Pretreatment systemic immune-inflammatory index (SII) for a prognostic impact in patients with locally advanced...

This study evaluates the predictive value of the systemic immune-inflammatory index (SII) in locally advanced cervical cancer treated with chemoradiotherapy and aims to develop a nomogram based on inflammatory and clinical-pathological factors to predict survival.

We retrospectively analyzed 421 stage IIB-IVA cervical cancer patients treated with chemoradiotherapy between 2012 and 2021. We analyzed the association between SII, other factors with overall survival (OS) and progression-free survival (PFS). And combined the variables to create a nomogram.

Using SII cutoff value of 957, a high SII (>957) was associated with larger tumor size (P < 0.001), BMI (P = 0.005), FIGO stage (P = 0.008), ECOG performance status (P = 0.001) and lymph node metastasis (P = 0.003). Univariate Cox regression analysis indicated that higher SII was associated with worse PFS and OS. In the training cohort, multivariate analysis identified factors affecting OS, including SII ≥ 957 (hazard ratio [HR]: 1.65, 95% confidence interval [CI]: 1.02-2.66), larger tumor size (HR: 1.71, 95% CI: 1.08-2.7), poor ECOG (HR: 2.31, 95% CI: 1.29-4.12), and metastatic lymph nodes (HR: 1.91, 95% CI: 1.1-3.33). A high SII was also linked to poorer survival outcomes in the validation cohort and correlated with shorter PFS in both cohorts. The nomogram, including SII, accurately predicted 3- and 5-year survival rates with good discriminatory ability (concordance probability, 0.7), which was consistent across validation cohorts.

Elevated SII was linked to poorer OS and PFS, which can help clinicians better assess and predict survival for these patients.