Prognostic significance of systemic immune-inflammation index in hepatocellular carcinoma: a meta-analysis
Zhi Li1, Juan Luo2, Lihua Peng1
1Clinical Laboratory, Affiliated Zigong TCM Hospital of Chengdu University of TCM, No.1000, Longhui South Street, Ziliujing District, Zigong, 643010, Sichuan, China.
Insights
A higher systemic immune-inflammation index (SII) in hepatocellular carcinoma (HCC) patients predicts poorer survival outcomes, including overall survival (OS), recurrence-free survival (RFS), and progression-free survival (PFS). SII is a valuable prognostic biomarker for HCC.
Area of Science:
- Oncology
- Immunology
- Biomarkers
Background:
- The systemic immune-inflammation index (SII) is increasingly recognized for its association with cancer patient outcomes.
- Existing research on SII's role in hepatocellular carcinoma (HCC) survival presents conflicting findings.
- A comprehensive analysis is needed to clarify the predictive value of SII in HCC.
Purpose of the Study:
- To evaluate the predictive accuracy of the systemic immune-inflammation index (SII) for survival outcomes in patients with hepatocellular carcinoma (HCC).
- To synthesize existing evidence regarding the association between SII and overall survival (OS), recurrence-free survival (RFS), and progression-free survival (PFS) in HCC.
Main Methods:
- A systematic review and meta-analysis of cohort studies was conducted.
- Databases searched included PubMed, Embase, Web of Science, and Cochrane Library up to January 14, 2025.
- Primary endpoints (OS, RFS, PFS) were assessed using hazard ratios (HRs) and 95% confidence intervals (CIs).
Main Results:
- 39 high-quality cohort studies with 47 comparison groups were included.
- Elevated SII levels were significantly associated with shorter OS (HR=1.64), RFS (HR=1.68), and PFS (HR=1.48) in HCC patients.
- Subgroup analyses indicated that factors like age, region, treatment strategy, and SII thresholds influenced SII's prognostic validity.
Conclusions:
- Pre-treatment SII is a significant predictor of reduced OS, RFS, and PFS in HCC patients, irrespective of treatment type (monotherapy or combination).
- The systemic immune-inflammation index (SII) demonstrates potential as a crucial biological indicator for assessing HCC prognosis.
- SII offers valuable insights for guiding scientific and systematic treatment strategies in HCC management.
Purpose:
Emerging evidence suggests an association between the systemic immune-inflammation index (SII) and the survival outcomes of individuals with hepatocellular carcinoma (HCC). However, existing research findings are inconsistent, and no definitive conclusions have been reached. This research aimed to explore the predictive accuracy of the SII in patients with HCC.
Methods:
Numerous databases, encompassing PubMed, Embase, Web of Science, and Cochrane Library, were thoroughly retrieved from the database inception until January 14, 2025, to identify studies on the correlation between SII and survival outcomes in HCC. Studies were screened according to pre-established eligibility criteria. The primary endpoints included overall survival (OS), recurrence-free survival (RFS), and progression-free survival (PFS), which were appraised via hazard ratios (HRs) with corresponding 95% confidence intervals (CIs).
Results:
39 high-quality cohort studies involving 47 comparison groups were included in this analysis. As proven by the aggregated data, increased SII was significantly linked to shorter OS (HR = 1.64, 95% CI: 1.45-1.85; p < 0.00001), RFS (HR = 1.68, 95% CI: 1.44-1.96; p < 0.00001), and PFS (HR = 1.48, 95% CI: 1.20-1.82; p = 0.0002) in individuals with HCC. Furthermore, subgroup analyses revealed that age, region, intervention strategy, and SII thresholds affected the validity of SII for predicting the prognosis of HCC.
Conclusion:
In HCC patients treated with monotherapy or combination therapy, a higher SII before treatment is significantly associated with shorter OS, RFS, and PFS. SII may serve as an important biological indicator for assessing the prognosis of HCC, providing a critical reference for the scientific and systematic treatment of HCC.
