Background: The systemic inflammatory response can be reflected by hematological parameters, including the neutrophil tolymphocyte ratio (NLR), the monocyte-to-lymphocyte ration (MLR) and the platelet-to-lymphocyte ration (PLR). A new inflammatory index, called systemic immune-inflammatory index (SII) has been recently suggested to be associated with poor survival outcomes in many cancers. However, there is no study of SII index and inflammatory marker demonstrated survival outcomes and response of chemotherapy in advanced staged solid tumor. Therefore, these questions are necessary to evaluate the prognostic value of SII index and inflammatory markers.
Objective: The present study was performed to investigation the prognostic role of these marker index in this setting.
Materials and Methods: The authors retrospectively analyzed 354 patients who diagnosed advanced stage or recurrent disease of cancer patients who received palliative chemotherapy between 2014 and 2019. Patients clinicopathological parameters were recorded. The authors calculated inflammatory-based biomarker (SII index, NLR, MLR and PLR) and analyzed correlation of SII index and systemic inflammatory markers as prognosis value in term of progression free survival (PFS) and overall survival (OS).
Results: The 354 patients were included in the present study. Most of the tumor types were primary lung cancer (42.9%), breast cancer (16.1%) and colorectal cancer (14.1%). A high SII index was correlated with good PFS (HR = 0.998), p-value = 0.019. While high NLR, MLR and PLR were correlated with poor PFS (HR = 1.036, 2.024 and 1.015), p-value = 0.007, 0.001 and <0.001, respectively. Likewise, overall survival outcome had the same correlation result. ROC curves determine the same values of these inflammatory markers as prediction prognosis.
Conclusion: SII index, NLR, MLR and PLR are prognostic predictor in advanced stage solid tumor patients received chemotherapy. Higher SII index might be good prognosis marker in these setting. The low cost, feasible and reproducibility of these markers may be helpful as a prognostic tool.

Keywords: Advance cancer; Chemotherapy; Inflammatory markers; SII; NLR; MLR; PLR