Prognostic impact of elevated pre-treatment systemic immune-inflammation index (SII) in hepatocellular carcinoma A meta-analysis

Background: There is a growing literature on the significance of systemic immune-inflammation index in hepatocellular carcinoma. However, the results were inconsistent due to the small sample size and different study endpoints. Therefore, the purpose of this study was to further systematically and comprehensively verify the prognostic role of the SII in HCC. Methods: Several databases were searched systematically, and relevant papers were selected. The main outcome measure was overall survival (OS); the secondary outcome measure was a composite of time to recurrence (TTR), progression-free survival (PFS), and recurrence-free survival (RFS). Results: Ten published retrospective studies involving 2796 HCC patients were included. The results revealed that elevated pre-treatment SII was related to lower OS (HR:1.54, P < .001) and earlier TTR (HR:1.77, P < .001). Conclusions: Elevated SII is a poor prognostic factor for patients with hepatocellular carcinoma. The clinical application of SII is encouraged to evaluate the progress of hepatocellular carcinoma.