Prognostic value of the systemic inflammation response index (SIRI) in glioma: A meta-analysis

Objective To systematically evaluate the predictive value of systemic inflammation response index (SIRI) for the prognosis of glioma patients. Methods PubMed, Cochrane Library, EMBASE, and Web of Science databases were searched to collect literature on the relationship between SIRI and glioma prognosis from database inception to July 2026. The primary outcome measures were overall survival (OS) and progression-free survival (PFS). STATA 15.0 and Review Manager 5.4 software were used, and random-effects models were employed with pooled hazard ratios (HR) and their 95% confidence intervals (CI) to assess the prognostic value of SIRI. Subgroup analyses, sensitivity analyses, and publication bias assessments were performed. Results Eight retrospective cohort studies involving 1778 glioma patients were included, forming 12 comparison groups for OS analysis and 4 comparison groups for PFS analysis. Meta-analysis results showed that a higher SIRI was significantly associated with poorer OS (pooled HR = 1.79, 95% CI: 1.34–2.38, P < 0.0001) and PFS (pooled HR = 1.46, 95% CI: 1.18–1.81, P = 0.0005) in glioma patients. Subgroup analysis showed that the prognostic value of SIRI for OS was not significant in the European population subgroup, suggesting that the association may be modulated by geographic region. Sensitivity analysis confirmed the robustness of the results. Egger’s test indicated publication bias in the OS analysis (P = 0.0001), but no significant bias was found in the PFS analysis. Conclusion This meta-analysis suggests that elevated SIRI is associated with poorer OS and PFS in glioma patients, although this association was not consistently observed across all subgroups, particularly in European populations. These findings highlight the need for further validation with standardized cut-off values in diverse populations.