The prognostic value of the new combined hemo-eosinophil inflammation index (Hei index): A multicenter analysis of anal cancer patients treated with concurrent chemo-radiation

Margherita Rimini, Pierfrancesco Franco, Berardino De Bari, Maria Giulia Zampino, Stefano Vagge, Giovanni Luca Frassinetti, Francesca Arcadipane, Almalina Bacigalupo, Martina Valgiusti, Deborah Aloi, Lorenzo Gervaso, Renzo Corvò, Giulia Bartolini, Marianna Alessandra Gerardi, Stefano Cascinu, Andrea Casadei-Gardini

Research output: Contribution to journalArticlepeer-review

Abstract

Anal squamous cell carcinoma (SCC) is a rare tumor, and bio-humoral predictors of response to chemo-radiation (CT-RT) are lacking. We developed a prognostic score system based on laboratory inflammation parameters. We investigated the correlation between baseline clinical and laboratory variables and disease-free (DFS) and overall (OS) survival in anal SCC patients treated with CT-RT in five institutions. The bio-humoral parameters of significance were included in a new scoring system, which was tested with other significant variables in a Cox’s proportional hazard model. A total of 308 patients was included. We devised a prognostic model by combining baseline hemoglobin level, SII, and eosinophil count: the Hemo-Eosinophils Inflammation (HEI) Index. We stratified patients according to the HEI index into low-and high-risk groups. Median DFS for low-risk patients was not reached, and it was found to be 79.5 months for high-risk cases (Hazard Ratio 3.22; 95% CI: 2.04–5.10; p < 0.0001). Following adjustment for clinical covariates found significant at univariate analysis, multivariate analysis confirmed the HEI index as an independent prognostic factor for DFS and OS. The HEI index was shown to be a prognostic parameter for DFS and OS in anal cancer patients treated with CT-RT. An external validation of the HEI index is mandatory for its use in clinical practice.

Original languageEnglish
Article number671
Pages (from-to)1-13
Number of pages13
JournalCancers
Volume13
Issue number4
DOIs
Publication statusPublished - Feb 2 2021

Keywords

  • Inflammation
  • Prognostic factors
  • Prognostic index
  • Squamous cell anal cancer

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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