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
ARTICLE HIGHLIGHTS
Research background

Gastric cancer is a prevalent type of tumor with consistently high morbidity and mortality rates worldwide. Robotic gastric cancer surgery has progressed rapidly in recent years, and its future prospects continue to attract attention. Robotic surgery has obvious technical advantages and superior efficacy compared with conventional laparoscopy. The progression and prognosis of patients with stomach cancer are influenced by various contributing conditions, with inflammation being an important contributor. The prolonged presence of inflammation may harm the gastric cancer and cause aberrant cellular proliferation. The activation of the inflammatory response creates favorable for the proliferation and colonization of remnant tumor cells, which promotes the local recurrence and distant metastasis of cancer and reduces patient survival. Systemic inflammatory response index (SIRI), an indicator used for assessing a patient's inflammatory status by integrating multiple inflammatory cells values, has certain advantages and prospects for application.

Research motivation

The accuracy and reliability of using the SIRI need further research and validation. Therefore, we performed a meta-analysis to examine the relevance of SIRI values to the prognoses of gastric cancer patients and investigated its predictive value for oncological survival benefits in patients undergoing robotic gastric cancer surgery with the aim of providing clinicians with more comprehensive information that can assist in making more accurate diagnostic and therapeutic decisions.

Research objectives

The main objective of this study was to examine the relevance of SIRI values to the prognoses of gastric cancer patients and investigate its predictive value for oncological survival benefits in patients undergoing robotic gastric cancer surgery. Our findings make SIRI an encouraging tool to add credibility to decision-making regarding cancer treatment strategies.

Research methods

We performed a meta-analysis to examine the correlation between SIRI values and the prognosis of patients with gastric cancer and investigated its predictive value for oncological survival benefit in patients who underwent robotic gastric cancer surgery by analyzing data from a retrospective cohort.

Research results

Overall, the conclusion of our meta-analysis supports an intrinsic link between SIRI levels and the prognosis of patients with gastric cancer. The findings of our cohort study showed that preoperative SIRI values independently contributed to the overall survival and disease-free survival in patients who underwent robotic surgery for stomach cancer.

Research conclusions

The SIRI is unique in reflecting the sophisticated interactions and complementary activities of the major immune cells in the cancer microenvironment. This new metric is designed to assess survival in patients with malignancy and reflects the state of equilibrium between the immune and inflammatory systems of the host. Our findings make SIRI an encouraging tool to add credibility to decision-making regarding cancer treatment strategies.

Research perspectives

A prospective investigation with a large sample size is needed to validate the potential implication of SIRI values in patients undergoing robotic gastric cancer surgery and clarify the optimal SIRI cutoff value. The mechanisms associated with SIRI values and cancer prognosis prediction remain unclear and require in-depth studies and confirmation.