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International Journal of Clinical Oncology

, Volume 24, Issue 5, pp 526–532 | Cite as

External validation of the systemic immune-inflammation index as a prognostic factor in metastatic renal cell carcinoma and its implementation within the international metastatic renal cell carcinoma database consortium model

  • Pawel ChromEmail author
  • Jakub Zolnierek
  • Lubomir Bodnar
  • Rafal Stec
  • Cezary Szczylik
Original Article
  • 123 Downloads

Abstract

Background

We conducted a study to validate the influence of the systemic immune-inflammation index (SII) on overall survival (OS) in patients with metastatic renal cell carcinoma (mRCC) and to verify whether the implementation of the SII in place of neutrophil and platelet counts within the International Metastatic Renal Cell Carcinoma Consortium (IMDC) model might increase its prognostic accuracy.

Patients and methods

We retrospectively analyzed consecutive patients with mRCC, who were treated with first-line tyrosine kinase inhibitors from 2008 to 2016 in two major oncology centres in Poland. We stratified patients into low SII (< 730) and high SII (≥ 730) groups according to a recent literature report. We used multivariable Cox proportional hazards regressions (CPHRs) to assess the impact of the SII on OS and concordance, global ‘goodness-of-fit’, calibration and reclassification measures to quantify a potential prognostic benefit from the modification of the IMDC model.

Results

Overall, 502 patients (294 with low and 208 with high SII) were included. Median OS was 36.7 months [95% confidence interval (CI) 30.4–41.5 months] and 17.0 months (95% CI 12.5–19.6 months) in the low and high SII groups, respectively. The SII status was significant in CPHRs with the hazard ratio ranging from 1.38 to 1.68. All prognostic accuracy measures favored the SII-modified-IMDC model over the original IMDC model.

Conclusions

Using an external dataset, we showed that high SII was an independent factor for poor OS. The addition of the SII to the IMDC model in place of neutrophil and platelet counts increased the model’s prognostic performance.

Keywords

International metastatic renal cell carcinoma database consortium model Overall survival Prognostic factor Systemic immune-inflammation index Tyrosine kinase inhibitors 

Notes

Funding

None.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The local ethics committee approved the study (Agreement no. 1/WIM/2014).

Informed consent

The individual informed consent was not required due to retrospective nature of the study.

Supplementary material

10147_2018_1390_MOESM1_ESM.doc (144 kb)
Supplementary material 1 (DOC 143 KB)

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Copyright information

© Japan Society of Clinical Oncology 2019

Authors and Affiliations

  1. 1.Department of OncologyMilitary Institute of MedicineWarsawPoland
  2. 2.Department of Genitourinary CancersMaria Skłodowska-Curie Memorial Cancer CenterWarsawPoland
  3. 3.Department of Clinical Oncology and Oncological SurgeryEuropejskie Centrum ZdrowiaOtwockPoland
  4. 4.Medical University of WarsawWarsawPoland

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