Published online Nov 27, 2023. doi: 10.4240/wjgs.v15.i11.2445
Peer-review started: August 30, 2023
First decision: September 13, 2023
Revised: September 22, 2023
Accepted: October 17, 2023
Article in press: October 17, 2023
Published online: November 27, 2023
Processing time: 89 Days and 1.6 Hours
Radical surgery is the most commonly used treatment for hepatocellular carcinoma (HCC). However, the surgical effect remains not ideal, and prognostic evaluation is insufficient. Furthermore, clinical intervention is rife with uncertainty and not conducive to prolonging patient survival.
To explore correlations between the systemic immune inflammatory index (SII) and geriatric nutritional risk index (GNRI) and HCC operation prognosis.
This retrospective study included and collected follow up data from 100 HCC. Kaplan–Meier survival curves were used to analyze the correlation between SII and GNRI scores and survival. SII and GNRI were calculated as follows: SII = neutrophil count × platelet count/lymphocyte count; GNRI = [1.489 × albumin (g/L) + 41.7 × actual weight/ideal weight]. We analyzed the predictive efficacy of the SII and GNRI in HCC patients using receiver operating characteristic (ROC) curves, and the relationships between the SII, GNRI, and survival rate using Kaplan–Meier survival curves. Cox regression analysis was utilized to analyze independent risk factors influencing prognosis.
After 1 year of follow-up, 24 patients died and 76 survived. The area under the curve (AUC), sensitivity, specificity, and the optimal cutoff value of SII were 0.728 (95% confidence interval: 0.600-0.856), 79.2%, 63.2%, and 309.14, respectively. According to ROC curve analysis results for predicting postoperative death in HCC patients, the AUC of SII and GNRI combination was higher than that of SII or GNRI alone, and SII was higher than that of GNRI (P < 0.05). The proportion of advanced differentiated tumors, tumor maximum diameter (5–10 cm, > 10 cm), lymph node metastasis, and TNM stage III-IV in patients with SII > 309.14 was higher than that in patients with SII ≤ 309.14 (P < 0.05). The proportion of patients aged > 70 years was higher in patients with GNRI ≤ 98 than that in patients with GNRI > 98 (P < 0.05). The 1-year survival rate of the SII > 309.14 group (compared with the SII ≤ 309.14 group) and GNRI ≤ 98 group (compared with the GNRI > 98 group) was lower (P < 0.05).
The prognosis after radical resection of HCC is related to the SII and GNRI and poor in high SII or low GNRI patients.
Core Tip: Hepatocellular carcinoma (HCC) has a high incidence and mortality. We evaluated the systemic immune inflammatory index (SII), geriatric nutritional risk index (GNRI), and clinicopathological features of 100 patients undergoing radical HCC resection in this research. We analyzed the correlation between SII, GNRI, and clinicopathological characteristics and addressed the problem of weak prognostic assessment by studying the changes in survival rates of patients undergoing HCC treatment under different levels of SII and GNRI.