Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Apr 24, 2025; 16(4): 102294
Published online Apr 24, 2025. doi: 10.5306/wjco.v16.i4.102294
Prognostic value of the preoperative systemic immune-inflammation nutritional index in patients with gastric cancer
Li-Jing Wang, Cai-Lu Lei, Ting-An Wang, Zhi-Feng Lin, Shi-Jie Feng, Tao Wei, Yan-Qin Li, Meng-Ru Shen, Yan Li, Liu-Feng Liao
Li-Jing Wang, Ting-An Wang, Shi-Jie Feng, Tao Wei, Yan-Qin Li, Meng-Ru Shen, Yan Li, Liu-Feng Liao, Department of Pharmacy, Guangxi Medical University Cancer Hospital, Nanning 530021, Guangxi Zhuang Autonomous Region, China
Cai-Lu Lei, Zhi-Feng Lin, School of Pharmaceutical Science, Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
Co-first authors: Li-Jing Wang and Cai-Lu Lei.
Co-corresponding authors: Yan Li and Liu-Feng Liao.
Author contributions: Wang LJ and Lei CL contributed equally to this manuscript as co-first author. Wang LJ and Wang TA collected the data; Lei CL wrote the paper; Liao LF and Li Y reviewed the paper and they contributed equally to this manuscript as co-corresponding authors; Feng SJ, Wei T, Shen MR, and Li YQ developed the methodology; Lin ZF and Liao LF analyzed the study data through statistics software. All authors contributed to the article and approved the submitted version.
Supported by the Scientific Research Project of Hospital Pharmacy of Guangxi Pharmaceutical Association in 2022, No. GXYXH1-202202.
Institutional review board statement: The study was reviewed and approved by the ethics committee of Guangxi Medical University Cancer Hospital Institutional Review Board, approval No. KY2024869.
Informed consent statement: Written informed consent for participation was not required for this study in accordance with national legislation and institutional requirements.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The raw data supporting the conclusions of this article will be made available by the authors without undue reservation.
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: Liu-Feng Liao, Department of Pharmacy, Guangxi Medical University Cancer Hospital, No. 71 Heji Road, Qingxiu District, Nanning 530021, Guangxi Zhuang Autonomous Region, China. lcyxllf@163.com
Received: October 14, 2024
Revised: December 4, 2024
Accepted: January 21, 2025
Published online: April 24, 2025
Processing time: 163 Days and 6.6 Hours
Abstract
BACKGROUND

Gastric cancer (GC) is the fifth most common cancer and the third leading cause of cancer-related deaths in China. Many patients with GC frequently experience symptoms related to the disease, including anorexia, nausea, vomiting, and other discomforts, and often suffer from malnutrition, which in turn negatively affects perioperative safety, prognosis, and the effectiveness of adjuvant therapeutic measures. Consequently, some nutritional indicators such as nutritional risk index (NRI), prognostic nutritional index (PNI), and systemic immune-inflammatory-nutritional index (SIINI) can be used as predictors of the prognosis of GC patients.

AIM

To examine the prognostic significance of PNI, NRI, and SIINI in postoperative patients with GC.

METHODS

A retrospective analysis was conducted on the clinical data of patients with GC who underwent surgical treatment at the Guangxi Medical University Cancer Hospital between January 2010 and December 2018. The area under the receiver operating characteristic (ROC) curve was assessed using ROC curve analysis, and the optimal cutoff values for NRI, PNI, and SIINI were identified using the You-Review-HTMLden index. Survival analysis was performed using the Kaplan-Meier method. In addition, univariate and multivariate analyses were conducted using the Cox proportional hazards regression model.

RESULTS

This study included a total of 803 patients. ROC curves were used to evaluate the prognostic ability of NRI, PNI, and SIINI. The results revealed that SIINI had superior predictive accuracy. Survival analysis indicated that patients with GC in the low SIINI group had a significantly better survival rate than those in the high SIINI group (P < 0.05). Univariate analysis identified NRI [hazard ratio (HR) = 0.68, 95% confidence interval (CI): 0.52-0.89, P = 0.05], PNI (HR = 0.60, 95%CI: 0.46-0.79, P < 0.001), and SIINI (HR = 2.10, 95%CI: 1.64-2.69, P < 0.001) as prognostic risk factors for patients with GC. However, multifactorial analysis indicated that SIINI was an independent risk factor for the prognosis of patients with GC (HR = 1.65, 95%CI: 1.26-2.16, P < 0.001).

CONCLUSION

Analysis of clinical retrospective data revealed that SIINI is a valuable indicator for predicting the prognosis of patients with GC. Compared with NRI and PNI, SIINI may offer greater application for prognostic assessment.

Keywords: Systemic immune-inflammatory-nutritional index; Prognostic nutritional index; Nutritional risk index; Gastric cancer; Prognosis

Core Tip: A retrospective analysis was conducted on the clinical data of patients with gastric cancer (GC) who underwent surgical treatment at the Cancer Hospital of Guangxi Medical University between January 2010 and December 2018. Receiver operating characteristic curves were used to evaluate and compare the prognostic ability of nutritional risk index, prognostic nutritional index, and systemic immune-inflammatory-nutritional index (SIINI). Survival analysis indicated that patients with GC in the low SIINI group had a significantly better survival rate than those in the high SIINI group (P < 0.05). Multifactorial analysis indicated that SIINI was an independent risk factor for the prognosis of patients with GC.