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Minimally Invasive Isolated Limb Perfusion (MI-ILP) for Locally Advanced Melanomas and Sarcomas of the Extremity

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Prognostic Value of Systemic Inflammatory Markers in Locally Advanced or Metastatic Melanoma: A Real-World Analysis

Burçin Çakan Demirel¹, Semra Taş², Taliha Güçlü Kantar³

¹Department of Medical Oncology, School of Medicine, Istanbul Medipol University, Istanbul Medipol Mega University Hospital, 34214 Istanbul, Türkiye.

|February 13, 2026

Abstract

Background/Objectives:

Malignant melanoma remains a highly aggressive malignancy with substantial mortality despite advances in systemic therapy. Identifying simple and reproducible prognostic biomarkers is essential for improving risk stratification. Inflammation- and nutrition-based indices-including the Systemic Immune-Inflammation Index (SII), Systemic Inflammatory Response Index (SIRI), dynamic SIRI, and the Controlling Nutritional Status (CONUT) score-have shown prognostic value in various cancers. This study assessed the prognostic significance of these indices in patients with locally advanced or metastatic melanoma using real-world data.

Methods:

A retrospective cohort of 138 patients treated between 2010 and 2023 was analyzed. Baseline demographic, clinical, nutritional, and inflammatory parameters were collected. Optimal cut-off values for SII, SIRI, 6-month SIRI, and dynamic SIRI were determined using receiver operating characteristic analysis. Overall survival (OS) and progression-free survival (PFS) were evaluated using the Kaplan-Meier method, and independent predictors were identified with multivariate Cox regression.

Results:

Elevated baseline SII and SIRI were significantly associated with shorter overall survival. Both 6-month SIRI and dynamic SIRI demonstrated strong prognostic value, emphasizing the importance of longitudinal inflammatory changes. In multivariate analysis, response to first-line therapy emerged as the only independent predictor of disease progression. Patients with a CONUT score ≥ 3 showed significantly shorter OS and PFS in univariate analyses, underscoring the prognostic relevance of nutritional status.

Conclusions:

SII, SIRI, 6-month SIRI, dynamic SIRI, and CONUT are practical, accessible, and reproducible biomarkers with meaningful prognostic value in advanced melanoma. Incorporating these indices into routine clinical assessment may enhance risk stratification and support more personalized treatment decision-making.

Keywords:

CONUT SII SIRI malignant melanoma prognosis systemic inflammation

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