Zhang WH, Zhao Y, Zhang CR, Huang JC, Lyu SC, Lang R. Preoperative systemic inflammatory response index as a prognostic marker for distal cholangiocarcinoma after pancreatoduodenectomy. World J Gastrointest Surg 2024; 16(9): 2910-2924 [PMID: 39351557 DOI: 10.4240/wjgs.v16.i9.2910]
Corresponding Author of This Article
Ren Lang, MD, PhD, Director, Doctor, Professor, Department of Hepatobiliary Surgery, Beijing Chao-Yang Hospital Affiliated to Capital Medical University, No. 8 Gongti South Road, Chaoyang District, Beijing 100020, China. dr_langren@126.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Wen-Hui Zhang, Cheng-Run Zhang, Jin-Can Huang, Shao-Cheng Lyu, Ren Lang, Department of Hepatobiliary Surgery, Beijing Chao-Yang Hospital Affiliated to Capital Medical University, Beijing 100020, China
Yu Zhao, Department of Urology Surgery, Beijing Chao-Yang Hospital Affiliated to Capital Medical University, Beijing 100020, China
Co-corresponding authors: Shao-Cheng Lyu and Ren Lang.
Author contributions: Zhang WH and Zhao Y collected the related papers and drafted the manuscript; Zhang WH, Zhao Y, Zhang CR and Huang JC collected data; Zhang WH, Lyu SC and Lang R contributed to conceiving the research, analyzing data and revised the manuscript; Lyu SC and Lang R provided administrative support; All authors read and approved the final manuscript.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Beijing Chao-Yang Hospital, No. 2024-D-511.
Informed consent statement: This study has been granted exemption from informed consent. All procedures and protocols were reviewed and approved by the Institutional Review Board (IRB) prior to the commencement of the study. The IRB determined that the study met the criteria for exemption under the federal regulations governing human subject’s research. We have followed all necessary ethical guidelines and regulations throughout the study.
Conflict-of-interest statement: All the Authors have no conflict of interest related to the manuscript.
Data sharing statement: All data and materials are available from the corresponding author.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ren Lang, MD, PhD, Director, Doctor, Professor, Department of Hepatobiliary Surgery, Beijing Chao-Yang Hospital Affiliated to Capital Medical University, No. 8 Gongti South Road, Chaoyang District, Beijing 100020, China. dr_langren@126.com
Received: July 3, 2024 Revised: August 5, 2024 Accepted: August 13, 2024 Published online: September 27, 2024 Processing time: 76 Days and 19.3 Hours
Abstract
BACKGROUND
The relationship between preoperative inflammation status and tumorigenesis as well as tumor progression is widely acknowledged.
AIM
To assess the prognostic significance of preoperative inflammatory biomarkers in patients with distal cholangiocarcinoma (dCCA) who underwent pancreatoduodenectomy (PD).
METHODS
This single-center study included 216 patients with dCCA after PD between January 1, 2011, and December 31, 2022. The individuals were categorized into two sets based on their systemic inflammatory response index (SIRI) levels: A low SIRI group (SIRI < 1.5, n = 123) and a high SIRI group (SIRI ≥ 1.5, n = 93). Inflammatory biomarkers were evaluated for predictive accuracy using receiver operating characteristic curves. Both univariate and multivariate Cox proportional hazards analyses were performed to estimate SIRI for overall survival (OS) and recurrence-free survival (RFS).
RESULTS
The study included a total of 216 patients, with 58.3% being male and a mean age of 65.6 ± 9.6 years. 123 patients were in the low SIRI group and 93 were in the high SIRI group after PD for dCCA. SIRI had an area under the curve value of 0.674 for diagnosing dCCA, showing better performance than other inflammatory biomarkers. Multivariate analysis indicated that having a SIRI greater than 1.5 independently increased the risk of dCCA following PD, leading to lower OS [hazard ratios (HR) = 1.868, P = 0.006] and RFS (HR = 0.949, P < 0.001). Additionally, survival analysis indicated a significantly better prognosis for patients in the low SIRI group (P < 0.001).
CONCLUSION
It is determined that a high SIRI before surgery is a significant risk factor for dCCA after PD.
Core Tip: The objective of this research was to evaluate the prognostic relevance of the systemic inflammatory response index (SIRI) in patients diagnosed with distal cholangiocarcinoma (dCCA) post-pancreatoduodenectomy (PD). A retrospective collection of all clinicopathological data was undertaken to further investigate the utility of SIRI in prognostication for dCCA patients post-PD. The results indicated that SIRI could potentially serve as a prognostic indicator for both overall survival and recurrence-free survival in dCCA patients following PD. Elevated levels of SIRI could predict recurrence and long-term survival in dCCA patients, thereby providing valuable guidance for treatment strategies.
