TY - JOUR
T1 - Immune inflammation indicators in anal cancer patients treated with concurrent chemoradiation
T2 - Training and validation cohort with online calculator (ARC: Anal Cancer Response Classifier)
AU - Casadei-Gardini, Andrea
AU - Montagnani, Francesco
AU - Casadei, Chiara
AU - Arcadipane, Francesca
AU - Andrikou, Kalliopi
AU - Aloi, Deborah
AU - Prete, Alessandra Anna
AU - Zampino, Maria Giulia
AU - Argentiero, Antonella
AU - Pugliese, Giuseppe
AU - Martini, Stefania
AU - Iorio, Giuseppe Carlo
AU - Scartozzi, Mario
AU - Mistrangelo, Massimiliano
AU - Fornaro, Lorenzo
AU - Cassoni, Paola
AU - Marisi, Giorgia
AU - Dell’Acqua, Veronica
AU - Ravenda, Paola Simona
AU - Lonardi, Sara
AU - Silvestris, Nicola
AU - De Bari, Berardino
AU - Ricardi, Umberto
AU - Cascinu, Stefano
AU - Franco, Pierfrancesco
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Background: In anal cancer, there are no markers nor other laboratory indexes that can predict prognosis and guide clinical practice for patients treated with concurrent chemo radiation. In this study, we retrospectively investigated the influence of immune inflammation indicators on treatment outcome of anal cancer patients undergoing concurrent chemo radiotherapy. Methods: All patients had a histologically proven diagnosis of squamous cell carcinoma of the anal canal/margin treated with chemoradiotherapy according to the Nigro’s regimen. Impact on prognosis of pre-treatment systemic index of inflammation (SII) (platelet x neutrophil/lymphocyte), neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) were analyzed. Results: A total of 161 consecutive patients were available for the analysis. Response to treatment was the single most important factor for progression-free survival (PFS) and overall survival (OS). At univariate analysis, higher SII level was significantly correlated to lower PFS (p<0.01) and OS (p=0.046). NLR level was significantly correlated to PFS (p=0.05), but not to OS (p=0.06). PLR level significantly affected both PFS (p<0.01) and OS (p=0.02). On multivariate analysis pre-treatment, SII level was significantly correlated to PFS (p=0.0079), but not to OS (p=0.15). We developed and externally validated on a cohort of 147 patients a logistic nomogram using SII, nodal status and pre-treatment Hb levels. Results showed a good predictive ability with C-index of 0.74. An online available calculator has also been developed. Conclusion: The low cost and easy profile in terms of determination and reproducibility make SII a promising tool for prognostic assessment in this oncological setting.
AB - Background: In anal cancer, there are no markers nor other laboratory indexes that can predict prognosis and guide clinical practice for patients treated with concurrent chemo radiation. In this study, we retrospectively investigated the influence of immune inflammation indicators on treatment outcome of anal cancer patients undergoing concurrent chemo radiotherapy. Methods: All patients had a histologically proven diagnosis of squamous cell carcinoma of the anal canal/margin treated with chemoradiotherapy according to the Nigro’s regimen. Impact on prognosis of pre-treatment systemic index of inflammation (SII) (platelet x neutrophil/lymphocyte), neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) were analyzed. Results: A total of 161 consecutive patients were available for the analysis. Response to treatment was the single most important factor for progression-free survival (PFS) and overall survival (OS). At univariate analysis, higher SII level was significantly correlated to lower PFS (p<0.01) and OS (p=0.046). NLR level was significantly correlated to PFS (p=0.05), but not to OS (p=0.06). PLR level significantly affected both PFS (p<0.01) and OS (p=0.02). On multivariate analysis pre-treatment, SII level was significantly correlated to PFS (p=0.0079), but not to OS (p=0.15). We developed and externally validated on a cohort of 147 patients a logistic nomogram using SII, nodal status and pre-treatment Hb levels. Results showed a good predictive ability with C-index of 0.74. An online available calculator has also been developed. Conclusion: The low cost and easy profile in terms of determination and reproducibility make SII a promising tool for prognostic assessment in this oncological setting.
KW - Anal cancer
KW - NLR
KW - PLR
KW - Prognostic factors
KW - SII
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U2 - 10.2147/CMAR.S197349
DO - 10.2147/CMAR.S197349
M3 - Article
AN - SCOPUS:85065550565
VL - 11
SP - 3631
EP - 3642
JO - Cancer Management and Research
JF - Cancer Management and Research
SN - 1179-1322
ER -