systematic review", retrieved yielded on the indices. The data comprised the 10 latest original research articles and up to 10 of the latest reviews. Thirty indices had 294 original research articles (6 covering two indices) and 131 reviews, most of which were from recent years. A total of 106 articles related the PA level to inflammation, and 136 related the PA level to nutrition. For the reviews, the equivalent numbers were 54 and 65. In conclusion, more publications mention the PA level as a marker of nutrition rather than inflammation. This is in contrast to several general reviews on albumin and nutritional guidelines, which state that the PA level is a marker of inflammation but not nutrition. Hypoalbuminemia should prompt clinicians to focus on the inflammatory aspects in their patients.
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Affiliation(s)
- Kim Oren Gradel
- Center for Clinical Epidemiology, Odense University Hospital, 5000 Odense, Denmark; ; Tel.: +45-21-15-80-85
- Research Unit of Clinical Epidemiology, Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark
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Prognostic value of a modified systemic inflammation score in breast cancer patients who underwent neoadjuvant chemotherapy. BMC Cancer 2022; 22:1249. [PMID: 36460981 PMCID: PMC9717545 DOI: 10.1186/s12885-022-10291-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 11/07/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND AND PURPOSE The modified systemic inflammation score (mSIS) system, which is constructed based on the neutrophil to lymphocyte ratio (NLR) and albumin (Alb), has not been applied to evaluate the prognosis of malignant breast cancer patients who underwent neoadjuvant chemotherapy (NAC). The present study aimed to explore the relationship between the mSIS and overall survival (OS), disease-free survival (DFS) and pathological complete response (pCR). METHODS A total of 305 malignant breast tumor patients who underwent NAC were incorporated into this retrospective analysis. We determined OS and DFS using K-M survival curves and the log-rank test. The relationship between the mSIS and OS and DFS was evaluated by a Cox regression model. A nomogram was constructed based on Cox regression analysis. RESULTS Patients in the mSIS low-risk group had better 5- and 8-year OS rates than those in the mSIS high-risk group (59.8% vs. 77.0%; 50.1% vs. 67.7%; X2 = 8.5, P = 0.0035, respectively). Patients in the mSIS (1 + 2 score) + pCR subgroup had the highest 5- and 8-year OS and disease-free survival (DFS) rates (OS: 55.0% vs. 75.7% vs. 84.8, 42.8% vs. 65.7% vs. 79.8%, X2 = 16.6, P = 0.00025; DFS: 38.8% vs. 54.7% vs. 76.3%, 33.3% vs. 42.3 vs. 72.1%, X2 = 12.4, P = 0.002, respectively). Based on the mSIS, clinical T stage and pCR results, the nomogram had better predictive ability than the clinical TNM stage, NLR and Alb. CONCLUSIONS mSIS is a promising prognostic tool for malignant breast tumor patients who underwent NAC, and the combination of mSIS and pCR is helpful in enhancing the ability to predict a pCR.
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Liu S, Yu X, Ye F, Jiang L. Can the systemic inflammation score be used to predict prognosis in gastric cancer patients undergoing surgery? A systematic review and meta-analysis. Front Surg 2022; 9:971326. [PMID: 36338660 PMCID: PMC9633000 DOI: 10.3389/fsurg.2022.971326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 08/23/2022] [Indexed: 01/17/2023] Open
Abstract
Background Inflammatory markers are being increasingly used to predict the prognosis of cancer patients. We hereby conducted the first meta-analysis assessing the association between systemic inflammation score (SIS) and prognosis of gastric cancer patients undergoing surgical intervention. Methods A literature search was carried out on PubMed, CENTRAL, Scopus, and Embase up to 3rd June 2022 for relevant studies. Adjusted data reported as hazard ratios (HR) was combined in a random-effects model. Results A total of seven studies with 5,338 patients could be included. All studies were from either China or Japan and published in the last four years. Meta-analysis showed that higher SIS scores (1 or 2) were significant predictors of poor overall survival (OS) in gastric cancer patients (HR: 1.25 95% CI: 1.05, 1.49, I2 = 11%). Similarly, the meta-analysis demonstrated that an SIS score of 2 was associated with poor OS as compared to scores of 0/1 (HR: 2.53 95% CI: 1.30, 4.89, I2 = 45%). Data on disease-free survival (DFS) was scarce to draw conclusions. Conclusion The SIS score can be a simple and useful tool to predict OS in gastric cancer patients undergoing surgery. Data on DFS is scarce and conflicting. Future studies should report using standard reference groups and provide data on DFS to enhance current evidence. Systematic Review Registration:https://www.crd.york.ac.uk/prospero/#searchadvanced, identifier: CRD42022335548.
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Affiliation(s)
- Shuai Liu
- Department of Gastrointestinal Surgery, Taizhou Hospital of Zhejiang Province, Taizhou, China
| | - Xiaowei Yu
- Department of Day Care Ward, Taizhou Hospital of Zhejiang Province, Taizhou, China
| | - Feifei Ye
- Department of Gastrointestinal Surgery, Taizhou Hospital of Zhejiang Province, Taizhou, China
| | - Liangxian Jiang
- Department of Gastrointestinal Surgery, Taizhou Hospital of Zhejiang Province, Taizhou, China
- Correspondence: Liangxian Jiang
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