Prognostic Value of Systemic Inflammation Markers and Clinical Factors in Grade 4 Diffuse Glioma: A Multicenter Retrospective Real-World Study.
5 affiliations
- 1Department of Medical Oncology, Antalya City Hospital, Antalya 07080, Türkiye.
- 2Department of Medical Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon 61080, Türkiye.
- 3Department of Medical Oncology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya 42080, Türkiye.
- 4Department of Medical Oncology, Adıyaman Training and Research Hospital, Adıyaman 02040, Türkiye.
- 5Department of Medical Oncology, Antalya Training and Research Hospital, Antalya 07100, Türkiye.
Abstract
Background/Objectives: Systemic inflammation contributes to tumor growth and spread. We aimed to evaluate the association of pretreatment inflammatory indices and clinical and laboratory factors with survival in newly diagnosed grade 4 diffuse glioma. Methods: A total of 120 patients diagnosed with grade 4 diffuse glioma at four centers between 2013 and 2026 were analyzed retrospectively. Nine indices derived from complete blood counts were calculated. Overall survival (OS) and progression-free survival (PFS) were analyzed with Kaplan-Meier and multivariable Cox regression. The cut-off for the systemic inflammation response index (SIRI) was determined with maximally selected rank statistics. Ten machine learning models were compared with the Cox model using repeated cross-validation. Results: Median follow-up was 70 months. Median OS was 22.8 months (95% confidence interval [CI] 15.8-26.3) and median PFS was 10.9 months (95% CI 9.1-14.4). In the multivariable model, SIRI > 2.85 was independently associated with OS (hazard ratio [HR] 2.62, 95% CI 1.38-4.96, p = 0.003), and this association persisted in the isocitrate dehydrogenase (IDH)-wildtype subgroup (HR 3.06, 95% CI 1.27-7.39, p = 0.013). Hemoglobin was independently associated with PFS (HR per g/dL 0.84, 95% CI 0.73-0.96, p = 0.011). Smoking was an independent indicator of poor prognosis for both OS (HR 2.02) and PFS (HR 1.73). Ki-67 and tumor size were not associated with survival. Machine learning models did not outperform the Cox model, and their variable importance rankings were consistent with the classical analysis. Conclusions: Pretreatment SIRI, hemoglobin, and smoking were independently associated with survival in grade 4 diffuse glioma. These markers are available from routine tests and may contribute to prognostic assessment.
Related
- Clinical utility of combining the C-reactive protein-to-albumin ratio and systemic immune-inflammation index for prognostic assessment in metastatic renal cell carcinoma
- Prognostic Significance and Clinical Robustness of the HALP Score in Super-Elderly Patients Undergoing Curative Gastrectomy for Gastric Cancer: A Multicenter Retrospective Cohort Study.
- The Predictive Value of the Systemic Immune‐Inflammation Index Combined With Clinical Stage for the Prognosis of Oesophageal Cancer Patients Treated With Radiotherapy: A Retrospective Cohort Study and Meta‐Analysis
- Prognostic value of systemic inflammation markers in advanced esophageal squamous cell carcinoma treated with second-line nivolumab: a real-world European study
- Association Among Systemic Immune-Inflammation Index, Vitamin D Status and Clinical Subtypes of ADHD: A Retrospective Investigation
BibTeX
@article{karancı2026prognostic,
title = {{Prognostic Value of Systemic Inflammation Markers and Clinical Factors in Grade 4 Diffuse Glioma: A Multicenter Retrospective Real-World Study.}},
author = {Ece Ulukal Karancı and Gamze Emin and Ahmet Oruç and Esma Uğuztemur and Atila Yıldırım and Melek Karakurt Eryılmaz and Asım Armağan Aydın},
journal = {Cancers},
year = {2026},
month = oct,
doi = {10.3390/cancers18193192},
url = {https://europepmc.org/article/MED/42882885},
note = {CC BY},
}
RIS
TY - JOUR
TI - Prognostic Value of Systemic Inflammation Markers and Clinical Factors in Grade 4 Diffuse Glioma: A Multicenter Retrospective Real-World Study.
AU - Ece Ulukal Karancı
AU - Gamze Emin
AU - Ahmet Oruç
AU - Esma Uğuztemur
AU - Atila Yıldırım
AU - Melek Karakurt Eryılmaz
AU - Asım Armağan Aydın
PY - 2026
DA - 2026/10/02
JO - Cancers
DO - 10.3390/cancers18193192
UR - https://europepmc.org/article/MED/42882885
AB - Background/Objectives: Systemic inflammation contributes to tumor growth and spread. We aimed to evaluate the association of pretreatment inflammatory indices and clinical and laboratory factors with survival in newly diagnosed grade 4 diffuse glioma. Methods: A total of 120 patients diagnosed with grade 4 diffuse glioma at four centers between 2013 and 2026 were analyzed retrospectively. Nine indices derived from complete blood counts were calculated. Overall survival (OS) and progression-free survival (PFS) were analyzed with Kaplan-Meier and multivariable Cox regression. The cut-off for the systemic inflammation response index (SIRI) was determined with maximally selected rank statistics. Ten machine learning models were compared with the Cox model using repeated cross-validation. Results: Median follow-up was 70 months. Median OS was 22.8 months (95% confidence interval [CI] 15.8-26.3) and median PFS was 10.9 months (95% CI 9.1-14.4). In the multivariable model, SIRI > 2.85 was independently associated with OS (hazard ratio [HR] 2.62, 95% CI 1.38-4.96, p = 0.003), and this association persisted in the isocitrate dehydrogenase (IDH)-wildtype subgroup (HR 3.06, 95% CI 1.27-7.39, p = 0.013). Hemoglobin was independently associated with PFS (HR per g/dL 0.84, 95% CI 0.73-0.96, p = 0.011). Smoking was an independent indicator of poor prognosis for both OS (HR 2.02) and PFS (HR 1.73). Ki-67 and tumor size were not associated with survival. Machine learning models did not outperform the Cox model, and their variable importance rankings were consistent with the classical analysis. Conclusions: Pretreatment SIRI, hemoglobin, and smoking were independently associated with survival in grade 4 diffuse glioma. These markers are available from routine tests and may contribute to prognostic assessment.
SN - 2072-6694
ER -