Keywords
Cáncer anal, Inflamación sistémica, Relación neutrófilos linfocitos, Relación plaquetas linfocitos, Supervivencia, Pronóstico, Anal cancer, Systemic inflammation, Neutrophil lymphocyte ratio, Platelet lymphocyte ratio, Survival, Prognosis
Prognostic significance of systemic inflammatory indices in squamous cell carcinoma of the anal canal: A retrospective cohort study
Abstract
El carcinoma de células escamosas del canal anal es una neoplasia gastrointestinal rara con resultados heterogéneos pese a la quimiorradioterapia estandarizada. Este estudio retrospectivo evaluó el valor pronóstico de índices inflamatorios previos al tratamiento —relación neutrófilos/linfocitos (NLR), relación plaquetas/linfocitos (PLR) e índice de inmunoinflamación sistémica (SII)— en 243 pacientes tratados entre 2006 y 2023. Los índices elevados se asociaron significativamente con una menor supervivencia libre de enfermedad y supervivencia global. En el análisis multivariante, SII ≥980 predijo de forma independiente una peor supervivencia libre de enfermedad, mientras que NLR ≥4 y PLR ≥250 predijeron una peor supervivencia global. La afectación ganglionar y la ausencia de respuesta completa también fueron factores pronósticos relevantes. Estos marcadores, económicos y disponibles en análisis rutinarios, pueden complementar los factores clinicopatológicos establecidos para mejorar la estratificación basal del riesgo.
Squamous cell carcinoma of the anal canal is a rare gastrointestinal malignancy with heterogeneous outcomes despite standardized chemoradiotherapy. This retrospective cohort study assessed the prognostic value of pre-treatment inflammatory indices—the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation score (SII)—in 243 patients treated between 2006 and 2023. Elevated indices were significantly associated with reduced disease-free survival and overall survival. In multivariate analysis, SII ≥980 independently predicted poorer disease-free survival, whereas NLR ≥4 and PLR ≥250 independently predicted poorer overall survival. Lymph node involvement and absence of complete response were also important prognostic factors. These inexpensive markers, readily available from routine blood tests, may complement established clinicopathological factors and improve baseline risk stratification in patients with squamous cell carcinoma of the anal canal.
Squamous cell carcinoma of the anal canal is a rare gastrointestinal malignancy with heterogeneous outcomes despite standardized chemoradiotherapy. This retrospective cohort study assessed the prognostic value of pre-treatment inflammatory indices—the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation score (SII)—in 243 patients treated between 2006 and 2023. Elevated indices were significantly associated with reduced disease-free survival and overall survival. In multivariate analysis, SII ≥980 independently predicted poorer disease-free survival, whereas NLR ≥4 and PLR ≥250 independently predicted poorer overall survival. Lymph node involvement and absence of complete response were also important prognostic factors. These inexpensive markers, readily available from routine blood tests, may complement established clinicopathological factors and improve baseline risk stratification in patients with squamous cell carcinoma of the anal canal.
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