Time-dependent prognostic value of perioperative changes in the systemic inflammation response index for overall survival in oral tongue squamous cell carcinoma: a retrospective cohort study.

OBJECTIVES

To investigate the association between perioperative changes in the systemic inflammation response index (SIRI) and overall survival (OS) in patients with oral tongue squamous cell carcinoma (OTSCC), with a focus on its time-dependent prognostic value.

MATERIALS AND

METHODS

This single-center retrospective cohort study included 264 patients with primary OTSCC who underwent curative-intent resection between June 2015 and February 2025. ΔSIRI was defined as postoperative SIRI minus preoperative SIRI. Time-dependent receiver operating characteristic (ROC) analysis was used to derive the ΔSIRI cutoff. Survival analyses included Kaplan-Meier curves, Cox regression, restricted mean survival time (RMST), and time-varying coefficient Cox models.

RESULTS

During follow-up, 70 deaths occurred. In multivariable Cox analysis, high ΔSIRI was significantly associated with poorer OS (adjusted hazard ratio [HR] = 2.13, 95% confidence interval [CI]: 1.24-3.67, P = 0.006). Adjusted RMST analysis showed an 8.02-month reduction in restricted mean survival time in the high ΔSIRI group within 60 months compared with the low ΔSIRI group (95% CI: - 12.76 to - 3.28, P < 0.001). The time-varying coefficient Cox model indicated that the adverse prognostic association of high ΔSIRI was most pronounced during the early follow-up period and gradually attenuated over time.

CONCLUSIONS

High perioperative ΔSIRI was associated with poorer OS in patients with OTSCC. ΔSIRI may serve as an adjunctive dynamic inflammatory-immune marker for early postoperative risk stratification, although external validation is warranted.

CLINICAL RELEVANCE: Perioperative ΔSIRI may provide supplementary information for identifying patients with OTSCC at higher early postoperative mortality risk.