Effect of combined systemic inflammatory score on the treatment response and prognosis in hepatopancreatobiliary system cancer patients who applied systemic therapy

Objective: We aimed to evaluate the effect of Systemic Inflammatory Response (SIR) and Combined Systemic Inflammation Score (cSIS) on treatment response and prognosis in patients with hepatopancreaticobiliary system cancer receiving systemic therapy. Method: Our study included patients with hepatopancreaticobiliary system cancer, over 18 years of age, who were followed up and treated at Dokuz Eylul University, Faculty of Medicine, Department of Internal Medicine, Department of Medical Oncology between 01.01.2010 and 31.12.2019, received systemic treatment. was done. LMR, NLR, CRP and mGPS were evaluated as SIR markers. SIS was calculated from these values: One score was given for each positive SIR marker; (LMR < 2.8, NLR > 5, CRP > 5 mg/dl and mGPS > 0) patients were divided into five sub-prognostic groups: those who scored 0, 1, 2, 3 and 4. The Combined Systemic Inflammation Score (cSIS) was determined by regrouping 0-1 points (good prognostic group) vs. 2-4 points (poor prognostic group). With SIR markers, SIS and cSIS values were evaluated before, 3 months and 6 months after treatment, and the effects of these markers on treatment response and survival were analyzed. Results: A total of 116 patients with hepatopancreaticobiliary system cancer were evaluated. Of these, 44 had pancreatic cancer, 41 had hepatocellular cancer, and 31 had gallbladder and biliary tract cancer. In patients with gallbladder and biliary tract cancer, high LMR level at 3rd month affected the first-line systemic treatment response positively, while high 3rd month mGPS negatively affected. It was observed that cSIS at 6 months in patients with HCC, and cSIS, which was checked before treatment in patients with gallbladder and bile duct cancer, had a significant effect on the treatment response. Only 3rd month mGPS was associated with survival in patients with early stage pancreatic cancer; It was observed that the 6th month NLR and mGPS values at every three months had significant effects on survival in locally advanced patients. It was found that mGPS had a significant effect in patients with HCC and gallbladder and bile duct cancer. In patients with pancreatic cancer, cSIS values measured in the whole group were found to be associated with survival before treatment and at the 3rd month of treatment. It was observed that patients in the good prognostic group had longer survival. It was observed that it had a significant effect in patients with early-stage gallbladder and biliary tract cancer. Conclusion: The use of combined prognostic markers in the prediction of treatment response and prognosis in patients with hepatopancreaticobiliary system cancer may guide both the follow-up of the patients and the planning of appropriate treatment. Keywords: Hepatopancreaticobiliary system cancer, inflammation, systemic inflammatory response, systemic inflammation score