Abstract
BACKGROUND: Previous studies have investigated the role of systemic immune-inflammation index (SII) as a prognostic factor for gastric cancer (GC) patients, although with inconsistent results. Thus, the aim of this study was to identify the prognostic value of SII in GC through meta-analysis. METHODS: We systematically searched the PubMed, Embase, and Web of Science databases for relevant studies investigating the prognostic role of SII in GC up to December 2019. The hazard ratios (HRs) and 95% confidence intervals (CIs) related to overall survival (OS) and disease-free survival (DFS) were combined. Odds ratios (ORs) and 95% CIs were pooled to assess the correlation between SII and clinicopathological features of GC. RESULTS: A total of eight studies, comprising 4,236 patients, were included in this meta-analysis. Pooled analysis indicated that a high pretreatment SII predicted poor OS (HR=1.40, 95% CI=1.08-1.81, p=0.010) but not poor DFS (HR=1.30, 95% CI=0.92-1.83, p=0.140) in GC. In addition, an elevated SII correlated with an advanced tumor-node-metastasis stage (OR=2.34, 95% CI=1.40-3.92, p=0.001), T3-T4 stage (OR=2.25, 95% CI=1.34-3.77, p=0.002), positive lymph node metastasis (OR=1.79, 95% CI=1.12-2.87, p=0.016), and tumor size ≥ 5 cm (OR=2.28, 95% CI=1.62-3.22, p<0.001) in patients with GC. CONCLUSIONS: A high pretreatment SII significantly associated with poorer survival outcomes as well as several clinical characteristics in GC. We suggest that SII could be monitored to guide prognostication and provide reliable information on the risk of disease progression in GC.