Systemic Inflammation Score as a Novel Prognostic Indicator for Patients Undergoing Video-Assisted Thoracoscopic Surgery Lobectomy for Non-Small-Cell Lung Cancer

Abstract

Background

To evaluate the prognostic significance of systemic inflammation score (SIS) for patients undergoing video-assisted thoracoscopic surgery (VATS) lobectomy for non-small-cell lung cancers (NSCLCs). Methods: This retrospective cohort study was conducted on the prospectively maintained database in our institution during the study period. Preoperative SIS comprising serum albumin (sALB) and lymphocyte-to-monocyte ratio (LMR) was graded into 0, 1 and 2. Survival analysis was performed to distinguish differences in postoperative survival between three groups of SIS. Finally, multivariate Cox proportional hazards regression analyses were conducted to determine independent prognostic factors. Results: There were 390 patients with operable NSCLCs included. We applied sALB at 40 g/L and our median LMR at 3.91 as the cutoffs for modified SIS scoring criteria. Both overall survival (OS) and disease-free survival (DFS) were significantly shortened in a step-wise fashion with each 1-point increase in SIS (Log-rank p < .001). There was a significant step-wise decline in both OS and DFS rates in proportion to SIS (p < .001). No difference was found in postoperative complications between three groups of SIS. Multivariate analyses finally demonstrated that both SIS = 1 and SIS = 2 could be independent prognostic factors for unfavorable OS and DFS of NSCLCs. Conclusions: SIS can serve as a novel risk stratification tool to refine the prognostic prediction for surgical NSCLCs.

Keywords:

• systemic inflammation score
• video-assisted thoracoscopic surgery
• non-small-cell lung cancer
• overall survival
• disease-free survival

ACKNOWLEDGMENTS

We give special thanks to Prof. Ralph A. Schmid, from Division of General Thoracic Surgery, Inselspital, Bern University Hospital, University of Bern, Switzerland, for his great assistance to this manuscript.

DECLARATION OF INTEREST

The authors declare that they have no conflict of interest.

Additional information

Funding

This study was supported by the Foundation of Science and Technology support plan Department of Sichuan Province [No: 2015SZ0158]. Dr. Shuangjiang Li is a research fellow supported by the China Scholarship Council [No. 201906240084].