Systemic immune-inflammation index is a promising non-invasive biomarker for predicting the survival of urinary system cancers: a systematic review and meta-analysis

Ann Med. 2021 Dec;53(1):1827-1838. doi: 10.1080/07853890.2021.1991591.

Abstract

Objective: Systemic immune-inflammation index (SII) has been reported in numerous studies to effectively predict the survival outcomes of urinary system cancers; however no agreement has been reached. This meta-analysis aimed to explore the prognostic significance of pre-treatment SII in tumours of the urinary system.

Methods: Relevant published articles were selected from Web of Science, PubMed, Embase, and the Cochrane Library up to 30 August 2020. The hazard ratios (HRs) with 95% confidence intervals (CIs) were computed to estimate the associations of pre-treatment SII with overall survival (OS), progression-free survival (PFS), cancer-specific survival (CSS) in urinary system cancers.

Results: 13 papers were included in our meta-analysis. From the combined data, we found that a high pre-treatment SII indicated a markedly worse OS (HR = 1.98; 95% CI: 1.75-2.23; p < .001), PFS (HR: 2.08; 95% CI: 1.32-3.26; p = .002), and CSS (HR: 2.41, 95% CI: 1.73-3.35, p < .001). Additionally, patients with an elevated SII value might have undesirable pathological characteristics, including a large tumour size, a poor differentiation grade, and an advanced tumour stage (all p < .001).

Conclusions: Pre-treatment SII could be used as a non-invasive and promising biomarker to indicate the prognosis of urinary system cancer patients.KEY MESSAGES:This meta-analysis evaluates the predictive value of systemic immune-inflammation index (SII) for patients with urinary system cancer.A high pre-treatment SII indicates a poor prognosis.SII can serve as a promising non-invasive biomarker to help clinicians assess the prognosis and develop treatment strategies for urinary system cancer patients.

Keywords: Urinary system cancers; meta-analysis; prognosis; systemic immune-inflammation index.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Biomarkers / blood
  • Humans
  • Inflammation / diagnosis*
  • Predictive Value of Tests
  • Prognosis
  • Proportional Hazards Models
  • Urologic Neoplasms / blood
  • Urologic Neoplasms / immunology*
  • Urologic Neoplasms / mortality*

Substances

  • Biomarkers

Grants and funding

This study was supported by grants from the National Natural Science Foundation of China [NSFC No. 81672958 to DLH].