Prognostic Value of Systemic Immune-Inflammation Index in Patients with Testicular Cancer: A Retrospective Case-Control Study

Objective: The primary aim of this study was to evaluate the correlation between the systemic immune-inflammation index (SII) and clinicopathological outcomes of patients with testicular cancer (TCa).The secondary aim was to evaluate the relation of SII with overall survival (OS).Materials and Methods: A total of 244 patients were included in the study.Patients were divided into the testicular tumor (group 1, n=184) and control group (group 2, n=60).Preoperative complete blood count, tumor markers, and imaging tests of the patients in group 1 were recorded.A subgroup analysis was performed according to the clinical stage, pathological stage, tumor type, and tumor size.Then, the effectiveness of TCa on SII was evaluated among the groups.Results: A significant difference was observed between the SII, neutrophil, and neutrophil-to-lymphocyte ratios between groups 1 and 2. The median SII was 719.92 in group 1 and 510.93 in group 2 (p<0.001).In the subgroup analysis, the median SII value was higher in patients with advanced disease stage and metastasis (p<0.001).In the receiver operating characteristics curve analysis, the area under the curve was 0.784, and the SII cut-off point was 719, with a sensitivity of 81% and specificity of 65.4%.The median follow-up time was 55 (interquartile range, 8-132) months.Ten patients died of TCa.In the multivariable analysis, SII (7.6-fold increase; p=0.005) and presence of metastasis (4.3-fold increase; p=0.001) were independent predictors of OS.Conclusion: SII can be an important marker in the diagnosis and follow-up of TCa.However, SII needs to be evaluated using larger data, especially in the risk assessment in TCa.