The prognostic value of systemic immune-inflammation index and prognostic nutritional index for colorectal cancer cases with liver metastasis post-transcatheter arterial chemoembolization.

[AIMS] This study aimed to evaluate the prognostic value of the systemic immune-inflammation index (SII) and prognostic nutritional index (PNI) for overall survival (OS) in colorectal cancer (CRC) patients with liver metastasis after transcatheter arterial chemoembolization (TACE).

[PATIENTS AND METHODS] A retrospective analysis of 270 CRC patients who underwent TACE was conducted. Baseline comparisons were made between survivors (n = 142) and non-survivors (n = 128) focusing on tumor size, AFP, SII, and PNI. Prognostic factors were analyzed using Cox regression, ROC curves, and Kaplan-Meier analysis.

[RESULTS] Significant differences in tumor size, AFP, SII, and PNI were found between the two groups. Multivariate Cox regression revealed that larger tumor size (HR = 1.110,  < 0.001), higher AFP (HR = 1.003,  < 0.001), and elevated SII (HR = 1.001,  < 0.001) were associated with poorer OS, while higher PNI (HR = 0.944,  < 0.001) was protective. ROC analysis yielded AUCs of 0.852 for SII and 0.876 for PNI, with a combined model improving to 0.948. Kaplan-Meier showed that high SII (≥1324.165) and low PNI (<40.915) were associated with poorer 3-year OS ( < 0.001).

[CONCLUSIONS] SII and PNI are valuable prognostic indicators for OS in CRC patients post-TACE. Elevated SII and reduced PNI predict worse outcomes, and their combination enhances survival prediction.