Aziz Ahmet SUREL, Serap ULUSOY, Muhammet Kadri ÇOLAKOĞLU

Pankreas kanseri hastalarında pankreatikoduodenektomi sonrası sistemik immün-inflamasyon indeksi ile uzun dönem mortalite arasındaki ilişki

Amaç: Sistemik immün inflamasyon (Sİİ) indeksi, kanser cerrahisi geçiren hastalarda umut verici prognostik bilgiler sağlayabilir. Pankreatikoduodenektomi yapılan pankreas kanseri tanılı hastalarda Sİİ indeksinin prognostik değeri daha önce araştırılmamıştır. Bu nedenle, bu çalışmada pankreatikoduodenektomi yapılan pankreas kanserli hastalarda Sİİ indeksinin prognostik değerini değerlendirmeyi amaçladık. Gereç ve Yöntem: 20 Şubat 2019 - 30 Haziran 2021 tarihleri arasında Ankara Şehir Hastanesi Genel Cerrahi Kliniği'nde pankreas kanseri nedeniyle pankreatikoduodenektomi yapılan 18 yaş üstü tüm hastalar çalışmaya dahil edildi. İlgilenilen ana belirteç, nötrofil*trombosit/lenfosit sayısı ile ölçülen Sİİ indeksiydi. Çalışmanın ana sonlanım noktası, tüm nedenlere bağlı uzun dönem mortaliteydi. Bulgular: Çalışmaya toplam 223 hasta dahil edildi. Çok değişkenli Cox regresyon analizi, konjestif kalp yetmezliği öyküsü [HR (%95 GA): 3.682 (1.140-11.892)] ve Sİİ indeksinin [HR (%95 GA): 1.001 (1.001-1.001)] uzun dönem mortalite ile bağımsız olarak ilişkili olduğunu gösterdi. Sİİ indeksinin mortalite öngörü doğruluğunu değerlendirmek için yapılan ROC analizinde eğri altında kalan alan 0.77 olarak belirlendi. Sİİ indeksinin 1305 ve üzerinde olmasının uzun dönem mortaliteyi öngörü duyarlılığı %76, özgüllüğü %67 olarak hesaplandı. Sonuçlar: Çalışmanın sonuçları, kolay elde edilebilen ve nispeten ucuz bir belirteç olan Sİİ indeksinin, pankreas kanseri tanılı hastalarda pankreatikoduodenektomi sonrası uzun dönem sağkalımı bağımsız olarak öngördürebilecek bir parametre olduğunu göstermektedir.

Anahtar Kelimeler:

inflamasyon, mortalite, pankreas kanseri, Sii indeksi

Association of systemic immune-inflammation index with long-term all-cause mortality in pancreatic cancer patients after pancreaticoduodenectomy

Aim: Systemic immune-inflammation (SII) index may provide more promising prognostic information in patients with cancer surgery. However, to the best of our knowledge, the prognostic value of SII index in patients with pancreatic cancer who underwent pancreaticoduodenectomy has not been studied. Thus, this study aimed to evaluate and compare the prognostic value of SII index in patients with pancreatic cancer who underwent pancreaticoduodenectomy. Materials and Methods: All patients over 18 years-old that underwent successful pancreaticoduodenectomy due to pancreatic cancer between February 20, 2019 and June 30, 2021 at Ankara City Hospital Department of General Surgery were included. The main predictor of interest was SII index which was measured by neutrophil*platelet / lymphocyte count. The main outcome of the study was long-term all-cause mortality. Results: A total of 223 patients were included in the current study. Multivariable cox regression analysis revealed that history of congestive heart failure [HR (95%CI): 3.682 (1.140-11.892)], and SII index [HR (95%CI): 1.001 (1.001-1.001)] were independently associated with all cause long-term mortality. The accuracy of predicting mortality for SII index was assessed by the area under the ROC curve which was = 0.77. A higher value of 1305 of SII index was found with 76% sensitivity and 67% specificity for predicting all-cause long-term mortality. Conclusions: The results of the study suggest that measurement of the SII index, an easily available and relatively cheap marker, is an independent predictor of long-term survival after pancreaticoduodenectomy in patients with pancreatic cancer.

Keywords:

inflammation, mortality, pancreatic cancer, SII index,

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