Prognostic value and clinicopathological significance of pre-and post-treatment systemic immune-inflammation index in colorectal cancer patients: a meta-analysis

Abstract Background In recent years, the association between systemic immune-inflammation index (SII) and the prognosis of patients with colorectal cancer (CRC) has remained a topic of considerable debate. To address this, the present study was carried out to investigate the prognostic significance...

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Main Authors: Yueting Tan, Bei’er Hu, Qian Li, Wen Cao
Format: Article
Language:English
Published: BMC 2025-01-01
Series:World Journal of Surgical Oncology
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Online Access:https://doi.org/10.1186/s12957-025-03662-z
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author Yueting Tan
Bei’er Hu
Qian Li
Wen Cao
author_facet Yueting Tan
Bei’er Hu
Qian Li
Wen Cao
author_sort Yueting Tan
collection DOAJ
description Abstract Background In recent years, the association between systemic immune-inflammation index (SII) and the prognosis of patients with colorectal cancer (CRC) has remained a topic of considerable debate. To address this, the present study was carried out to investigate the prognostic significance of SII in CRC. Methods Databases including PubMed, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science were scrutinized up to March 27, 2024. The relationship between pre- and post-treatment SII levels and the prognosis of CRC was evaluated. Following literature screening, quality assessment, and extraction of outcome measures, a meta-analysis was conducted using Stata. Publication bias was assessed by funnel plots and Egger’s test. Results A total of 27 studies were included in the analysis. Pooled results demonstrated that a high SII level was associated with poor overall survival (OS, HR = 1.78, 95% CI = 1.40–2.26), progression-free survival (PFS, HR = 1.80, 95% CI = 1.26–2.56), disease-free survival (DFS, HR = 1.91, 95% CI = 1.43–2.56), and recurrence-free survival (RFS, HR = 3.29, 95% CI = 1.58–6.88). Notably, the association between pre-treatment SII and OS, PFS, and DFS was stronger than that observed for post-treatment SII, indicating that treatment may attenuate the predictive valueof SII for survival outcomes. Additionally, elevated SII was correlated with poor tumor differentiation, tumor location in the rectum, and larger tumor size ≥ 5 cm. Conclusion Our meta-analysis suggested that a high SII is a predictor of poor prognosis in CRC patients. High SII levels were strongly correlated with inferior OS, PFS, DFS, and RFS. The relationship between SII and survival outcomes was attenuated post-treatment compared to pre-treatment. Additionally, elevated SII was correlated with clinicopathological factors in CRC patients. These findings suggest that SII can serve as an independent prognostic indicator for CRC.
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spelling doaj-art-9eb0f6c918ae457baadc610a9b520e652025-01-19T12:25:51ZengBMCWorld Journal of Surgical Oncology1477-78192025-01-0123111510.1186/s12957-025-03662-zPrognostic value and clinicopathological significance of pre-and post-treatment systemic immune-inflammation index in colorectal cancer patients: a meta-analysisYueting Tan0Bei’er Hu1Qian Li2Wen Cao3Hunan University of Traditional Chinese Medicine, The Second Affiliated Hospital of Hunan University of Traditional Chinese MedicineHunan University of Traditional Chinese Medicine, The Second Affiliated Hospital of Hunan University of Traditional Chinese MedicineHunan University of Traditional Chinese Medicine, The Second Affiliated Hospital of Hunan University of Traditional Chinese MedicineHunan University of Traditional Chinese Medicine, The Second Affiliated Hospital of Hunan University of Traditional Chinese MedicineAbstract Background In recent years, the association between systemic immune-inflammation index (SII) and the prognosis of patients with colorectal cancer (CRC) has remained a topic of considerable debate. To address this, the present study was carried out to investigate the prognostic significance of SII in CRC. Methods Databases including PubMed, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science were scrutinized up to March 27, 2024. The relationship between pre- and post-treatment SII levels and the prognosis of CRC was evaluated. Following literature screening, quality assessment, and extraction of outcome measures, a meta-analysis was conducted using Stata. Publication bias was assessed by funnel plots and Egger’s test. Results A total of 27 studies were included in the analysis. Pooled results demonstrated that a high SII level was associated with poor overall survival (OS, HR = 1.78, 95% CI = 1.40–2.26), progression-free survival (PFS, HR = 1.80, 95% CI = 1.26–2.56), disease-free survival (DFS, HR = 1.91, 95% CI = 1.43–2.56), and recurrence-free survival (RFS, HR = 3.29, 95% CI = 1.58–6.88). Notably, the association between pre-treatment SII and OS, PFS, and DFS was stronger than that observed for post-treatment SII, indicating that treatment may attenuate the predictive valueof SII for survival outcomes. Additionally, elevated SII was correlated with poor tumor differentiation, tumor location in the rectum, and larger tumor size ≥ 5 cm. Conclusion Our meta-analysis suggested that a high SII is a predictor of poor prognosis in CRC patients. High SII levels were strongly correlated with inferior OS, PFS, DFS, and RFS. The relationship between SII and survival outcomes was attenuated post-treatment compared to pre-treatment. Additionally, elevated SII was correlated with clinicopathological factors in CRC patients. These findings suggest that SII can serve as an independent prognostic indicator for CRC.https://doi.org/10.1186/s12957-025-03662-zColorectal cancerMeta-analysisSystemic immune-inflammation indexPrognosisRisk factors
spellingShingle Yueting Tan
Bei’er Hu
Qian Li
Wen Cao
Prognostic value and clinicopathological significance of pre-and post-treatment systemic immune-inflammation index in colorectal cancer patients: a meta-analysis
World Journal of Surgical Oncology
Colorectal cancer
Meta-analysis
Systemic immune-inflammation index
Prognosis
Risk factors
title Prognostic value and clinicopathological significance of pre-and post-treatment systemic immune-inflammation index in colorectal cancer patients: a meta-analysis
title_full Prognostic value and clinicopathological significance of pre-and post-treatment systemic immune-inflammation index in colorectal cancer patients: a meta-analysis
title_fullStr Prognostic value and clinicopathological significance of pre-and post-treatment systemic immune-inflammation index in colorectal cancer patients: a meta-analysis
title_full_unstemmed Prognostic value and clinicopathological significance of pre-and post-treatment systemic immune-inflammation index in colorectal cancer patients: a meta-analysis
title_short Prognostic value and clinicopathological significance of pre-and post-treatment systemic immune-inflammation index in colorectal cancer patients: a meta-analysis
title_sort prognostic value and clinicopathological significance of pre and post treatment systemic immune inflammation index in colorectal cancer patients a meta analysis
topic Colorectal cancer
Meta-analysis
Systemic immune-inflammation index
Prognosis
Risk factors
url https://doi.org/10.1186/s12957-025-03662-z
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AT qianli prognosticvalueandclinicopathologicalsignificanceofpreandposttreatmentsystemicimmuneinflammationindexincolorectalcancerpatientsametaanalysis
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