The following is a summary of “Systemic inflammation response index: An independent predictive factor for survival outcomes of bladder cancer stronger than other inflammatory markers,” published in the May 2023 issue of the Urologic Oncology by Yilmaz et al.
The study aimed to determine the prognostic value of the preoperative systemic inflammation response index (SIRI) in predicting the outcomes of open radical cystectomy (RC). Researchers performed a retrospective analysis of the institution’s database on cystectomy and identified 241 consecutive RC patients. The demographics and oncologic outcomes of patients were recorded. They calculated the SIRI as previously described (NeutrophilxMonocytes/Lymphocytes) based on blood tests performed the day before surgery and at least >30 days later.
The median duration of follow-up was 20 months (interquartile range, 9–52). Two, three, and five-year recurrence-free survival (RFS) and overall survival (OS) rates were 60.6%, 57.1%, 48.9%, 54.7%, 47.0%, and 37.2%. Significantly higher recurrence rates (P<0.001) and shorter OS (P<0.001) were observed in patients with preoperative SIRI >1,91. For internal validation, they evaluated postoperative SIRI >1.91 (repeatability testing) and found substantially higher recurrence rates (P< 0.001) and shorter OS (P = 0.001) as previously observed (P<0.001 and P = 0.001, respectively). Persistently elevated SIRI increased the risk of recurrence and mortality by 5.79 and 2.87, respectively.
In multivariable Cox regression analyses (P<0.05), SIRI was also a significant independent predictor of RFS and OS. SIRI increased the discriminative ability of the models by 1.5% to 4.2%, which was significantly higher than other inflammatory indicators (NLR, MLR, PLR, SII) across all models. Patients with a SIRI>1.91 had significantly higher recurrence and overall survival (OS) rates. The threshold value is internally validated. SIRI is an independent factor in predicting RFS and OS. In the Cox models, SIRI contributes more than other inflammatory markers.