Can the systemic inflammation score be used to predict prognosis in gastric cancer patients undergoing surgery? A systematic review and meta-analysis

Shuai Liu, Xiaowei Yu, Feifei Ye, Liangxian Jiang, Shuai Liu, Xiaowei Yu, Feifei Ye, Liangxian Jiang

Abstract

Background: Inflammatory markers are being increasingly used to predict the prognosis of cancer patients. We hereby conducted the first meta-analysis assessing the association between systemic inflammation score (SIS) and prognosis of gastric cancer patients undergoing surgical intervention.

Methods: A literature search was carried out on PubMed, CENTRAL, Scopus, and Embase up to 3rd June 2022 for relevant studies. Adjusted data reported as hazard ratios (HR) was combined in a random-effects model.

Results: A total of seven studies with 5,338 patients could be included. All studies were from either China or Japan and published in the last four years. Meta-analysis showed that higher SIS scores (1 or 2) were significant predictors of poor overall survival (OS) in gastric cancer patients (HR: 1.25 95% CI: 1.05, 1.49, I 2 = 11%). Similarly, the meta-analysis demonstrated that an SIS score of 2 was associated with poor OS as compared to scores of 0/1 (HR: 2.53 95% CI: 1.30, 4.89, I 2 = 45%). Data on disease-free survival (DFS) was scarce to draw conclusions.

Conclusion: The SIS score can be a simple and useful tool to predict OS in gastric cancer patients undergoing surgery. Data on DFS is scarce and conflicting. Future studies should report using standard reference groups and provide data on DFS to enhance current evidence.Systematic Review Registration: https://www.crd.york.ac.uk/prospero/#searchadvanced, identifier: CRD42022335548.

Keywords: gastric cancer; inflammation; prognosis; surgery; survival.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

© 2022 Liu, Yu, Ye and Jiang.

Figures

Figure 1
Figure 1
PRISMA study flowchart denoting number of articles at every stage of the inclusion process.
Figure 2
Figure 2
Meta-analysis assessing the relationship between high SIS and clinicopathological features of gastric cancer namely, age (≥70 years vs.

Figure 3

Meta-analysis of the association between…

Figure 3

Meta-analysis of the association between SIS score and OS in gastric cancer patients…

Figure 3
Meta-analysis of the association between SIS score and OS in gastric cancer patients with subgroup analysis based on different reference SIS score (1 vs. 0, 2 vs. 0, or 1–2 vs. 0). Blue boxes indicate the point estimates of individual studies and horizontal lines denote the confidence intervals. Black diamond indicates the total effect size.

Figure 4

Meta-analysis of the association between…

Figure 4

Meta-analysis of the association between SIS score of 2 vs. reference value of…

Figure 4
Meta-analysis of the association between SIS score of 2 vs. reference value of 0/1 for OS in gastric cancer patients. Blue boxes indicate the point estimates of individual studies and horizontal lines denote the confidence intervals. Black diamond indicates the total effect size.
Figure 3
Figure 3
Meta-analysis of the association between SIS score and OS in gastric cancer patients with subgroup analysis based on different reference SIS score (1 vs. 0, 2 vs. 0, or 1–2 vs. 0). Blue boxes indicate the point estimates of individual studies and horizontal lines denote the confidence intervals. Black diamond indicates the total effect size.
Figure 4
Figure 4
Meta-analysis of the association between SIS score of 2 vs. reference value of 0/1 for OS in gastric cancer patients. Blue boxes indicate the point estimates of individual studies and horizontal lines denote the confidence intervals. Black diamond indicates the total effect size.

