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Introduction <p>Biliary tract cancers (BTC) are aggressive malignancies where systemic inflammation significantly influences tumor progression. This study evaluates the Systemic Immune-Inflammation Index (SII) as a prognostic tool for short- and long-term outcomes in patients undergoing curative-intent resection.</p> Materials and Methods <p>We retrospectively reviewed 27 patients with non-metastatic BTC (2018–2023). SII was calculated as PlateletsxNeutrophils/Lymphocytes. ROC curve analysis identified an optimal SII cutoff correlating with severe postoperative complications (Clavien-Dindo ≥ 3). Survival outcomes (OS and DFS) were analyzed using Kaplan-Meier and Cox regression models.</p> Results <p>The cohort was 63% male with a mean age of 58.2 years; hilar cholangiocarcinoma was the most common diagnosis (37.1%). The mean SII was 845.1. ROC analysis established an SII cutoff of 380.3 (AUC: 0.768, sensitivity: 79.7%, specificity: 74.8%) for predicting severe complications. Median OS and DFS were 30.3 and 28.2 months, respectively. On univariable analysis, preoperative biliary drainage (HR: 10.87) and severe complications (HR: 9.59) significantly correlated with OS, though neither maintained significance in multivariable analysis. No direct significant correlation was found between SII and long-term survival (HR 0.52).</p> Conclusion <p>A preoperative SII &gt; 380.3 is a significant predictor of severe postoperative complications in resected BTC. While direct survival correlation was not reached—likely due to sample size—the SII serves as a simple, accessible tool for perioperative risk stratification. Larger prospective trials are warranted to clarify its long-term prognostic value.</p>

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The Prognostic Role of Systemic Immune-Inflammation Index on Long and Short Term Outcomes in Patients Undergoing Curative Surgery for Biliary Tract Cancers

  • 期刊论文

  • 发表日期：

    2026年4月11日

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  • Ashwin Krishnamoorthy,
  • Madhu Muralee,
  • Subhash Raveendran,
  • Chandramohan K,
  • Mira Wagh,
  • Anand Hari

摘要

Introduction

Biliary tract cancers (BTC) are aggressive malignancies where systemic inflammation significantly influences tumor progression. This study evaluates the Systemic Immune-Inflammation Index (SII) as a prognostic tool for short- and long-term outcomes in patients undergoing curative-intent resection.

Materials and Methods

We retrospectively reviewed 27 patients with non-metastatic BTC (2018–2023). SII was calculated as PlateletsxNeutrophils/Lymphocytes. ROC curve analysis identified an optimal SII cutoff correlating with severe postoperative complications (Clavien-Dindo ≥ 3). Survival outcomes (OS and DFS) were analyzed using Kaplan-Meier and Cox regression models.

Results

The cohort was 63% male with a mean age of 58.2 years; hilar cholangiocarcinoma was the most common diagnosis (37.1%). The mean SII was 845.1. ROC analysis established an SII cutoff of 380.3 (AUC: 0.768, sensitivity: 79.7%, specificity: 74.8%) for predicting severe complications. Median OS and DFS were 30.3 and 28.2 months, respectively. On univariable analysis, preoperative biliary drainage (HR: 10.87) and severe complications (HR: 9.59) significantly correlated with OS, though neither maintained significance in multivariable analysis. No direct significant correlation was found between SII and long-term survival (HR 0.52).

Conclusion

A preoperative SII > 380.3 is a significant predictor of severe postoperative complications in resected BTC. While direct survival correlation was not reached—likely due to sample size—the SII serves as a simple, accessible tool for perioperative risk stratification. Larger prospective trials are warranted to clarify its long-term prognostic value.