Prognostic Utility of the Modified Systemic Inflammation Score for Patients Undergoing Oral Cavity Cancer Surgery

Background/Objectives: Chronic inflammation significantly contributes to human malignancies. We investigated the prognostic significance of the preoperative modified systemic inflammation score (mSIS) in patients with primary oral cavity squamous cell carcinoma (OCSCC). Methods: We retrospectively r...

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Main Authors: Ku-Hao Fang, Sheng-Wei Lo, Adarsh Kudva, Andrea De Vito, Yuan-Hsiung Tsai, Cheng-Ming Hsu, Geng-He Chang, Ethan I. Huang, Ming-Shao Tsai, Chia-Hsuan Lai, Ming-Hsien Tsai, Chun-Ta Liao, Chung-Jan Kang, Yao-Te Tsai
Format: Article
Language:English
Published: MDPI AG 2024-12-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/14/24/2856
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author Ku-Hao Fang
Sheng-Wei Lo
Adarsh Kudva
Andrea De Vito
Yuan-Hsiung Tsai
Cheng-Ming Hsu
Geng-He Chang
Ethan I. Huang
Ming-Shao Tsai
Chia-Hsuan Lai
Ming-Hsien Tsai
Chun-Ta Liao
Chung-Jan Kang
Yao-Te Tsai
author_facet Ku-Hao Fang
Sheng-Wei Lo
Adarsh Kudva
Andrea De Vito
Yuan-Hsiung Tsai
Cheng-Ming Hsu
Geng-He Chang
Ethan I. Huang
Ming-Shao Tsai
Chia-Hsuan Lai
Ming-Hsien Tsai
Chun-Ta Liao
Chung-Jan Kang
Yao-Te Tsai
author_sort Ku-Hao Fang
collection DOAJ
description Background/Objectives: Chronic inflammation significantly contributes to human malignancies. We investigated the prognostic significance of the preoperative modified systemic inflammation score (mSIS) in patients with primary oral cavity squamous cell carcinoma (OCSCC). Methods: We retrospectively reviewed data from 320 OCSCC patients who underwent curative surgery between 2007 and 2017. Based on preoperative lymphocyte-to-monocyte ratio (LMR) and serum albumin levels, patients were classified into three groups: mSIS = 2 (LMR < 3.4 and albumin < 4.0 g/dL), mSIS = 1 (LMR < 3.4 or albumin < 4.0 g/dL), and mSIS = 0 (LMR ≥ 3.4 and albumin ≥ 4.0 g/dL). We explored the associations between the preoperative mSIS and overall survival (OS) and disease-free survival (DFS). We developed a nomogram based on mSIS for OS prediction. Results: The distribution was mSIS = 0 (<i>n</i> = 197, 61.6%), mSIS = 1 (<i>n</i> = 99, 30.9%), and mSIS = 2 (<i>n</i> = 24, 7.5%). Kaplan–Meier estimated OS and DFS for the mSIS = 0, mSIS = 1, and mSIS = 2 groups demonstrated a sequential decrease (both <i>p</i> < 0.001). The prognostic significance of mSIS was consistent across subgroup analyses. Multivariable analysis revealed that mSIS = 1 and mSIS = 2 were independent negative prognostic indicators. The mSIS-based nomogram effectively predicted OS (concordance index: 0.755). Conclusions: The mSIS reliably predicts OS and DFS in OCSCC patients undergoing surgery, with the nomogram providing individualized OS estimates, enhancing mSIS’s clinical utility.