References

    1. Petryszyn P, Chapelle N, Matysiak-Budnik T. Gastric cancer: where are we heading? Dig Dis. (2020) 38:280–5. 10.1159/000506509
    1. Lin Y, Zheng Y, Liang WH, Wu J. Global patterns and trends in gastric cancer incidence rates (1988–2012) and predictions to 2030. Gastroenterology. (2021) 161:116–27.e8. 10.1053/J.GASTRO.2021.03.023
    1. Chen W, Zheng R, Baade PD, Zhang S, Zeng H, Bray F, et al. Cancer statistics in China, 2015. CA Cancer J Clin. (2016) 66:115–32. 10.3322/CAAC.21338
    1. Mullaney PJ, Wadley MS, Hyde C, Wyatt J, Lawrence G, Hallissey MT, et al. Appraisal of compliance with the UICC/AJCC staging system in the staging of gastric cancer. Union internacional contra la cancrum/American joint committee on cancer. Br J Surg. (2002) 89:1405–8. 10.1046/J.1365-2168.2002.02262.X
    1. Hernández M, Martín R, García-Cubillas MD, Maeso-Hernández P, Nieto ML. Secreted PLA2 induces proliferation in astrocytoma through the EGF receptor: another inflammation-cancer link. Neuro Oncol. (2010) 12:1014–23. 10.1093/NEUONC/NOQ078
    1. Liu S, Li C, Zhang P. Enhanced recovery after surgery for hip fractures: a systematic review and meta-analysis. Perioper Med. (2021) 10:31. 10.1186/S13741-021-00201-8
    1. McMillan DC. Cancer and systemic inflammation: stage the tumour and stage the host. Br J Cancer. (2013) 109:529. 10.1038/BJC.2013.418
    1. Kim MR, Kim AS, Choi HI, Jung JH, Park JY, Ko HJ. Inflammatory markers for predicting overall survival in gastric cancer patients: a systematic review and meta-analysis. PLoS One. (2020) 15:e0236445. 10.1371/JOURNAL.PONE.0236445
    1. Hirahara T, Arigami T, Yanagita S, Matsushita D, Uchikado Y, Kita Y, et al. Combined neutrophil-lymphocyte ratio and platelet-lymphocyte ratio predicts chemotherapy response and prognosis in patients with advanced gastric cancer. BMC Cancer. (2019) 19:672. 10.1186/S12885-019-5903-Y
    1. Jiang Y, Xu D, Song H, Qiu B, Tian D, Li Z, et al. Inflammation and nutrition-based biomarkers in the prognosis of oesophageal cancer: a systematic review and meta-analysis. BMJ Open. (2021) 11:e048324. 10.1136/BMJOPEN-2020-048324
    1. Nomoto D, Baba Y, Akiyama T, Okadome K, Iwatsuki M, Iwagami S, et al. Adapted systemic inflammation score as a novel prognostic marker for esophageal squamous cell carcinoma patients. Ann Gastroenterol Surg. (2021) 5:669–76. 10.1002/AGS3.12464
    1. Feng Y, Liu L, Zhu Y. Systemic inflammation score in locally advanced rectal cancer patients following total mesorectal excision. Onco Targets Ther. (2019) 12:6617–22. 10.2147/OTT.S213720
    1. Li S, Zhang W, Yang Z, Li Y, Du H, Che G. Systemic inflammation score as a novel prognostic indicator for patients undergoing video-assisted thoracoscopic surgery lobectomy for non-small-cell lung cancer. J Invest Surg. (2021) 34:428–40. 10.1080/08941939.2019.1641169
    1. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Int J Surg. (2021) 88:105906. 10.1016/j.ijsu.2021.105906
    1. Wells G, Shea B, O’Connell D, Peterson J, Welch V, Losos M, Tugwell P. The Newcastle-Ottawa scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Available at: (Accessed October 30, 2020).
    1. Sato B, Kanda M, Tanaka C, Kobayashi D, Iwata N, Hattori N, et al. Significance of preoperative systemic inflammation score in short-term and long-term outcomes of patients with pathological T2-4 gastric cancer after radical gastrectomy. World J Surg. (2018) 42:3277–85. 10.1007/S00268-018-4597-7
    1. Ma M, Weng M, Chen F, Hu Y, Lai J, Wang Y, et al. Systemic inflammation score is a prognostic marker after curative resection in gastric cancer. ANZ J Surg. (2019) 89:377–82. 10.1111/ANS.15103
    1. Chen YR, Chen YL, Ouyang SS, Xu HW, Li P, He LJ, et al. Prognostic efficacy of preoperative mGPS, SIS and LCS in patients with gastric cancer. Clin Chim Acta. (2020) 511:81–9. 10.1016/J.CCA.2020.09.027
    1. Hara K, Aoyama T, Yamada T, Nakazono M, Nagasawa S, Shimoda Y, et al. The prognostic value of the perioperative systemic inflammation score for patients with advanced gastric cancer. Anticancer Res. (2020) 40:1503–12. 10.21873/ANTICANRES.14095
