ArticleRare tumors2026
Prognostic significance of systemic inflammatory indices in squamous cell carcinoma of the anal canal: A retrospective cohort study.
Article in Rare tumors, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Squamous cell carcinoma of the anal canal is a rare gastrointestinal malignancy with heterogeneous outcomes despite standardized chemoradiotherapy. Systemic inflammation has been implicated in tumor progression, and hematological indices such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation score (SII) have emerged as potential prognostic markers. This study aimed to assess the prognostic significance of pre-treatment inflammatory indices (NLR, PLR, SII) for disease-free survival (DFS) and overall survival (OS). Methods: This retrospective cohort study included 243 adult patients treated between 2006 and 2023 with combined chemoradiotherapy (5-fluorouracil and mitomycin C). Inflammatory indices were calculated from baseline laboratory values. Optimal cut-offs were determined using ROC analysis. Survival was evaluated using Kaplan-Meier curves and log-rank tests. Independent prognostic factors were identified through multivariate Cox regression. Results: Elevated indices were frequent (NLR ≥4: 56.8%; PLR ≥250: 47.7%; SII ≥980: 52.3%). Higher NLR, PLR, and SII were significantly associated with reduced DFS and OS (p < 0.05). In multivariate analysis, lymph node involvement (HR 1.94; p = 0.003), SII ≥980 (HR 2.01; p = 0.013), and absence of complete response (HR 5.67; p < 0.001) independently predicted poorer DFS. For OS, ECOG ≥1 (HR 2.70; p = 0.005), lymph node involvement (HR 3.45; p = 0.001), absence of complete response (HR 4.21; p < 0.001), NLR ≥4 (HR 2.47; p = 0.049), and PLR ≥250 (HR 3.28; p = 0.006) were independent predictors. Conclusion: Pre-treatment inflammatory indices provide significant prognostic information in squamous cell carcinoma of the anal canal and may enhance baseline risk stratification alongside established clinical factors.
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