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Prognostic value of preoperative systemic immune-inflammation index/albumin for patients with hepatocellular

Kun-Lin Chen1, Yi-Wen Qiu1, Ming Yang1

  • 1Department of Liver Surgery, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China.

World Journal of Gastroenterology
|December 30, 2024
PubMed
Summary

The systemic immune-inflammation index to albumin ratio (SII/ALB) can predict outcomes for hepatocellular carcinoma (HCC) patients after surgery. This ratio, combined with other factors in a nomogram, aids in HCC treatment decisions.

Keywords:
Hepatocellular carcinomaInflammationLiver resectionPrognosisSystemic immune-inflammation index/albumin

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Area of Science:

  • Hepatobiliary surgery
  • Surgical oncology
  • Cancer biomarkers

Background:

  • Hepatocellular carcinoma (HCC) is a leading cause of cancer mortality worldwide.
  • The prognostic value of systemic immune-inflammation index (SII) and albumin (ALB) is known individually, but their combined predictive power (SII/ALB) in HCC post-hepatectomy is unexplored.
  • A higher SII/ALB ratio is hypothesized to correlate with poorer overall survival (OS) and recurrence-free survival (RFS) in HCC patients.

Purpose of the Study:

  • To evaluate the preoperative SII/ALB ratio as a predictor of prognosis in HCC patients undergoing hepatectomy.
  • To develop and validate a nomogram incorporating SII/ALB for predicting HCC patient outcomes.

Main Methods:

  • Retrospective analysis of 1653 HCC patients who underwent curative hepatectomy (2014-2019).
  • Utilized Cox proportional hazards models and Kaplan-Meier curves to assess OS and RFS.
  • Developed a nomogram using least absolute shrinkage and selection operator (LASSO) regression and multivariate Cox analysis, validated internally with ROC, DCA, and C-index.

Main Results:

  • The SII/ALB ratio independently predicted OS (HR=1.22, P=0.025) and RFS (HR=1.19, P=0.022) in HCC patients.
  • A nomogram incorporating SII/ALB, age, AFP, HBsAg, ALB-grade, tumor diameter, PVTT, and tumor number showed good predictive accuracy (C-index 0.73 training, 0.71 validation).
  • Nomogram performance was confirmed by high accuracy in ROC, DCA, and calibration analyses.

Conclusions:

  • The preoperative SII/ALB ratio is an independent predictor of outcomes for HCC patients undergoing curative surgical treatment.
  • The developed nomogram demonstrates high accuracy and clinical utility for aiding in HCC treatment decision-making.