Systemic Inflammation with Sarcopenia Predict Survival in Patients with Gastric

Objective: The levels of platelet-related inflammation indicators and sarcopenia have been reported to affect the survival of patients with cancer. To evaluate the prognostic influence of platelet count (PLT), platelet–lymphocyte ratio (PLR), and systemic immune inflammation index (SII), and SII combined with sarcopenia on the survival of patients with gastric cancer (GC).Methods: A total of 1131 patients with GC (811 men and 320 women, average age: 59.45 years) were evaluated. Receiver operating characteristic curves were used to determine the best cut-off values of PLT, PLR, and SII, and univariate and multivariate Cox risk regression models were used to evaluate whether SII is an independent predictor of overall survival (OS). The prognostic SS (SII-sarcopenia) was established based on SII and sarcopenia. Finally, a comprehensive analysis of the prognostic SS was performed. Results: SII had the strongest prognostic effect. The SII and OS of patients with GC were in an inverted U-shape (adjusted HR = 1.06; 95% CI: 0.95-1.18; adjusted P = 0.271). In patients with SII >1800, SII was negatively correlated with OS (adjusted HR = 0.57; 95% CI: 0.29-1.12; adjusted P = 0.102), however, there is no statistical difference. Interestingly, a high SS was associated with a poorer prognosis. The higher the SS score, the worse the OS (PConclusion: SII is an independent prognostic indicator of GC, and high SII is related to poor prognosis. A Higher SS score had worse survival. Thus, the prognostic SS is a reliable predictor of OS in patients with GC.