Prognostic Value of Systemic Immune-Inflammation Index-Based Nomogram in Patients with Extrahepatic Cholangiocarcinoma Treated by Percutaneous Transhepatic Biliary Stenting Combined with

Purpose: This study aimed to investigate the prognostic value of systemic immune-inflammation index (SII) in patients with extrahepatic cholangiocarcinoma (EHCC) treated by percutaneous transhepatic biliary stenting (PTBS) combined with (125) I seed intracavitary irradiation and further develop a pr...

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Bibliographic Details
Published in:International journal of general medicine 2023-05, Vol.16, p.2081
Main Author: Wei, Jing Yang, Chengsen Shu, Xianfu Shang, Hao Xu, Ning
Format: Article
Language:English
Subjects:
Cancer
Care and treatment
Chemotherapy
Health aspects
Inflammation
Medical research
Medicine, Experimental
Prognosis
Stent (Surgery)
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Summary:Purpose: This study aimed to investigate the prognostic value of systemic immune-inflammation index (SII) in patients with extrahepatic cholangiocarcinoma (EHCC) treated by percutaneous transhepatic biliary stenting (PTBS) combined with (125) I seed intracavitary irradiation and further develop a predictive model related to SII. Methods: A total of 145 patients with EHCC who received PTBS combined with (125) I seed implantation were retrospectively analyzed. The optimal cut-off value of SII was identified by receiver operating characteristic (ROC) curve analysis. Kaplan-Meier curves and Cox regression were applied to estimate the prognostic value of SII and identify other significant factors of overall survival (OS). Additionally, a novel nomogram was constructed. The concordance index (C-index), calibration plots and decision curve analysis were used to evaluate the performance of the nomogram model. Results: The optimal cut-off value for preoperative SII of 890.2 stratified the patients into High-SII (H-SII) and Low-SII (L-SII) groups. Univariate and multivariate analyses demonstrated that SII was an independent factor for OS. We also found that better therapeutic effect could be obtained with combined postoperative chemotherapy (P < 0.001). Moreover, we revealed that elevated preoperative CA19-9 (P = 0.038) and TBIL level (P = 0.024) were reason for poor prognosis of EHCC. A well-discriminated and calibrated nomogram was developed to predict the 1-year and 2-year OS of EHCC (C-index: 0.709). Conclusion: The SII may be a feasible and convenient prognosis predictor for EHCC. The comprehensive nomogram based on SII presented in this study is a promising model for predicting OS in EHCC patients after PTBS combined with (125) I seed intracavitary irradiation. Keywords: extrahepatic cholangiocarcinoma, biliary stenting, (125) I seed, systemic immune-inflammation index, nomogram
ISSN:1178-7074
1178-7074