A Low Systemic Inflammatory Response Index Is Associated With Improved Survival in Adenoid Cystic Carcinoma Patients

Xuanqi Feng; Zhongyang Sun; Yang Huang; Yu Zhang; Yanru Chen; Bin Deng

doi:10.1016/j.joms.2024.03.022

A Low Systemic Inflammatory Response Index Is Associated With Improved Survival in Adenoid Cystic Carcinoma Patients

J Oral Maxillofac Surg. 2024 Mar 27:S0278-2391(24)00204-0. doi: 10.1016/j.joms.2024.03.022. Online ahead of print.

Authors

Xuanqi Feng¹, Zhongyang Sun², Yang Huang³, Yu Zhang⁴, Yanru Chen¹, Bin Deng⁵

Affiliations

¹ Graduate Student, Medical School of Chinese PLA, Beijing, China.
² Resident Doctor, Medical School of Chinese PLA, Beijing, China.
³ Dentistry, Attending Physician, Department of Stomatology, The First Medical Center, Chinese PLA General, Medical School of Chinese PLA, Beijing, China.
⁴ Graduate Student, Department of Infectious Disease Management, The Second Affiliated Hospital of Xiamen Medical College (Xiamen Second Hospital), Xiamen, China.
⁵ Dentistry, Associate Chief Physician, Deputy Director Physician, Department of Stomatology, Medical School of Chinese PLA, The First Medical Center, Chinese PLA General, Medical School of Chinese PLA, Beijing, China. Electronic address: dengbin301@139.com.

PMID: 38615695
DOI: 10.1016/j.joms.2024.03.022

Abstract

Background: Predicting the long-term survival in adenoid cystic carcinoma (ACC) patients remains challenging. Inflammatory cell-based indices are emerging as prognostic indicators of oncology.

Purpose: This study aimed to determine the associations between the preoperative systemic inflammatory response index (SIRI) and the systemic immunoinflammatory index (SII) and the 10-year survival rates in patients with ACC of the head and neck (ACCHN).

Study design, setting, sample: This retrospective cohort study comprised ACCHN patients treated at the Chinese People's Liberation Army General Hospital between November 2003 and December 2020.

Predictor variable: The inflammatory response, assessed using the SIRI and SII, was the predictor variable. The optimal cutoff values were based on the maximum Youden index values (sensitivity ＋ specificity－1). The patients were divided into two groups each, based on the SIRI (low, ≤ 0.15) and (high, > 0.15), and SII (low, ≤ 562.8 and high, > 562.8) values.

Main outcome variable(s): Overall survival (OS), or the number of days, weeks, or months between treatment initiation and death (or the last follow-up date), was the primary outcome variable.

Covariates: The covariates were classified as demographic (age, gender, body mass index), medical (hypertension, diabetes), inflammatory (neutrophils, lymphocytes, monocytes, platelets, lymphocyte-monocyte ratio, platelet-lymphocyte ratio, neutrophil-lymphocyte ratio), and perioperative (tumor stage, lymph node metastasis, tumor size, treatment type).

Analyses: Descriptive, univariate, and multivariate Cox proportional risk regression analyses were performed to determine whether the SIRI and SII were independent prognostic factors for OS. Kaplan-Meier survival curves and log-rank tests were used to determine their associations with the OS.

Results: The study sample comprised 162 patients (mean age, 52 ± 14; males, 39.5%). The median follow-up time was 6.81 ± 0.23, and the 10-year OS rate was 7.68 ± 0.25. The low and high SIRI groups comprised 109 and 53 patients, while the low and high SII groups comprised 116 and 46 patients, respectively. SIRI was identified as a prognostic factor (P < .01; hazard ratio, 2.45; 95% confidence interval, 1.35-4.45).

Conclusion and relevance: The SIRI has the advantages of reproducibility, convenience, noninvasiveness, and affordability, making it a promising prognostic inflammatory index for patients with ACCHN.