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Systematic Inflammatory Response Index (SIRI) and Systemic Immune-Inflammation Index (SII), as well as high platelet and low lymphocyte counts, were found to be independent predictors of metastasis in patients with renal cell cancer (RCC).

 1. This prospective study found that the Systematic Inflammatory Response Index (SIRI) and Systemic Immune-Inflammation Index (SII), as well as high platelet and low lymphocyte counts, were independent predictors of metastasis in patients with renal cell cancer (RCC). 

Evidence Rating Level: 2 (Good)

Cancer is a major contributing cause of mortality and morbidity worldwide, and survival rates vary greatly based on the type of cancer as well as the rate of spread. Renal cell cancer (RCC) in particular has varying survival rates which are drastically impacted in the case of distant metastases. There is also emerging literature to suggest the role of inflammatory-mediated pathways in the development of cancer. The Systemic Inflammatory Response Index (SIRI) and Systemic Immune-Inflammation Index (SII) are used as markers of an inflammatory environment, and take into account several blood cell line counts (including neutrophils, monocytes, platelets, and lymphocytes). The predictive value of the SII and SIRI in RCC was investigated in the current study. Seventy-two patients (51 male, 21 female; 22 with metastatic RCC and 50 with non-metastatic RCC diagnosed through surgery, biopsy, lymph node dissection, and imaging) were identified. Their medical records for laboratory results, histopathological findings, and tumor staging/grading were used. Inflammatory indices for the SII and SIRI were calculated based on lab results. There were statistically significant differences in SIRI and SII scores (collected at time of admission for RCC diagnosis) between the metastatic and non-metastatic patients (ps < .05 and < .001, respectively), indicating the presence of predictive value for metastasis based on these inflammatory markers. High platelet and low lymphocyte counts were also found to be independently predictive of metastasis in this sample. These results align with other studies pointing to the potential predictive and prognostic value of these tools and present a potentially cost-effective method of screening and risk stratification for patients with RCC and risk of metastatic progression. However, the power of these results would be bolstered if replicated with a larger sample size and standardized diagnostic methods (e.g., biopsy).

Click to read the study in BMC Urology

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