THE COMBINATION OF INFLAMMATORY BIOMARKERS AS PROGNOSTIC FACTOR IN MALIGNANT SALIVARY GLAND TUMORS
Authors:
Stefania Troise, Vincenzo Abbate, Giovanni Dell’ Aversana Orabona
Affiliation:
1 Maxillo-Facial Surgery Specialization School, University of Milan
2 Maxillo-Facial Division, IRCCS San Gerardo Dei Tintori, Monza – University of Milano Bicocca
3 Maxillo-Facial Division, Grande Ospedale Metropolitano Niguarda, Milan
4 Regional Center for CLP San Paolo Hospital, Milano
Doi: 10.54936/haoms242p97
ABSTRACT:
Objectives: The aim of this study was to investigate how the main preoperative inflammatory biomarkers, as systemic inflammation response index (SIRI), systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR), taken individually and combined, might be related to overall survival (OS) in surgically treated patients for malignant salivary gland tumors (MSGTs).
Methods: A retrospective analysis on 74 cases of MSGTs following surgery at Maxillofacial Surgery Unit between January 2011 and June 2018 was performed. For each patient the values of SII, SIRI, PLR, and NLR were calculated and the Receiver Operating Characteristic (ROC) curves were used to obtain the optimal cutoff values for each index. Survival curves at 1–3–5 years of patients with different combinations of inflammatory biomarkers values were estimated using the Kaplan– Meier method.
Results: The optimal thresholds with the highest sensitivity and specificity were 3.95 for NLR, 187.6 for PLR, 917.585 for SII, and 2.045 for SIRI. The univariate analysis revealed that all the indices, when above the calculated threshold value, were related with a worse prognosis; the ROC curves revealed that the more significant prognostic combination was SII + SIRI. The estimated 5-year OS rate in patients with SII + SIRI above cut-off was 12.5% (p < 0.001).
Conclusion: Preoperative inflammatory biomarkers can be used as an effective and low-cost prognostic factor to stratify high-risk patients surgically treated for MSGT. SII + SIRI combination can independently predict the OS of these patients, because when both indices are above the threshold, the prognosis is worse. The prognostic score system based on SII + SIRI may be good clinical practice as a reference for clinical decision-making.
KEY WORDS: malignant salivary gland tumors; overall survival; inflammatory biomarkers; systemic immune-inflammation index; platelet-to-lymphocyte ratio; neutrophil-to-lymphocyte ratio; systemic inflammation response index.
Authors:
Stefania Troise, Vincenzo Abbate, Giovanni Dell’ Aversana Orabona
Affiliation:
1 Maxillo-Facial Surgery Specialization School, University of Milan
2 Maxillo-Facial Division, IRCCS San Gerardo Dei Tintori, Monza – University of Milano Bicocca
3 Maxillo-Facial Division, Grande Ospedale Metropolitano Niguarda, Milan
4 Regional Center for CLP San Paolo Hospital, Milano
Doi: 10.54936/haoms242p97
ABSTRACT:
Objectives: The aim of this study was to investigate how the main preoperative inflammatory biomarkers, as systemic inflammation response index (SIRI), systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR), taken individually and combined, might be related to overall survival (OS) in surgically treated patients for malignant salivary gland tumors (MSGTs).
Methods: A retrospective analysis on 74 cases of MSGTs following surgery at Maxillofacial Surgery Unit between January 2011 and June 2018 was performed. For each patient the values of SII, SIRI, PLR, and NLR were calculated and the Receiver Operating Characteristic (ROC) curves were used to obtain the optimal cutoff values for each index. Survival curves at 1–3–5 years of patients with different combinations of inflammatory biomarkers values were estimated using the Kaplan– Meier method.
Results: The optimal thresholds with the highest sensitivity and specificity were 3.95 for NLR, 187.6 for PLR, 917.585 for SII, and 2.045 for SIRI. The univariate analysis revealed that all the indices, when above the calculated threshold value, were related with a worse prognosis; the ROC curves revealed that the more significant prognostic combination was SII + SIRI. The estimated 5-year OS rate in patients with SII + SIRI above cut-off was 12.5% (p < 0.001).
Conclusion: Preoperative inflammatory biomarkers can be used as an effective and low-cost prognostic factor to stratify high-risk patients surgically treated for MSGT. SII + SIRI combination can independently predict the OS of these patients, because when both indices are above the threshold, the prognosis is worse. The prognostic score system based on SII + SIRI may be good clinical practice as a reference for clinical decision-making.
KEY WORDS: malignant salivary gland tumors; overall survival; inflammatory biomarkers; systemic immune-inflammation index; platelet-to-lymphocyte ratio; neutrophil-to-lymphocyte ratio; systemic inflammation response index.