Prognostic significance of systemic immune inflammation index and systemic inflammation response index for cervical cancer: A systematic review and meta-analysis

Abstract

Objective: We present the first systematic review and meta-analysis examining the association between systemic immune inflammation index (SII) and systemic inflammation response index (SIRI) for predicting prognosis of cervical cancer.

Methodology: Cochrane CENTRAL library, Embase, Medline (PubMed), Scopus and Web of Science databases were explored up to 25th October 2024 for all study types examining if SII or SIRI could predict overall survival (OS) and/or disease-free survival (DFS) in cervical cancer.

Results: We included 13 studies with 15 cohorts. We noted that high SII scores were associated with statistically significant increased risk of poor OS (HR: 2.15 95% CI: 1.48, 3.14 I2=78%) and worse DFS (HR: 2.05 95% CI: 1.21, 3.46 I2=83%) in cervical cancer. Meta-analysis also showed a statistically significant association between SIRI and OS (HR: 1.47 95% CI: 1.02, 2.13 I2=67%) but not for DFS (HR: 1.59 95% CI: 0.96, 2.64 I2=79%). Subgroup analysis based on country of the study, sample size, cancer stage, treatment, cut-off, use of adjusted data and study quality showed variables results.

Conclusions: SII can be used to predict OS and DFS in cervical cancer. However, SIRI was found to predict only OS and not DFS with less robust results. Further studies shall provide better evidence.