Systemic Immun e-Inflammation Index as a Predictor for Head and Neck Cancer Prognosis: A Meta-Analysis

Yun-Ting Wang; Liang-Tseng Kuo; Hsu-Huei Weng; Cheng-Ming Hsu; Ming-Shao Tsai; Geng-He Chang; Yi-Chan Lee; Ethan I Huang; Yao-Te Tsai

doi:10.3389/fonc.2022.899518

Systemic Immun e-Inflammation Index as a Predictor for Head and Neck Cancer Prognosis: A Meta-Analysis

Front Oncol. 2022 Jun 24:12:899518. doi: 10.3389/fonc.2022.899518. eCollection 2022.

Authors

Yun-Ting Wang¹, Liang-Tseng Kuo², Hsu-Huei Weng³, Cheng-Ming Hsu¹, Ming-Shao Tsai¹, Geng-He Chang¹, Yi-Chan Lee⁴, Ethan I Huang¹, Yao-Te Tsai¹

Affiliations

¹ Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan.
² Division of Sports Medicine, Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan.
³ Department of Radiology, Chang Gung Memorial Hospital, Chiayi, Taiwan.
⁴ Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan.

Abstract

Background: Studies have reported inconsistent results regarding the prognostic value of the systemic immune-inflammation index (SII) in head and neck cancer (HNC). Thus, the present meta-analysis assessed the literature on the prognostic value of SII in those with HNC.

Methods: The Cochrane Library, EMBASE, and PubMed databases were searched, and study methodological quality was assessed using the Newcastle-Ottawa quality assessment scale. To determine the association of the SII with survival outcomes, pooled hazard ratios (HRs) as well as the associated 95% confidence intervals (CIs) were used. To assess the associations of the SII with clinicopathological features, the odds ratios (ORs) and corresponding 95% CIs were considered. Begg's funnel plot and Egger's linear regression test were used to assess publication bias.

Results: A total of 12 studies that together enrolled 4369 patients with HNC were analyzed. In the pooled results, a high pretreatment SII was correlated with poorer overall survival (HR = 2.09, 95% CI = 1.62-2.70, p < 0.001), disease-free survival (HR = 2.79, 95% CI = 1.99-3.89, p < 0.001), and progression-free survival (HR = 1.80, 95% CI = 1.30-2.48, p < 0.001). A stratified analysis indicated that SII for overall survival was applicable regardless of tumor site, treatment modality, overall stage, sample size, SII cutoff, and method for determining the SII cutoff. Furthermore, a high SII was correlated with a more advanced T classification (OR = 1.14, 95% CI = 1.09-1.18, p < 0.001) and nodal metastasis (OR = 1.55, 95% CI = 1.18-2.05, p = 0.002) in patients with HNC.

Conclusions: An elevated pretreatment SII predicts more advanced tumor and nodal status and poorer survival outcomes in cases of HNC. Because the measurement of SII is convenient and its use is cost-effective, we suggest that it can be applied by clinicians in the management of HNC.

Keywords: biomarker; head and neck cancer; meta-analysis; prognosis; systemic immune–inflammation index.

Publication types

Systematic Review