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Cited by 90Inflammatory Biomarkers in Disease PrognosisTesticular diseases and treatmentsLung Cancer Research Studies

Systemic immune-inflammation index in germ-cell tumours

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Chovanec, Michal, Cierna, Zuzana, Miskovska, Viera, Machalekova, Katarina, Kalavska, Katarina, Rejlekova, Katarina, Svetlovska, Daniela, Macak, Dusan +6 more·2018·British Journal of Cancer
DOI 10.1038/bjc.2017.460PMC PMC5877428
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Abstract

BACKGROUND: We evaluated systemic immune-inflammation index (SII) and its association with patient outcome in germ-cell tumours (GCTs). METHODS: Two independent cohorts of patients were analysed; the discovery set (n=171) from a single institution and the validation set (n=181) previously included in a study evaluating PD-L1 in GCTs. The SII was calculated using platelet (P), neutrophil (N) and lymphocyte (L) counts before chemotherapy and correlated with survival using regression analyses and Kaplan-Meier method. RESULTS: In the discovery cohort, the SII was associated with poor risk clinical features. Patients with low SII had significantly longer progression-free survival (HR=0.22, 95% CI 0.12-0.41, P<0.001) and overall survival (OS) (HR=0.16, 95% CI 0.08-0.32, P<0.001) compared to high SII. This index was independent of International Germ Cell Cancer Collaborative Group criteria in multivariable Cox regression analysis for OS and was validated in an independent cohort. When combining PD-L1 expression on tumour infiltrating lymphocytes (TILs) and SII, we identified three distinctive prognostic groups. CONCLUSIONS: High SII was associated with poor outcome in GCTs. Combination of PD-L1 positive TILs and SII could further refine prognosis in GCTs.

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  • Various studies reported significant differences between NLR, LMR, and SII in early and advanced stage GCTs.

    “Various studies reported that there were significant differences between neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR) and systemic inflammation index (SII), in early and advanced stage GCTs [31,32,33,34,35].”

    From The Immune Landscape and Immunotherapeutic Strategies in Platinum-Refractory Testicular Germ Cell Tumors (2024) · cites this paper as [32]

    The Results section, “Association between the SII and patient/tumour characteristics” (page unavailable), reports a significant association between high SII and poorer IGCCCG risk categories and multiple metastatic sites in GCTs. It does not report an early-versus-advanced-stage comparison for all three measures: NLR is mentioned in the Discussion, while LMR is not reported. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • SII levels may serve as an independent prognostic indicator for PFS and OS.

    “although the levels of SII may serve as an independent prognostic indicator for progression-free survival (PFS) and overall survival (OS)”

    From The Immune Landscape and Immunotherapeutic Strategies in Platinum-Refractory Testicular Germ Cell Tumors (2024) · cites this paper as [32]

    In Results, ‘A prognostic role of the SII’ (page not provided), SII was associated with both PFS and OS. But the multivariable analysis found it prognostic independently of IGCCCG for OS, not PFS; the OS result also lost statistical significance when three IGCCCG risk categories were used. The claim overstates the evidence for independent prognostic value. (LLM, conf=0.92)

    Experimental — accuracy not yet measured

  • Best prognosis is seen in patients with high PD-L1 in TILs and low SII (SII < 1003), with 5-year PFS and OS of 100%.

    “The best prognosis is seen in patients with a high expression of PD-L1 in TILs and a low SII (SII < 1003) with a 5-year PFS and OS of 100%”

    From The Immune Landscape and Immunotherapeutic Strategies in Platinum-Refractory Testicular Germ Cell Tumors (2024) · cites this paper as [32]

  • When combined with PD-L1 expression on TILs, SII can further stratify patients into three distinct prognostic groups.

    “when combined with PD-L1 expression on TILs, they can further stratify patients into three distinct prognostic groups [32].”

    From The Immune Landscape and Immunotherapeutic Strategies in Platinum-Refractory Testicular Germ Cell Tumors (2024) · cites this paper as [32]

  • Patients with high/high or low/low SII and PD-L1 in TILs have an intermediate prognosis.

    “Patients with combinations of high/high or low/low SII and PD-L1 in TILs have an intermediate prognosis [32].”

    From The Immune Landscape and Immunotherapeutic Strategies in Platinum-Refractory Testicular Germ Cell Tumors (2024) · cites this paper as [32]

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Cited by

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Authors
Chovanec, M., Cierna, Z., Miskovska, V., Machalekova, K., Kalavska, K., Rejlekova, K., Svetlovska, D., Macak, D., Spanik, S., Kajo, K., Babal, P., De Giorgi, U., Mego, M., & Mardiak, J.
Affiliations
Comenius University Bratislava (SK)
Corresponding author
Mego, Michal
ORCID
Venue
British Journal of Cancer
Publisher
Springer Science and Business Media LLC
Published
2018-02-27
Volume
118
Issue
6
Pages
831-838
ISSN
  • 0007-0920 (ISSN-L)
  • 1532-1827
DOI
10.1038/bjc.2017.460
PMC
PMC5877428
OpenAlex
W2789821034
Cited by
90
References
4
Citations by year
2026: 5 · 2025: 10 · 2024: 4 · 2023: 8 · 2022: 14 · 2021: 15 · 2020: 15 · 2019: 11 · 2018: 8
FWCI
4.60
Type
journal article
Language
en
Open access
Licence
Locations
  • British Journal of Cancer (publishedVersion, cc-by-nc-sa)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-sa)
  • PubMed Central (publishedVersion, cc-by-nc-sa)
  • PubMed (publishedVersion)
  • AIRUS (submittedVersion)
Funders
Agentúra na Podporu Výskumu a Vývoja (APVV-15-0086, 15-0086, APVV-15)
Topics
  • Health Sciences › Medicine › Oncology › Inflammatory Biomarkers in Disease Prognosis
  • Health Sciences › Medicine › Surgery › Testicular diseases and treatments
  • Health Sciences › Medicine › Oncology › Lung Cancer Research Studies
Keywords
systemic immune-inflammation index, germ cell tumors, prognostic factors, platelet count, neutrophil count, lymphocyte count, PD-L1 expression, tumor-infiltrating lymphocytes, progression-free survival, overall survival
MeSH terms
Progression-Free Survival, Adolescent, Adult, Aged, Blood Platelets, Humans, Inflammation, Lymphocytes, Male, Middle Aged, Neoplasms, Germ Cell and Embryonal, Neutrophils, Regression Analysis, Retrospective Studies, Testicular Neoplasms, Lymphocytes, Tumor-Infiltrating, Kaplan-Meier Estimate, Young Adult, B7-H1 Antigen

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