Abstract:
Objective To investigate the clinical value of the preoperative systemic immune-inflammation index (SII)–prognostic nutritional index (PNI) score in predicting the prognosis of elderly patients with gastric cancer after radical surgery based on SII values derived from peripheral blood neutrophil, lymphocyte, and platelet counts and PNI values determined based on serum albumin levels and peripheral blood lymphocyte counts.
Methods Elderly patients with gastric cancer (aged ≥70 years) treated with radical surgery from January 2012 to January 2015 at Fourth Hospital of Hebei Medical University were retrospectively analyzed, and preoperative SII and PNI values were calculated. The optimal cut-off values of SII and PNI were determined using ROC curves, and patients were assigned into three groups based on SII and PNI scores to compare clinicopathological characteristics and survival prognosis between the groups.
Results Patients with different preoperative SII-PNI scores were compared in terms of tumor diameter, degree of tumor infiltration (pT stage), lymph node metastasis rate, pTNM stage, incidence of vascular infiltration, and nerve invasion. Cox multifactorial analysis showed that tumor histological type (P=0.023), depth of tumor infiltration (pT stage) (P=0.016), presence of lymph node metastasis (P=0.014), tumor pTNM stage (P=0.001), and preoperative SII-PNI score (P=0.001) were independent risk factors that affected the prognosis of elderly patients with gastric cancer.
Conclusions The preoperative SII-PNI score correlates closely with the clinicopathological characteristics of elderly patients with gastric cancer, while higher scores predispose patients to postoperative complications and poorer prognosis.
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