Application of systemic immune-inflammation index in survival prediction after radical resection of gallbladder cancer: A multicenter retrospective clinical study

Zhenhao Huang; Jixing Wang; Baoyong Zhou; Xiang Zhang; Rui Liao; Jie Xu; Peng Guo; Zhipeng Liu; Nan You; Rui Tao; Qihui Hu

doi:10.1016/j.ejso.2025.110267

Application of systemic immune-inflammation index in survival prediction after radical resection of gallbladder cancer: A multicenter retrospective clinical study

Eur J Surg Oncol. 2025 Jun 20;51(9):110267. doi: 10.1016/j.ejso.2025.110267. Online ahead of print.

Authors

Zhenhao Huang¹, Jixing Wang¹, Baoyong Zhou¹, Xiang Zhang¹, Rui Liao², Jie Xu³, Peng Guo⁴, Zhipeng Liu⁵, Nan You⁶, Rui Tao⁷, Qihui Hu⁸

Affiliations

¹ Department of Hepatopancreatobiliary Surgery, Bishan Hospital of Chongqing Medical University, Chongqing, 402760, China.
² Department of Hepatopancreatobiliary Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400042, China.
³ Department of Hepatopancreatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China.
⁴ Department of Hepatopancreatobiliary Surgery, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, 401120, China.
⁵ Department of Hepatopancreatobiliary Surgery, The First Affiliated Hospital of Army Medical University, Chongqing, 400038, China.
⁶ Department of Hepatopancreatobiliary Surgery, The Second Affiliated Hospital of Army Medical University, Chongqing, 400037, China.
⁷ Department of Hepatopancreatobiliary Surgery, Bishan Hospital of Chongqing Medical University, Chongqing, 402760, China. Electronic address: taoruihzh123@163.com.
⁸ Department of Hepatopancreatobiliary Surgery, Bishan Hospital of Chongqing Medical University, Chongqing, 402760, China. Electronic address: hqh6421@126.com.

PMID: 40570589
DOI: 10.1016/j.ejso.2025.110267

Abstract

Background: The Systemic Immune-Inflammation Index (SII) is a novel biomarker reflecting immune and inflammatory status, increasingly used for prognostic evaluation in various cancers. Its prognostic value in gallbladder cancer (GBC) remains unclear. This study investigates SII as a predictor of postoperative survival in GBC patients undergoing radical resection.

Methods: This retrospective study analyzed data from 210 GBC patients who underwent radical resection at six hospitals between 2015 and 2023. Time-dependent receiver operating characteristic (ROC) curve analysis was used to determine the optimal cutoff value of SII for assessing 1-year overall survival (OS). The relationships between SII and clinicopathological features were analyzed using Pearson's chi-square test and Fisher's exact test. Survival curves were plotted using the Kaplan-Meier method, with univariate analysis identifying prognostic factors. Independent prognostic factors were evaluated using multivariate Cox proportional hazards models.

Results: An SII cutoff of 590.105 stratified patients into low and high SII groups. High SII was significantly associated with worse OS and recurrence-free survival (RFS) (P < 0.05). Multivariate analysis identified SII, lymph node metastasis, and hemoglobin (Hb) as independent prognostic factors. The combined SII-Hb model (AUC = 0.774) demonstrated superior predictive performance compared to SII alone (AUC = 0.745).

Conclusions: This study indicates that a high SII value is a significant predictor of poor long-term prognosis in GBC patients. As a readily accessible biomarker, SII, when combined with Hb, enhances the predictive accuracy of postoperative survival assessment, providing a new tool and guidance for individualized management of GBC patients.

Keywords: Gallbladder cancer; Hemoglobin; Prognosis; Surgery; Systemic immune-inflammation index.