Novel systemic inflammation response index to predict prognosis after thoracoscopic lung cancer surgery: a propensity score‐matching study

Abstract

Background Our propensity score‐matching (PSM) study evaluated the prognostic significance of systemic inflammation response index (SIRI) for patients undergoing video‐assisted thoracoscopic surgery lobectomy for non‐small‐cell lung cancer (NSCLC). Methods This study was conducted on prospectively maintained database in our institution between December 2013 and March 2015. Pre‐operative SIRI was calculated by peripheral monocyte × neutrophil/lymphocyte counts. Survival analysis was performed to distinguish differences in post‐operative survival between patients stratified by an optimum cut‐off of SIRI. Multivariable Cox proportional hazards regression models were established to determine independent prognostic factors. Results There were 390 patients with resected NSCLC included. A SIRI of 0.99 was identified as the optimum cut‐off regarding to post‐operative survival. Both overall survival (OS) and disease‐free survival (DFS) in patients with SIRI >0.99 were significantly shortened than those in patient with SIRI ≤0.99. Patients with SIRI >0.99 had significantly lower rates of OS and DFS compared to those patients with SIRI ≤0.99. These differences still remained significant after subgroup analyses and PSM analyses. Multivariable analyses on the entire cohort and the PSM cohort commonly demonstrated that high pre‐operative SIRI could be an independent prognostic factor for unfavourable OS and DFS of NSCLC. Conclusions SIRI serves as a novel risk stratification tool to refine prognostic prediction for surgically resected NSCLC. SIRI may help surgeons to screen high‐surgical‐risk patients and formulate individualized treatment schemes.