Prognostic significance of systemic inflammation score in patients who undergo hepatic resection for hepatocellular carcinoma

Shoichi Inokuchi, Shinji Itoh, Tomoharu Yoshizumi, Akinari Morinaga, Takeo Toshima, Kazuki Takeishi, Yoshihiro Nagao, Noboru Harada, Toru Ikegami, Mototsugu Shimokawa, Masaki Mori

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)


Purpose: Systemic inflammation score (SIS) is a novel prognostic score (0, 1, or 2) for various cancers, based on preoperative serum albumin level and lymphocyte-to-monocyte ratio (LMR); modified SIS (mSIS) uses a different LMR cutoff value and was thought to be a more accurate predictor for cancer prognosis. Here, we assessed the prognostic value of SIS and mSIS in patients who receive hepatic resection for hepatocellular carcinoma (HCC). Methods: We retrospectively evaluated SIS and mSIS of 314 patients after hepatic resection for HCC, against their clinicopathological factors and outcomes, using receiver operating characteristics (ROC) analysis over time. Results: Among patients with preoperative SIS 2, significantly more HCC specimens were poorly differentiated (P = 0.0281), larger (P = 0.0006), and had more microscopic vascular invasion (P = 0.0136) than the SIS 0–1 group; the mSIS 2 group also had significantly larger tumors (P = 0.0039) than the mSIS 0–1 group. In ROC analysis, SIS was a better predictor of overall survival (OS) and recurrence-free survival (RFS) than mSIS. The SIS 2 group had shorter OS (P = 0.0015) and RFS (P = 0.0065) than other patients. In multivariate analysis, SIS 2 was an independent risk factor for shorter OS (hazard ratio (HR) 1.53, P = 0.0497) and RFS (HR 1.58, P = 0.0053). Conclusion: SIS is superior to mSIS in predicting prognosis of patients with HCC. mSIS is not a great predictor of prognosis in resected HCC.

Original languageEnglish
Pages (from-to)773-779
Number of pages7
JournalLangenbeck's Archives of Surgery
Issue number3
Publication statusPublished - May 2021

All Science Journal Classification (ASJC) codes

  • Surgery


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