• Arsalan A Khan, Savan K Shah, Sanjib Basu, Gillian C Alex, Michael J Liptay, Nicole M Geissen, and Christopher W Seder.
• Department of Cardiovascular and Thoracic Surgery, Rush University Medical Center, Chicago, Illinois, USA.
• J. Am. Coll. Surg. 2024 Nov 15.

BackgroundIt has been proposed that more aggressive tumors trigger a stronger inflammatory response than less aggressive types. We hypothesize that systemic immune inflammatory index (SII) is associated with occult nodal disease (OND) in clinically node negative (cN0) patients undergoing lung resection for non-small cell lung cancer (NSCLC).Study DesignThe study included patients who underwent lung resection with nodal dissection, according to current guidelines, at a single center between 2010-2021 for NSCLC. Pre-operative SII within three weeks of surgery, was calculated. OND was defined as a clinically node-negative patient found to be pathologically node-positive. Cut-point analysis for SII was performed to identify the level most strongly associated with OND. Univariable and multivariable logistic regressions were used to examine the association between SII, clinical factors, and OND.ResultsA total of 199 patients met inclusion criteria, of which 51% (102/199) were female. The median number of nodes and nodal stations examined was 13 (IQR 9-17) and 6 (IQR 5-6), respectively. The cut-point was determined to be SII ≥112. On univariable analysis, high SII was associated with OND (OR 15.75, CI 2.09-118.73, p=0.007). On multivariable analysis, after controlling for age, BMI, approach, gender, pack years, FEV1, performance status, comorbidities, histology, lymphovascular invasion, tumor differentiation and tumor size, high SII was associated with OND (OR 34.59, CI 2.69-444.88, p=0.007).ConclusionIncreased SII is associated with OND in patients undergoing lung resection for NSCLC.Copyright © 2024 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

4 keywords...

hide…