A novel prognostic model integrating the skeletal muscle index and systemic immune-inflammation index improves...

This investigation sought to assess whether integrating the Skeletal Muscle Index (SMI) and Systemic Immune-Inflammation Index (SII) could enhance prognostic stratification and improve survival prediction in patients with advanced, unresectable esophageal squamous cell carcinoma (ESCC).

The study included 200 individuals with confirmed unresectable ESCC, all of whom received chemoradiotherapy either as monotherapy or combined with immunotherapy. Kaplan-Meier methods were used to generate overall survival (OS) and progression-free survival (PFS) curves, with survival differences between groups evaluated by the log-rank test. The prognostic value of the novel predictive scoring system, combining SMI and SII (SSG score), was analyzed using Cox proportional hazards regression models.

In the overall cohort, the median OS and PFS were 18 months and 11 months, respectively. The prognostic significance of the SSG score was confirmed by receiver operating characteristic (ROC) curve analysis, which yielded an area under the curve (AUC) of 0.690 (P < .05), reflecting strong discriminative power for patient prognosis stratification. Multivariate Cox regression identified the SSG score as an independent prognostic factor for both OS (HR 2.955, 95% CI: 1.351-6.465, P = .007) and PFS (HR 2.028, 95% CI: 1.187-3.463, P = .010) in unresectable ESCC patients.

We developed and validated the SSG scoring system, integrating SMI and systemic SII, for prognostic assessment in unresectable ESCC. The SSG score demonstrated independent prognostic value for both OS and PFS. These findings support its clinical applicability in risk stratification and individualized treatment decision-making.

The SSG score holds promise for improving treatment decisions and prognosis management in patients with unresectable ESCC.