The Combination of Inflammatory Biomarkers as Prognostic Indicator in Salivary Gland Malignancy

Simple Summary Clinical management of Malignant Salivary Gland Tumors is still a challenge for clinicians. Direct and indirect costs for the diagnosis and treatment of these tumors are significant. For this reason, the need to develop a fast and low-cost prognostic system to stratify patients at higher risk appears to be mandatory. The efficacy of inflammatory biomarkers such as the systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), platelet-to-lymphocyte ratio (PLR), and neutrophil-to-lymphocyte ratio (NLR), as prognostic values that are quickly available and low cost, has been confirmed in various fields of oncology. The aim of this study was to investigate the impact of these biomarkers taken individually and combined, to assess the overall survival (OS) in patients surgically treated for malignant salivary gland tumors. This study determined that the combination of SII + SIRI can independently predict the overall survival of patients after surgery for malignant salivary gland tumors. Background: The aim of this study was to investigate how the systemic inflammation response index (SIRI), systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR), taken individually and combined, are associated with overall survival (OS) in patients surgically treated for malignant salivary gland tumors (MSGTs). Methods: A retrospective analysis of 74 cases following surgery at our department between January 2011 and June 2018 was performed. The Receiver Operating Characteristic (ROC) curve was used to calculate the optimal cutoff values for SII, SIRI, PLR, and NLR. Survival curves of different groups at 1-3-5 years were estimated using the Kaplan-Meier method. Results: The optimal thresholds with the highest sensitivity and specificity were 3.95 for NLR, 187.6 for PLR, 917.585 for SII, and 2.045 for SIRI. The ROC curves revealed that the best combination with AUC = 0.884 was SII + SIRI. The estimated 5-year OS probability in patients with SII+ SIRI scores of 0, 1, and 2 was 96%, 87.5% and 12.5%, respectively (p < 0.001). Conclusion: SII+ SIRI can independently predict the OS of patients after MSGT surgery. The prognostic score system based on SII+ SIRI may be good clinical practice as a reference for clinical decision-making.

Automated summary

This study investigated the impact of inflammatory biomarkers, including SIRI, SII, NLR, and PLR, on the overall survival of patients with malignant salivary gland tumors. The results showed that the combination of SII + SIRI can independently predict the overall survival of patients after surgery for these tumors.