{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T09:30:06Z","timestamp":1784799006416,"version":"3.55.0"},"reference-count":28,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Med Insights Oncol"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The systemic immune-inflammation index (SII) is an effective tool for predicting the prognosis of patients with cancer. However, its value in patients with locally advanced pancreatic ductal adenocarcinoma (LA-PDAC) undergoing definitive chemoradiotherapy has yet to be addressed. Therefore, we aimed to retrospectively investigate the prognostic significance of the pretreatment SII on the survival outcomes of patients with unresectable LA-PDAC treated with concurrent chemoradiotherapy (C-CRT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The study included 163 patients with LA-PDAC who had received C-CRT. Using receiver operating characteristic (ROC) curve analysis, the utility of a pre-C-CRT cutoff that could stratify survival results was investigated. The primary and secondary endpoints were the correlations between SII levels and overall survival (OS) and progression-free survival (PFS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>At a median follow-up period of 15\u2009months (range: 3.2-94.5), the median OS and PFS rates for the entire group were 15.7\u2009months (95% confidence interval [CI]: 13.4-17.9), and 7.8\u2009months (95% CI: 6.1-9.4), respectively. We divided the patients into 2 SII cohorts based on the ROC curve analysis (area under the curve [AUC]: 71.9%; sensitivity: 68.9%; specificity: 66.7%): SII\u2009&lt;\u2009538 (N\u2009=\u200970) and SII\u2009\u2a7e\u2009538 (N\u2009=\u200993). Comparative survival analysis showed significantly inferior median OS (13.0 vs 25.4\u2009months; P\u2009&lt;\u2009.001) and PFS (7.0 vs 15.2\u2009months; P\u2009=\u2009.003) in patients with SII\u2009\u2a7e\u2009538 compared with those with SII\u2009&lt;\u2009538 before treatment. In multivariate analyses, the Eastern Cooperative Oncology Group (ECOG) performance of 2, N1-2 lymph node, CA 19-9\u2009&gt;\u200990 U\/mL, and SII\u2009\u2a7e\u2009538 status emerged as independent prognosticators of inferior OS and PFS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Present results indicate that patients with unresectable LA-PDAC who underwent C-CRT and had a pretreatment SII\u2009\u2a7e\u2009538 had significantly worse OS and PFS outcomes compared with those with lower SII values.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11795549241298552","type":"journal-article","created":{"date-parts":[[2024,11,7]],"date-time":"2024-11-07T23:50:55Z","timestamp":1731023455000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["High Systemic Immune-Inflammation Index Values Before Treatment Predict Poor Pancreatic Cancer Outcomes After Definitive Chemoradiotherapy"],"prefix":"10.1177","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8120-7123","authenticated-orcid":false,"given":"Erkan","family":"Topkan","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Faculty of Medicine, Baskent University, Adana, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmet","family":"Kucuk","sequence":"additional","affiliation":[{"name":"Clinic of Radiation Oncology, Mersin Education and Research Hospital, Mersin, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duriye","family":"Ozturk","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9168-3756","authenticated-orcid":false,"given":"Emine Elif","family":"Ozkan","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Suleyman Demirel University, Isparta, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nil\u00fcfer","family":"K\u0131l\u0131\u00e7 Duranku\u015f","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Koc University School of Medicine, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u015e\u00fckran","family":"\u015eeny\u00fcrek","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Koc University School of Medicine, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ugur","family":"Selek","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Koc University School of Medicine, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berrin","family":"Pehlivan","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Bahcesehir University, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,11,7]]},"reference":[{"key":"bibr1-11795549241298552","doi-asserted-by":"publisher","DOI":"10.1053\/j.seminoncol.2007.05.007"},{"key":"bibr2-11795549241298552","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.4324"},{"key":"bibr3-11795549241298552","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1011923"},{"key":"bibr4-11795549241298552","doi-asserted-by":"publisher","DOI":"10.1093\/jjco\/hyaa198"},{"key":"bibr5-11795549241298552","doi-asserted-by":"publisher","DOI":"10.1155\/2021\/6647145"},{"key":"bibr6-11795549241298552","doi-asserted-by":"publisher","DOI":"10.1016\/j.pan.2016.03.006"},{"key":"bibr7-11795549241298552","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-012-2809-1"},{"key":"bibr8-11795549241298552","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2013.10.005"},{"key":"bibr9-11795549241298552","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2011-301008"},{"key":"bibr10-11795549241298552","doi-asserted-by":"publisher","DOI":"10.4103\/sjg.SJG_390_18"},{"key":"bibr11-11795549241298552","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-14-0442"},{"key":"bibr12-11795549241298552","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000002660"},{"key":"bibr13-11795549241298552","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-019-04187-z"},{"key":"bibr14-11795549241298552","doi-asserted-by":"publisher","DOI":"10.1016\/j.tranon.2020.100818"},{"key":"bibr15-11795549241298552","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-019-08094-0"},{"key":"bibr16-11795549241298552","doi-asserted-by":"publisher","DOI":"10.1186\/s12967-019-1782-x"},{"key":"bibr17-11795549241298552","first-page":"222","volume":"12","author":"Zhao Y","year":"2020","journal-title":"Chin J Oncol Prev Treat"},{"key":"bibr18-11795549241298552","doi-asserted-by":"publisher","DOI":"10.2147\/CMAR.S222297"},{"key":"bibr19-11795549241298552","doi-asserted-by":"publisher","DOI":"10.1016\/S0959-8049(99)00229-4"},{"key":"bibr20-11795549241298552","doi-asserted-by":"publisher","DOI":"10.1001\/jama.297.3.267"},{"key":"bibr21-11795549241298552","doi-asserted-by":"publisher","DOI":"10.21037\/atm-20-3499"},{"key":"bibr22-11795549241298552","first-page":"206","volume":"12","author":"Xu C","year":"2021","journal-title":"Chin J Hepatobiliary Sur"},{"key":"bibr23-11795549241298552","first-page":"222","volume":"12","author":"Zhao Y","year":"2020","journal-title":"Chin J Oncol Prev Treat"},{"key":"bibr24-11795549241298552","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2021.585271"},{"key":"bibr25-11795549241298552","doi-asserted-by":"publisher","DOI":"10.1016\/j.critrevonc.2017.06.002"},{"key":"bibr26-11795549241298552","doi-asserted-by":"publisher","DOI":"10.1042\/BSR20204401"},{"key":"bibr27-11795549241298552","doi-asserted-by":"publisher","DOI":"10.18632\/aging.203449"},{"key":"bibr28-11795549241298552","doi-asserted-by":"publisher","DOI":"10.1007\/s10238-021-00785-x"}],"container-title":["Clinical Medicine Insights: 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