Current Thoracic Surgery 2020 , Vol 5 , Issue 3
The prognostic significance of the systemic immune-inflammatory index in surgically treated non-small cell lung cancers
Muhammet Sayan1,Irmak Akarsu1,İsmail Tombul1,Aykut Kankoç1,Dilvin Özkan1,Elgun Valiyev1,Ali Celik1,İsmail Cüneyt Kurul1,Olgun Kadir Arıbaş1,Abdullah İrfan Taştepe1
1Department of Thoracic Surgery, Gazi University School of Medicine, Ankara, Turkey DOI : 10.26663/cts.2020.00022 Viewed : 567 - Downloaded : 230 Background: Lung cancer is a leading cause of cancer-related deaths worldwide, and the majority of lung cancer deaths are due to non-small cell cancers. The most important indicator of prognosis in lung cancer is the tumor stage. In recent years, studies investigating the correlation between cancer development, prognosis, and inflammation have increased. In our study, the prognostic efficacy of the systemic immune-inflammation index (SSI) was investigated in patients with surgically treated nonsmall cell lung cancer in pathologic stage III-A, according to the eighth edition TNM stage classification.

Materials and Methods: Following the approval of the local ethics committee, the data of patients with stage III-A lung cancer who were operated on in our clinic between January 2010 and December 2019 were retrospectively analyzed. In accordance with the definitions in the literature, systemic immune-inflammation index groups were calculated using the following formula: (neutrophil count) x (platelet count) / (lymphocyte count) in the preoperative complete blood count tests of patients; the cut-off value was determined by ROC analysis. According to this value, high and low SSI groups were created. The survival difference between the groups was determined by Kaplan–Meier, log-rank, and Cox regression analysis.

Results: A total of 181 patients were included in the study -27 women and 154 men. The median age was 62 (age range: 25 - 82), and the median tumor diameter was 4.5 cm (0.1 - 10 cm). The cut-off value for the SII was calculated as 1,046.105 by ROC analysis. There were 27 patients in the high SSI group and 154 patients in low SSI group. Survival was significantly worse in the high SSI group (P = 0.02, HR: 1.9, 95% CI). In addition, survival was significantly worse in the pneumonectomy group (P = 0.01).

Conclusions: Using the SSI is a simple and inexpensive way to predict prognosis in patients with stage III-A lung cancer who are treated surgically. Keywords : lung cancer, prognosis, systemic immune-inflammatory index