    1. Inagaki K, Kanda M, Nakanishi K, Ito S, Mochizuki Y, Teramoto H, et al. Accurate prediction of prognosis after radical resection of gastric cancer by the modified systemic inflammation score; a multicenter dataset analysis. World J Surg. (2021) 45:2513–20. 10.1007/S00268-021-06138-9
    1. Lin JX, Huang YQ, Wang ZK, Xie JW, Bin WJ, Lu J, et al. Prognostic importance of dynamic changes in systemic inflammatory markers for patients with gastric cancer. J Surg Oncol. (2021) 124:282–92. 10.1002/JSO.26498
    1. He K, Si L, Pan X, Sun L, Wang Y, Lu J, et al. Preoperative systemic immune-inflammation index (SII) as a superior predictor of long-term survival outcome in patients with stage I–II gastric cancer after radical surgery. Front Oncol. (2022) 12:829689. 10.3389/FONC.2022.829689
    1. Song Z, Wu Y, Yang J, Yang D, Fang X. Progress in the treatment of advanced gastric cancer. Tumour Biol. (2017) 39:1010428317714626. 10.1177/1010428317714626
    1. Kumagai K, Sano T. Revised points and disputed matters in the eighth edition of the TNM staging system for gastric cancer. Jpn J Clin Oncol. (2021) 51:1024–7. 10.1093/JJCO/HYAB069
    1. Candido J, Hagemann T. Cancer-related inflammation. J Clin Immunol. (2013) 33(Suppl 1):S79–S84. 10.1007/S10875-012-9847-0
    1. Qiu Y, Zhang Z, Chen Y. Prognostic value of pretreatment systemic immune-inflammation index in gastric cancer: a meta-analysis. Front Oncol. (2021) 11:537140. 10.3389/FONC.2021.537140
    1. Cao W, Yao X, Cen D, Zhi Y, Zhu N, Xu L. The prognostic role of platelet-to-lymphocyte ratio on overall survival in gastric cancer: a systematic review and meta-analysis. BMC Gastroenterol. (2020) 20:16. 10.1186/S12876-020-1167-X
    1. Fu X, Li T, Dai Y, Li J. Preoperative systemic inflammation score (SIS) is superior to neutrophil to lymphocyte ratio (NLR) as a predicting indicator in patients with esophageal squamous cell carcinoma. BMC Cancer. (2019) 19:721. 10.1186/S12885-019-5940-6
    1. Xiong J, Kang W, Ma F, Liu H, Ma S, Li Y, et al. Modified systemic inflammation score is an independent predictor of long-term outcome in patients undergoing surgery for adenocarcinoma of the esophagogastric junction. Front Surg. (2021) 8:622821. 10.3389/FSURG.2021.622821
    1. Markus M, Abendroth A, Noureddine R, Paul A, Breitenbuecher S, Virchow I, et al. Combined systemic inflammation score (SIS) correlates with prognosis in patients with advanced pancreatic cancer receiving palliative chemotherapy. J Cancer Res Clin Oncol. (2021) 147:579–91. 10.1007/S00432-020-03361-0
    1. Zhang Y, Shi SM, Yang H, Yang LX, Wang Z, Li XD, et al. Systemic inflammation score predicts survival in patients with intrahepatic cholangiocarcinoma undergoing curative resection. J Cancer. (2019) 10:494–503. 10.7150/JCA.26890
    1. Liu C, Li X. Stage-dependent changes in albumin, NLR, PLR, and AFR are correlated with shorter survival in patients with gastric cancer. Clin Lab. (2019) 65:1623–33. 10.7754/CLIN.LAB.2019.190132
    1. Dunn GP, Old LJ, Schreiber RD. The immunobiology of cancer immunosurveillance and immunoediting. Immunity. (2004) 21:137–48. 10.1016/J.IMMUNI.2004.07.017
    1. Azimi F, Scolyer RA, Rumcheva P, Moncrieff M, Murali R, McCarthy SW, et al. Tumor-infiltrating lymphocyte grade is an independent predictor of sentinel lymph node status and survival in patients with cutaneous melanoma. J Clin Oncol. (2012) 30:2678–83. 10.1200/JCO.2011.37.8539
    1. Evani SJ, Prabhu RG, Gnanaruban V, Finol EA, Ramasubramanian AK. Monocytes mediate metastatic breast tumor cell adhesion to endothelium under flow. FASEB J. (2013) 27:3017–29. 10.1096/FJ.12-224824
    1. Augier S, Ciucci T, Luci C, Carle GF, Blin-Wakkach C, Wakkach A. Inflammatory blood monocytes contribute to tumor development and represent a privileged target to improve host immunosurveillance. J Immunol. (2010) 185:7165–73. 10.4049/JIMMUNOL.0902583

Source: PubMed

Sponsorzy i współpracownicy

Warunki medyczne

Interwencje lekowe

3
Subskrybuj