Improving Prognostic Prediction in Head and Neck Cancer Through a Combined Systemic Immune-Inflammation Index and Prognostic Nutritional Index Score

This study evaluated whether a composite index combining the systemic immune-inflammation index (SII) and prognostic nutritional index (PNI), the coSII-PNI score, enhances prognostic prediction in head and neck cancer. We retrospectively evaluated 166 patients who underwent curative surgery between 2015 and 2023. Patients were stratified into three groups according to the coSII-PNI score (range, 0-2) derived from preoperative blood data. The optimal cutoff values for SII and PNI were 743 and 49, respectively. A significant correlation was observed between the SII and PNI (r = -0.386, <i>p</i> < 0.01). Patients with a high coSII-PNI score (low SII + high PNI) showed significantly better disease-free and overall survival than those with lower scores (both <i>p</i> < 0.01). The areas under the curve for predicting prognosis were 0.649 for SII, 0.717 for PNI, and 0.730 for the coSII-PNI score. These findings indicate that integrating systemic inflammation and nutritional status improves prognostic accuracy compared with either index alone. Therefore, the coSII-PNI score may serve as a simple, practical preoperative biomarker for risk stratification in patients with head and neck cancer.