Am J Cancer Res. 2026 May 15;16(5):1907-1921. doi: 10.62347/CQAN4296. eCollection 2026.
ABSTRACT
Systemic inflammation represents a crucial pathophysiological link between cancer, cardiovascular disease, and mortality, yet the predictive value of individual inflammatory indices is still unclear. The cohort study of 1,752 cancer survivors developed new Integrated Inflammation Response Scores (IIRS) using principal component analysis. The IIRS-1 predicted all-cause mortality with a C-index of 0.721 over a median follow-up of 113 months with 761 deaths (169 cardiovascular deaths), whereas the parsimonious IIRS-2 (combining neutrophil-to-lymphocyte and monocyte-to-lymphocyte ratios) demonstrated exceptional performance for cardiovascular mortality (C-index: 0.771, 10-year AUC: 0.811), greatly outperforming most single indices. An independent external validation cohort of 923 cancer survivors confirmed the discriminatory performance of IIRS-1 (C-index: 0.653) and IIRS-2 (C-index: 0.736). The clinical utility was validated by nomograms and decision curve analysis, and the monocyte-to-lymphocyte ratio demonstrated a nonlinear correlation with the risk of cardiovascular mortality (threshold: 0.3). The IIRS offers a robust, clinically practical tool for risk assessment and precise intervention in cancer survivorship care.
PMID:42266760 | PMC:PMC13243683 | DOI:10.62347/CQAN4296