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Associations of systemic inflammatory markers with cancer survival outcomes: a systematic umbrella review
Sheng Li1,2, Yan-Yu Zhu2,3, Harry Asena Musonye2,3
1Department of Health Promotion and Behavioral Sciences, School of Public Health, Anhui Medical University, Hefei, Anhui, China.
Background:
The systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI) have been associated with poor cancer outcomes; however, no comprehensive evaluation across various cancer types has been conducted.
Objectives:
To assess the impact of SII/SIRI on survival outcomes in cancer patients.
Methods:
Meta-analyses up to May 10, 2025 were retrieved. Pooled hazard ratios were calculated using random-effects models, and evidence quality was evaluated with AMSTAR 2 and Ioannidis criteria.
Results:
Seventy-four meta-analyses were included. Elevated SIRI was significantly associated with worse overall survival (HR=1.98), supported by Class I evidence. High SII was also linked to poor prognosis across multiple cancers, with consistent subgroup results.
Conclusions:
SII and SIRI are reliable prognostic biomarkers across cancers and may aid clinical decision-making.
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