Background: Epithelial ovarian cancer is an aggressive malignancy with poor prognosis despite advances in multimodal treatment. The systemic immune-inflammation index (SII) has emerged as a prognostic biomarker in various cancers; however, the impact of surgery-induced inflammatory changes remains unclear. Methods: This study evaluated the prognostic significance of postoperative changes in SII among patients with epithelial ovarian cancer undergoing primary surgery. Data from 374 patients treated at Samsung Medical Center and Kangbuk Samsung Hospital between 2016 and 2021 were retrospectively reviewed. SII was calculated from complete blood counts obtained within one month before surgery and on postoperative day 1. The percentage change in SII was analyzed, and the optimal cutoff was determined using receiver operating characteristic curve analysis. Survival outcomes were assessed using Kaplan–Meier and multivariable Cox regression models. Results: Patients with a postoperative SII increase > 98.4% (Group 2) had significantly poorer overall (HR = 1.86,p= 0.009) and progression-free survival (HR = 1.30,p= 0.112) compared with those with smaller changes (Group 1). Discussion: High-grade histology, serous subtype, and greater intraoperative blood loss were associated with higher postoperative SII. A marked postoperative increase in SII independently predicted poor survival, suggesting that dynamic inflammatory responses rather than static baseline levels provide additional prognostic information. Conclusions: Perioperative SII monitoring, easily obtainable from routine blood tests, may help identify high-risk patients who could benefit from intensified surveillance or adjuvant treatment. Prospective multicenter studies are warranted to validate these findings and explore whether perioperative modulation of systemic inflammation can improve outcomes.
背景：尽管多模式治疗取得进展，上皮性卵巢癌仍是一种预后不良的侵袭性恶性肿瘤。全身免疫炎症指数（SII）已成为多种癌症的预后生物标志物，但手术引起的炎症变化对其影响尚不明确。方法：本研究评估了接受初次手术的上皮性卵巢癌患者术后SII变化的预后意义。回顾性分析了2016年至2021年间在三星医疗中心和江北三星医院治疗的374例患者数据。SII根据术前一个月内及术后第一天获取的全血细胞计数计算。分析SII百分比变化，并通过受试者工作特征曲线分析确定最佳截断值。使用Kaplan-Meier法和多变量Cox回归模型评估生存结局。结果：与SII变化较小的患者（第1组）相比，术后SII增幅>98.4%的患者（第2组）总生存期（HR=1.86，p=0.009）和无进展生存期（HR=1.30，p=0.112）显著更差。讨论：高级别组织学、浆液性亚型和术中失血量较大与术后SII升高相关。术后SII显著升高独立预测不良生存结局，提示动态炎症反应而非静态基线水平能提供额外的预后信息。结论：围手术期SII监测可通过常规血液检查便捷获取，有助于识别可能从强化监测或辅助治疗中获益的高危患者。有必要开展前瞻性多中心研究以验证这些发现，并探讨围手术期调控全身炎症能否改善患者预后。
肿瘤(癌症)患者之家