Prognostic Value of Preoperative Systemic Immune-Inflammation Index in Non-Metastatic Paediatric Wilms' Tumour Patients Undergoing Upfront Radical Nephrectomy.

Kai Sai, Yi-Bo Ding, Qun Gao
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Abstract

Objective: To analyse the relationship between the preoperative systemic immune-inflammation index (SII) and the relapse-free survival (RFS) of paediatric patients with Wilms' tumour (WT) after radical surgery, and to establish and validate a prognostic survival model.

Study design: Observational study. Place and Duration of the Study: Department of Oncologic Surgery, Anhui Children's Hospital of Fudan University, Hefei, China, from January 2013 to August 2023.

Methodology: A retrospective analysis was conducted on 79 WT patients treated with radical resection, with their preoperative SII values computed. The best cut-off for SII was determined through the ROC curve, categorising patients into high and low SII groups. The Kaplan-Meier method and Cox-regression were used for survival analysis. A survival prognostic model was constructed and its predictive capability gauged (AUC of the ROC).

Results: The study included 79 WT patients with a median RFS of 65 months and an average of 75.5 ± 3.4 months. The optimal cut-off value for SII was 534.95. The low SII group had a higher RFS (Log-rank: χ2 = 9.380, p = 0.002). Preoperative SII (HR = 3.277, 95% CI: 1.167 - 9.200, p = 0.024), clinical staging (HR = 8.408, 95% CI: 2.604 - 27.147, p <0.001), and tissue differentiation (HR = 2.237, 95% CI: 1.043 - 5.828, p = 0.039) were independent risk factors for RFS. The model's diagnostic performance was 0.749 (95% CI: 0.636 - 0.861). Internal validation showed an AUC of 0.723 (95% CI: 0.608 - 0.838).

Conclusion: Lower preoperative SII suggests a more favourable prognosis. The SII-based nomogram efficiently forecasts post-radical surgery prognosis for WT.

Key words: Wilms' Tumour, Systemic immune-inflammation index, Relapse-free survival, Nomogram.

接受前期根治性肾切除术的非转移性儿科 Wilms' 肿瘤患者术前全身免疫炎症指数的预后价值
研究目的分析Wilms'肿瘤(WT)儿科患者术前全身免疫炎症指数(SII)与根治术后无复发生存率(RFS)之间的关系,并建立和验证预后生存模型:观察性研究。研究地点和时间研究地点和时间:中国合肥复旦大学附属安徽儿童医院肿瘤外科,2013年1月至2023年8月:对79例接受根治性切除术的WT患者进行回顾性分析,计算其术前SII值。通过ROC曲线确定SII的最佳临界值,将患者分为高SII组和低SII组。采用 Kaplan-Meier 法和 Cox 回归法进行生存分析。构建了生存预后模型,并对其预测能力(ROC 的 AUC)进行了评估:研究共纳入 79 例 WT 患者,中位 RFS 为 65 个月,平均为(75.5 ± 3.4)个月。SII 的最佳临界值为 534.95。低 SII 组的 RFS 较高(Log-rank:χ2 = 9.380,P = 0.002)。术前 SII(HR = 3.277,95% CI:1.167 - 9.200,P = 0.024)、临床分期(HR = 8.408,95% CI:2.604 - 27.147,P 结论:术前 SII 值越低,预后越好。基于SII的提名图能有效预测WT根治术后的预后:Wilms' Tumour 全身免疫炎症指数 无复发生存期 直方图
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