Abstract
Background Since inflammation and the immune system contribute to the development and progression of malignancies, parameters that reflect a host’s immune-inflammatory status may be useful prognostic indicators of gastric cancer (GC). The present study examined the clinical significance of a preoperative systemic immune-inflammation index (SII) for predicting postoperative survival outcomes in GC.Methods A total of 447 patients who underwent curative gastrectomy for GC were included in the present study. SII was calculated as platelet count × neutrophil count/lymphocyte count. The prognostic impact of preoperative SII was examined using univariate and multivariate analyses.Results Preoperative SII ranged between 105 and 4455 (median 474), and the optimal cut-off value for predicting overall survival (OS) was 395 based on a receiver operating characteristic curve. The 5-year OS rate of the SII≥395 group was 80.0%, which was significantly worse than that (92.7%) of the SII<395 group (p<0.001). The multivariate analysis identified SII≥395 (Hazard ratio [HR] 3.016; 95% confidence interval [CI] 1.593-6.262; p<0.001), carcinoembryonic antigen≥5.0 (HR 2.224, 95% CI 1.128-4.100), pT4 (HR 4.554, 95% CI 2.525-8.234), and pN+ (HR 3.621, 95% CI 1.916-7.074) as independent predictors of worse OS. Peritoneal recurrence was more frequent in the high SII group than in the low SII group (p=0.028).Conclusion Preoperative SII may be a useful predictor of postoperative survival outcomes in GC. The meticulous surveillance of GC relapse, particularly peritoneal dissemination, is necessary for patients with SII≥395 even after curative gastrectomy.
A Resected Case of Uterine Metastasis after Curative Gastrectomy for Gastric Cancer
