Systemic immune-inflammation index and lymphocyte-to-monocyte ratio predict recurrence after radical surgery for stage I/II endometrial cancer

Early-stage endometrial cancer (stage I/II) is often treated successfully with radical surgery, but recurrence remains a concern in some patients. Identifying reliable biomarkers for recurrence risk is essential for improving post-surgical management. This study investigated the prognostic significance of systemic immune-inflammation index (SII) and lymphocyte-to-monocyte ratio (LMR) in predicting recurrence after radical surgery for stage I/II endometrial cancer. This retrospective cohort study analyzed 950 patients who underwent radical surgery for stage I/II endometrial cancer between March 2015 and October 2024. Patients were classified into recurrence (n=95) and non-recurrence (n=855) groups. The predictive value of LMR and SII was assessed using logistic regression. Predictive accuracies were evaluated using the area under the curve (AUC). Additionally, an external validation cohort consisting of 495 patients, who met the same inclusion criteria, was used to further validate the predictive model. LMR and SII were significantly associated with cancer recurrence. High SII and low LMR were predominantly observed in the recurrence group, demonstrating substantial predictive power. Multivariate logistic regression revealed that LMR was the strongest independent predictor of recurrence (OR=1.795, 95% CI, 1.417-2.274). The combined model of LMR and SII achieved an AUC of 0.876, highlighting its excellent predictive performance. SII and LMR are valuable systemic immune-inflammation indices for predicting recurrence in stage I/II endometrial cancer patients after radical surgery.