Systemic inflammatory response index is a predictor of prognosis in gastric cancer patients: Retrospective cohort and meta-analysis

Table 1 The fundamental description of the inclusion studies

Population	Patients	Included years	Detection method	Cut-off value	Survival type (analysis type)	Treatments	Follow- up	HR	LL	UL	NOS score
Localized or regional gastric cancer	782	2007-2009/2010-2011	ROC analysis	0.82	DFS/DSS	With surgery	≥ 5 yr	DFS 2.529	DFS 1.922	DFS 3.326	7
Gastric cancer	594	2011-2016	ROC analysis	0.85	OS	With surgery	≥ 5 yr	OS 2.06	OS 1.6	OS 2.66	8
Respectable gastric cancer	240	2007-2016	X-tile	1.2	DFS/OS	With surgery	≥ 5 yr	OS 1.999/DFS 1.964	OS 1.387/DFS 1.363	OS 2.881/DFS 2.828	8
Locally advanced gastric cancer	89	2010-2018	ROC analysis	0.58	DFS	With surgery and adjuvant chemoradiotherapy	< 5 yr	DFS 3.002	DFS 0.912	DFS 9.882	7
Received neoadjuvant chemotherapy gastric cancer	107	2007-2015	ROC analysis	1.21	DFS/OS	With neoadjuvant chemotherapy and surgery	≥ 5 yr	OS 3.331/DFS 3.437	OS 1.001/DFS 1.059	OS 11.082/DFS 11.149	8
Adenocarcinoma of the esophagogastric junction	302	2008-2010	ROC analysis	0.68	OS	With neoadjuvant chemotherapy and surgery	≥ 5 yr	OS 1.9	OS 1.36	OS 2.64	8

OS: Overall survival; DFS: Disease-free survival; ROC: Receiver operating characteristic; NOS: Newcastle-Ottawa Scale; HR: Hazard ratios; LL: Lower limit; UL: Upper limit.

Table 2 Patient baseline characteristics and their correlations with systemic inflammatory response index level after robotic gastrectomy

Variables		SIRI ≤ 1.38 (n = 106)	SIRI > 1.38 (n = 55)	P value
Gender				0.0791
	Male	80	48
	Female	26	7
Age (yr)		60.80 (12)	63.71 (14)	0.0582
Underlying disease	No	91	37	0.0061
	Yes	15	18
BMI		22.36 (4.7)	22.19 (4.2)	0.7652
Tumor location	Upper third	12	7	0.9381
	Middle third	9	4
	Lower third	85	44
Tumor dimensions (cm)				0.0561
	< 3	32	9
	≥ 3	74	46
Differentiation				0.1661
	Moderate and poor	101	55
	Well	5	0
T stage				0.0151
	T1	17	4
	T2	11	0
	T3	53	31
	T4	25	20
N stage				0.3381
	N0	40	13
	N1	19	11
	N2	13	9
	N3	34	22
TNM stage				0.0861
	I	22	4
	II	31	18
	III	53	33
Operation				0.4471
	Subtotal gastrectomy	51	23
	Total gastrectomy	55	32
Operation time (minutes)
ASA				0.7961
	I-II	95	50
	III-IV	11	5
Perioperative transfusion				0.141
	No	86	39
	Yes	20	16
CA199 (ng/mL)				0.0771
	Negative	91	41
	Positive	15	14
CEA (ng/mL)				0.0031
	Negative	88	34
	Positive	18	21
Blood loss (mL)				0.0531
	< 200	79	31
	200 ≤ X ≤ 400	24	20
	> 400	3	4
Postoperative complication				0.0011
	No	99	41
	Yes	7	14
Postoperative chemotherapy				0.9251
	No	32	17
	Yes	74	38
P53				0.7621
	Wild	36	20
	Mutant	70	35
Ki-67				0.7721
	0%-49%	7	5
	50%-74%	34	19
	75%-100%	65	31
Her-2				0.7741
	Negative	99	52
	Positive	7	3
Lymph node metastasis rate (%)				0.0231
	0.00%	42	12
	> 0.00%	64	43
Enteral nutrition time				0.3181
	≤ 7 d	73	42
	> 7 d	33	13
Duration of surgery (minutes)		267.3 (90)	269.7 (60)	0.8012
Length of hospitalization (days)		17.89 (5)	18.04 (6)	0.8762

¹χ² test.

