Research Papers:

Systemic immune-inflammation index predicts the clinical outcome in patients with metastatic renal cell cancer treated with sunitinib

Cristian Lolli, Umberto Basso, Lisa Derosa, Emanuela Scarpi, Teodoro Sava, Matteo Santoni, Simon J. Crabb, Francesco Massari, Michele Aieta, Vincenza Conteduca, Marco Maruzzo, Francesca La Russa, Matthew Wheater, Rossana Berardi, Luca Galli and Ugo De Giorgi _

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Oncotarget. 2016; 7:54564-54571. https://doi.org/10.18632/oncotarget.10515

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Cristian Lolli1, Umberto Basso2, Lisa Derosa3, Emanuela Scarpi1, Teodoro Sava4, Matteo Santoni5, Simon J. Crabb6, Francesco Massari4,8, Michele Aieta7, Vincenza Conteduca1, Marco Maruzzo2, Francesca La Russa4, Matthew Wheater6, Rossana Berardi5, Luca Galli3, Ugo De Giorgi1

1Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy

2Medical Oncology Unit 1, Department of Clinical and Experimental Oncology, Istituto Oncologico Veneto IOV IRCCS, Padova, Italy

3Oncology Unit 2, University Hospital of Pisa, Pisa, Italy

4Department of Medical Oncology, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy

5Department of Medical Oncology, Polytechnic University of the Marche Region, Azienda Ospedaliero-Universitaria, Ospedali Riuniti Umberto I-GM Lancisi and G Salesi, Ancona, Italy

6Department of Medical Oncology, University Hospital Southampton NHS Foundation Trust, Southampton General Hospital, Southampton, UK

7Department of Medical Oncology, IRCCS CROB Centro di Riferimento Oncologico della Basilicata, Rionero in Vulture, Italy

8Present address: Division of Oncology, S.Orsola-Malpighi Hospital, Bologna, Italy

Correspondence to:

Ugo De Giorgi, email: [email protected]

Keywords: systemic immune inflammation index, renal cell carcinoma, RCC, prognostic factor, sunitinib

Received: April 20, 2016     Accepted: May 23, 2016     Published: July 09, 2016


Background: In this retrospective analysis, we explored the prognostic and predictive value of the systemic immune-inflammation index (SII), based on lymphocyte, neutrophil, and platelet counts, at baseline and changes at week 6 during first-line sunitinib in patients with metastatic renal cell cancer (RCC).

Results: Patients were stratified into high SII (≥ 730) and low SII (< 730) groups. SII was associated with objective response, p < 0.0001. The median PFS was 6.3 months (95% CI 5.5–8.9) in patients with SII ≥ 730 and 18.7 months (95% CI 14.7–22.8) in those with SII < 730, p < 0.0001. The median OS was 43.6 months (95% CI 35.3–52.1) in patients with SII < 730, and 13.5 months (95% CI 9.8–18.5) in those with SII ≥ 730, p < 0.0001. In multivariate analysis, performance status, IMDC score and SII were able to predict OS (HR = 3.29, HR = 1.71 and HR = 1.79, respectively).

Materials and Methods: We included 335 consecutive RCC patients treated with first-line sunitinib. The X-tile 3.6.1 software (Yale University, New Haven, CT) was used for bioinformatic analysis of the data to determine the cutoff value of SII. Progression-free survival (PFS), overall survival (OS) and their 95% confidence interval (95% CI) were estimated by Kaplan-Meier method and compared with logrank test. The impact of SII conversion at week 6 of treatment on PFS and OS was evaluated by Cox regression analyses.

Conclusions: The SII and its changes during treatment represent a powerful prognostic indicator of clinical outcome in patients with metastatic RCC.

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