Assessment of Preoperative Systemic Inflammation Response Index in Surgically Treated Young Head and Neck Cancer
Pei-Yin Wu1, Yao-Te Tsai2,3, Yu-Tsai Lin1,3,4,5
1Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taiwan.
Insights
The preoperative Systemic Inflammation Response Index (SIRI) effectively predicts prognosis in young head and neck squamous cell carcinoma (HNSCC) patients. High SIRI and lymphovascular invasion indicate poorer cancer-specific survival.
Area of Science:
- Oncology
- Head and Neck Cancer Research
- Inflammation Biomarkers
Background:
- Head and neck squamous cell carcinoma (HNSCC) affects young adults, necessitating accurate prognostic tools.
- The Systemic Inflammation Response Index (SIRI) is a potential biomarker for systemic inflammation.
- Understanding prognostic factors in young HNSCC patients is crucial for tailored treatment strategies.
Purpose of the Study:
- To evaluate the prognostic value of preoperative Systemic Inflammation Response Index (SIRI) in young HNSCC patients (≤40 years old).
- To identify independent prognostic factors for cancer-specific survival (CSS) in this demographic.
- To develop and validate a predictive model for CSS.
Main Methods:
- Retrospective analysis of 175 young HNSCC patients who underwent radical surgery (2007-2017).
- Calculation of preoperative SIRI (neutrophils × monocytes / lymphocytes) within one week of surgery.
- Univariate and multivariate Cox regression analyses and nomogram construction for CSS prediction.
Main Results:
- A preoperative SIRI cutoff of 0.87 stratified patients into distinct prognostic groups.
- High SIRI and lymphovascular invasion were identified as independent predictors of poorer CSS.
- The developed nomogram demonstrated strong predictive accuracy (C-index 0.744-0.839) in training and validation cohorts.
Conclusions:
- Preoperative SIRI is a valuable tool for risk stratification in young HNSCC patients.
- Combining SIRI with pathological findings like lymphovascular invasion enhances prognostic assessment.
- These findings support incorporating SIRI into clinical decision-making for young HNSCC patients.
Objectives:
To assess the prognosis of young patients (≤40 years old) with head and neck squamous cell carcinoma (HNSCC), focusing on the preoperative Systemic Inflammation Response Index (SIRI).
Methods:
Between January 2007 and February 2017, 175 young patients with HNSCC (≤40 years old) who underwent radical surgery were retrospectively enrolled in this study. The patients were randomly divided into a training cohort (N = 131) and a validation cohort (N = 44). The SIRI is defined as the absolute neutrophil count (×10⁹/L) multiplied by the absolute monocyte count (×10⁹/L), divided by the absolute lymphocyte count (×10⁹/L) in peripheral blood, all measured within one week prior to radical surgery. Univariate and multivariate Cox regression analyses were conducted to identify variables associated with survival outcomes, which were then used to construct and evaluate a predictive nomogram.
Results:
In both the training and validation cohorts, patients were classified into low- and high-SIRI groups based on a cutoff value of 0.87, which was determined by receiver operating characteristic analysis. This SIRI cutoff effectively stratified patients into two distinct prognostic groups with significant survival differences. Multivariable Cox analysis identified the presence of lymphovascular invasion and the high preoperative SIRI as significant independent prognostic factors associated with poorer cancer-specific survival (CSS) in young patients with HNSCC. Using these variables, a predictive model for 5 year CSS was constructed and visualized as a nomogram. The model demonstrated strong predictive performance, with a C-index of 0.744 [95% CI (0.643-0.845)] in the training cohort and 0.839 [95% CI (0.740-0.938)] in the validation cohort.
Conclusion:
Data from preoperative SIRI assessment, coupled with the presence of pathological adverse features, serve as valuable references for risk stratification in young patients with HNSCC.
