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Systemic Inflammation Linked to Shorter Mesothelioma Survival

systemic inflammation

Mesothelioma patients whose bodies respond to the illness with systemic inflammation are less likely to survive.

Chinese researchers have linked a measure of systemic inflammation called SII to shorter survival in people with pleural mesothelioma.

The new study involved 97 people with confirmed malignant mesothelioma. It suggests that SII could be a simple, non-invasive way to determine mesothelioma prognosis.

What is SII?

SII stands for “systemic immune-inflammation index”. When a body is under stress, such as when it is fighting mesothelioma, the innate immune system kicks into action. Certain kinds of white blood cells and proteins are released. The result is systemic inflammation.

SII can be determined with a blood test. The test measures the levels of white blood cells called lymphocytes and neutrophils. It also measures blood platelets. High SSI has been linked to poor prognosis in many different kinds of cancer.

Systemic Inflammation in Mesothelioma Patients

Pleural mesothelioma is a type of cancer that grows on the lining around the lungs. It is usually caused by exposure to asbestos. Many people do not know that they have mesothelioma until the disease is in an advanced stage.

There is no cure for mesothelioma. While most people diagnosed with mesothelioma do not live more than a year, others live for many years. Mesothelioma survivor Paul Kraus is one example.

Right now, doctors do not have a simple way to predict which patients are likely to survive mesothelioma. The Chinese study suggests that measuring systemic inflammation with an SII test could help.

SSI is Related to Mesothelioma Survival

The Chinese researchers analyzed the medical records of 97 mesothelioma patients. They compared each patient’s length of survival with their pretreatment level of systemic inflammation.

Forty-four patients had high SII and 53 had low SII. The median overall mesothelioma survival for all study participants was 18.5 months. But there was a big difference between mesothelioma patients with high levels of systemic inflammation and those with low levels.

Mesothelioma patients with low SII had a median survival of 47 months. The median survival for patients with high SII was 13 months.

Eighty-five percent of mesothelioma patients in the low SII category were still alive a year later and half lived for at least three years. Only 13.8 percent of mesothelioma patients with high systemic inflammation were still alive at three years.

The longest living mesothelioma patients in the study had good overall health and a low SII. They also received adjuvant treatment. Adjuvant treatment is additional treatment given after the primary mesothelioma therapy to keep cancer from coming back.

The researchers conclude that it is easy and efficient to test mesothelioma patients for signs of systemic inflammation.

“High SII represents an unfavorable independent prognostic factor of MPM, and this needs to be validated in further studies,” writes lead study author Ming Ma.

The new study appears in Cancer Management and Research.


Ma, M, et al, “High systemic immune-inflammation index represents an unfavorable prognosis of malignant pleural mesothelioma”, May 2, 2019, Cancer Management and Research, eCollection 2019, https://www.dovepress.com/high-systemic-immune-inflammation-index-represents-an-unfavorable-prog-peer-reviewed-article-CMAR

Yang, R, et al, “Prognostic value of Systemic immune-inflammation index in cancer: A meta-analysis”, 2018, Journal of Cancer, pp. 3295-3302, http://www.jcancer.org/v09p3295.htm

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