AUTHOR=Sun Lejia , Jin Yukai , Hu Wenmo , Zhang Mengyuan , Jin Bao , Xu Haifeng , Du Shunda , Xu Yiyao , Zhao Haitao , Lu Xin , Sang Xinting , Zhong Shouxian , Yang Huayu , Mao Yilei 

TITLE=The Impacts of Systemic Immune-Inflammation Index on Clinical Outcomes in Gallbladder Carcinoma

JOURNAL=Frontiers in Oncology

VOLUME=Volume 10 - 2020

YEAR=2020

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2020.554521

DOI=10.3389/fonc.2020.554521

ISSN=2234-943X

ABSTRACT=Systemic immune-inflammation index (SII) is considered to be a prognostic marker in several cancers. However, the prognostic value of baseline pre-operative SII in gallbladder carcinoma (GBC) has not been evaluated. This study aimed to determine the prognostic significance of SII and generate a predictive nomogram.
   We retrospectively studied 142 GBC patients who underwent surgical resection at the Peking Union Medical College Hospital between 2003 and 2017. SII, neutrophil-to-lymphocyte ratio (NLR) and lymphocyte-to-monocyte ratio (LMR) were evaluated for their prognostic values. A multivariate Cox proportional hazards model was used to construct a nomogram. Calibration curves were used to estimate the performance of the nomogram and decision curve analysis was performed to evaluate its net benefit. 
   The predictive accuracy of SII (Harrell’s concordance index [C-index]: 0.624), NLR (C-index: 0.626) and LMR (C-index: 0.622) was evaluated. The multivariate Cox model showed that SII was a superior independent predictor than NLR and LMR were. SII level (≥600) (hazard ratio [HR]: 1.555; 95% confidence interval [CI]: 1.007–2.401; P=0.047), CA19-9 level (≥37 U/ml) (HR: 2.375; 95% CI: 1.487–3.792; P<0.001) and TNM stage (P=0.026) were selected to construct a nomogram for predicting overall survival (OS). The predictive ability of this model was assessed by C-index (0.752). Good performance was demonstrated by the calibration plot. A high net benefit was proven by DCA.
   SII is an independent prognostic indicator in GBC patients after surgical resection, and the nomogram based on it is a useful tool for predicting OS.