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spelling doaj-art-4bfe1919c4e44c949ef49a8d70f1f61e2025-08-20T02:53:38ZengMDPI AGDiagnostics2075-44182024-12-011424285610.3390/diagnostics14242856Prognostic Utility of the Modified Systemic Inflammation Score for Patients Undergoing Oral Cavity Cancer SurgeryKu-Hao Fang0Sheng-Wei Lo1Adarsh Kudva2Andrea De Vito3Yuan-Hsiung Tsai4Cheng-Ming Hsu5Geng-He Chang6Ethan I. Huang7Ming-Shao Tsai8Chia-Hsuan Lai9Ming-Hsien Tsai10Chun-Ta Liao11Chung-Jan Kang12Yao-Te Tsai13Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan 333423, TaiwanDepartment of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi 613016, TaiwanDepartment of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal 576104, IndiaEar Nose Throat (ENT) Unit, Department of Surgery, Forlì Hospital Health Local Agency of Romagna, 47121 Forlì, ItalyCollege of Medicine, Chang Gung University, Taoyuan 330036, TaiwanCollege of Medicine, Chang Gung University, Taoyuan 330036, TaiwanCollege of Medicine, Chang Gung University, Taoyuan 330036, TaiwanCollege of Medicine, Chang Gung University, Taoyuan 330036, TaiwanCollege of Medicine, Chang Gung University, Taoyuan 330036, TaiwanCollege of Medicine, Chang Gung University, Taoyuan 330036, TaiwanCollege of Medicine, Chang Gung University, Taoyuan 330036, TaiwanDepartment of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan 333423, TaiwanDepartment of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan 333423, TaiwanCollege of Medicine, Chang Gung University, Taoyuan 330036, TaiwanBackground/Objectives: Chronic inflammation significantly contributes to human malignancies. We investigated the prognostic significance of the preoperative modified systemic inflammation score (mSIS) in patients with primary oral cavity squamous cell carcinoma (OCSCC). Methods: We retrospectively reviewed data from 320 OCSCC patients who underwent curative surgery between 2007 and 2017. Based on preoperative lymphocyte-to-monocyte ratio (LMR) and serum albumin levels, patients were classified into three groups: mSIS = 2 (LMR < 3.4 and albumin < 4.0 g/dL), mSIS = 1 (LMR < 3.4 or albumin < 4.0 g/dL), and mSIS = 0 (LMR ≥ 3.4 and albumin ≥ 4.0 g/dL). We explored the associations between the preoperative mSIS and overall survival (OS) and disease-free survival (DFS). We developed a nomogram based on mSIS for OS prediction. Results: The distribution was mSIS = 0 (<i>n</i> = 197, 61.6%), mSIS = 1 (<i>n</i> = 99, 30.9%), and mSIS = 2 (<i>n</i> = 24, 7.5%). Kaplan–Meier estimated OS and DFS for the mSIS = 0, mSIS = 1, and mSIS = 2 groups demonstrated a sequential decrease (both <i>p</i> < 0.001). The prognostic significance of mSIS was consistent across subgroup analyses. Multivariable analysis revealed that mSIS = 1 and mSIS = 2 were independent negative prognostic indicators. The mSIS-based nomogram effectively predicted OS (concordance index: 0.755). Conclusions: The mSIS reliably predicts OS and DFS in OCSCC patients undergoing surgery, with the nomogram providing individualized OS estimates, enhancing mSIS’s clinical utility.https://www.mdpi.com/2075-4418/14/24/2856oral cavity cancersquamous cell carcinomamodified systemic inflammation scorenomogramsurvival outcomes
spellingShingle Ku-Hao Fang
Sheng-Wei Lo
Adarsh Kudva
Andrea De Vito
Yuan-Hsiung Tsai
Cheng-Ming Hsu
Geng-He Chang
Ethan I. Huang
Ming-Shao Tsai
Chia-Hsuan Lai
Ming-Hsien Tsai
Chun-Ta Liao
Chung-Jan Kang
Yao-Te Tsai
Prognostic Utility of the Modified Systemic Inflammation Score for Patients Undergoing Oral Cavity Cancer Surgery
Diagnostics
oral cavity cancer
squamous cell carcinoma
modified systemic inflammation score
nomogram
survival outcomes
title Prognostic Utility of the Modified Systemic Inflammation Score for Patients Undergoing Oral Cavity Cancer Surgery
title_full Prognostic Utility of the Modified Systemic Inflammation Score for Patients Undergoing Oral Cavity Cancer Surgery
title_fullStr Prognostic Utility of the Modified Systemic Inflammation Score for Patients Undergoing Oral Cavity Cancer Surgery
title_full_unstemmed Prognostic Utility of the Modified Systemic Inflammation Score for Patients Undergoing Oral Cavity Cancer Surgery
title_short Prognostic Utility of the Modified Systemic Inflammation Score for Patients Undergoing Oral Cavity Cancer Surgery
title_sort prognostic utility of the modified systemic inflammation score for patients undergoing oral cavity cancer surgery
topic oral cavity cancer
squamous cell carcinoma
modified systemic inflammation score
nomogram
survival outcomes
url https://www.mdpi.com/2075-4418/14/24/2856
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