Retrospective Cohort Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Feb 27, 2024; 16(2): 382-395
Published online Feb 27, 2024. doi: 10.4240/wjgs.v16.i2.382
Systemic inflammatory response index is a predictor of prognosis in gastric cancer patients: Retrospective cohort and meta-analysis
Jing-Yao Ren, Meng Xu, Xiang-Dong Niu, Shi-Xun Ma, Ya-Jun Jiao, Da Wang, Miao Yu, Hui Cai
Jing-Yao Ren, School of Clinical Medicine, Ningxia Medical University, Yinchuan 750000, Ningxia Hui autonomous region, China
Meng Xu, Gansu Provincial Hospital, Gansu Provincial Hospital, Lanzhou 730000, Gansu Province, China
Xiang-Dong Niu, Shi-Xun Ma, Ya-Jun Jiao, Hui Cai, General Surgery Clinical Medical Center, Gansu Provincial Hospital, Lanzhou 730000, Gansu Province, China
Da Wang, Medical College of Jiangsu University, Jiangsu University, Zhenjiang 212013, Jiangsu Province, China
Miao Yu, Key Laboratory of Molecular Diagnostics and Precision Medicine for Surgical Oncology in Gansu Province, Gansu Provincial Hospital, Lanzhou 730000, Gansu Province, China
Co-first authors: Jing-Yao Ren and Meng Xu.
Author contributions: Ren JY conceived and designed the study; Xu M revised the manuscript and provided important guidance on data analysis; Ren JY, Xu M, Niu XD, Ma SX, Jiao YJ, Wang D and Yu M conducted all data collection and analysis and compiled charts; all authors were involved in the critical review of the results and have contributed to, read, and approved the final manuscript. Ren JY and Xu M contributed equally to this work as co-first authors. Substantial contribution: Ren JY and Xu M have made substantial contributions to the research project. This included involvement in the data collection and analysis, and the revision of the research content. Responsibility for research results: Ren JY and Xu M bear some responsibility for the research results and have been involved in the critical review and approval of the final submitted version. Adherence to guidelines: We adhere to the guidelines provided by academic journals and publishing organizations to ensure that all listed authors meet the relevant standards and requirements. In summary, we believe that designating Ren JY and Xu M as co-first authors is fitting for our manuscript as it accurately reflects our team's collaborative spirit, equal contributions, and diversity.
Supported by National Natural Science Foundation of China, No. 8236110677; Natural Science Foundation of Gansu Province, No. 18JR2RA033; Gansu Da Vinci Robot High-End Diagnosis and Treatment Team Construction Project, National Key Research and Development Program, No. 2020RCXM076.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Gansu Provincial Hospital (ethical consent: 21/10/2022-410).
Informed consent statement: This study has been granted exemption from informed consent. All procedures and protocols were reviewed and approved by the Institutional Review Board (IRB) prior to the commencement of the study. The IRB determined that the study met the criteria for exemption under the federal regulations governing human subject’s research. We have followed all necessary ethical guidelines and regulations throughout the study.
Conflict-of-interest statement: All the Authors have no conflict of interest related to the manuscript.
Data sharing statement: The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hui Cai, Doctor, PhD, Chief Doctor, Dean, Doctor, General Surgery Clinical Medical Center, Gansu Provincial Hospital, No. 204 Donggang West Road, Lanzhou 730000, Gansu Province, China. caialonteam@163.com
Received: November 7, 2023
Peer-review started: November 7, 2023
First decision: December 17, 2023
Revised: December 25, 2023
Accepted: February 1, 2024
Article in press: February 1, 2024
Published online: February 27, 2024
Processing time: 110 Days and 6 Hours
Abstract
BACKGROUND

The systemic inflammatory response index (SIRI) has been demonstrated to make a significant difference in assessing the prognosis of patients with different solid neoplasms. However, research is needed to ascertain the accuracy and reliability of applying the SIRI to patients who undergo robotic radical gastric cancer surgery.

AIM

To validate the applicability of the SIRI in assessing the survival of gastric cancer patients and evaluate the clinical contribution of preoperative SIRI levels to predicting long-term tumor outcomes in patients, who received robotic radical gastric cancer surgery.

METHODS

Initially, an exhaustive retrieval was performed in the PubMed, the Cochrane Library, EMBASE, Web of Science, and Scopus databases to identify relevant studies. Subsequently, a meta-analysis was executed on 6 cohort studies identifying the value of the SIRI in assessing the survival of gastric cancer patients. Additionally, the clinical data of 161 patients undergoing robotic radical gastric cancer surgery were retrospectively analyzed to evaluate their clinicopathological characteristics and relevant laboratory indicators. The association between preoperative SIRI levels and 5-year overall survival (OS) and disease-free survival (DFS) was assessed.

RESULTS

The findings demonstrated an extensive connection between SIRI values and the outcome of patients with gastric cancer. Preoperative SIRI levels were identified as an independent hazard feature for both OS and DFS among those who received robotic surgery for gastric cancer. SIRI levels in gastric cancer patients were observed to be associated with the presence of comorbidities, T-stage, carcinoembryonic antigen levels, the development of early serious postoperative complications, and the rate of lymph node metastasis.

CONCLUSION

SIRI values are correlated with adverse in the gastric cancer population and have the potential to be utilized in predicting long-term oncological survival in patients who undergo robotic radical gastric cancer surgery.

Keywords: Systemic inflammatory response index; Prognosis; Gastric cancer; Complications; Meta-analysis

Core Tip: The aim of this study was to assess the clinical importance and prognostic significance of systemic inflammatory response index (SIRI) on postoperative outcomes in patients with robotic gastrectomy. We collected all the available data in a meta-analysis, and then retrospectively collected baseline data to further explore the relationship of SIRI values with clinicopathological characteristics and prognosis. The results discovered that SIRI values were an independent hazard feature for both overall survival and disease-free survival among those who received robotic surgery. Evaluation of SIRI value levels can help surgeons and oncologists to more effectively assess preoperative treatment and develop postoperative management strategies for gastric cancer patients.