²Mann-Whitney U test with median (interquartile range).

The bold numbers in the tables are P values with statistical significance (< 0.05). SIRI: Systemic inflammation response index; BMI: Body mass index; ASA: American society of anesthesiology; CA199: Carbohydrate antigen 199; CEA: Carcinoembryonic antigen; TNM: Tumor-node-metastasis.

Table 3 Univariate and multivariate Cox regression analyses for overall survival in patients with robotic gastrectomy

Variables		Univariate analysis			Multivariate analysis
		HR	95%CI value	P value	HR	95%CI	P value
Gender	Male/female	0.743	0.400-1.379	0.346
Age (yr)		1.05	1.023-1.077	< 0.001	1.067	1.035-1.099	< 0.001
Underlying disease	No/yes	1.307	0.759-2.248	0.334
BMI		0.98	0.915-1.048	0.553
Tumor location				0.264
	Upper third	Ref
	Middle third	0.434	0.117-1.604	0.211
	Lower third	1.13	0.379-2.274	0.733
Tumor dimensions (cm)	< 3/≥ 3	0.494	0.266-0.917	0.025	0.672	0.338-1.338	0.258
Differentiation	Moderate and poor/well	0.047	0.000-11.342	0.275
TNM stage				0.005			0.025
	I	Ref			Ref
	II	3.77	1.264-8.709	0.042	3.03	1.243-7.984	0.047
	III	5.695	2.181-9.845	0.001	5.68	2.161-9.541	0.01
Operation	Subtotal gastrectomy /total gastrectomy	1.423	0.893-2.269	0.138
ASA	I-II/III-IV	1.118	0.535-2.336	0.767
Perioperative transfusion	No/yes	1.58	0.959-2.603	0.073
Blood loss (mL)	> 200 mL/≤ 200 mL	1.763	1.109-2.803	0.016	1.498	0.914-2.458	0.109
Operation time (minutes)		1.001	0.997-1.004	0.938
CA199 (ng/mL)	Negative/positive	1.347	0.780-2.327	0.286
CEA (ng/mL)	Negative/positive	2.473	1.543-3.963	< 0.001	1.266	0.76-2.108	0.365
Postoperative complication	No/yes	4.787	2.846-8.052	< 0.001	7.244	3.780-13.781	< 0.001
Postoperative chemotherapy	No/yes	2.929	1.543-5.562	0.001	1.298	0.649-2.597	0.461
P53	Wild/Mutant	0.728	0.455-1.165	0.186	0.392	0.231-0.663	< 0.001
Ki-67				0.137			0.003
	0%-49%	Ref			Ref
	50%-74%	1.137	0.471-2.743	0.775	2.088	0.822-5.303	0.121
	75%-100%	0.702	0.297-1.661	0.421	0.788	0.321-1.932	0.603
Her-2	Negative/positive	0.321	0.079-1.310	0.113
Lymph node metastasis rate (%)	< 4.6%/≥ 4.6%	5.943	2.845-12.414	< 0.001	2.266	0.897-5.724	0.083
Enteral nutrition time		1.023	0.965-1.186	0.443
Length of hospitalization (days)		1.032	0.995-1.070	0.092
SIRI	≤ 1.38/> 1.38	3.787	2.376-6.034	< 0.001	2.696	1.579-4.404	< 0.001

The bold numbers in the tables are P values with statistical significance (< 0.05). OS: Overall survival; BMI: Body mass index; ASA: American society of anesthesiology; CA199: Carbohydrate antigen 199; CEA: Carcinoembryonic antigen; SIRI: Systemic inflammation response index; TNM: Tumor-node-metastasis.