Comparison of pan-immune-inflammation value across different cancer types and stages and determination of its prognostic significance

The present study aimed to investigate the relationship between the Pan-Immune-Inflammation Value (PIV) and overall survival (OS) in a large pan-cancer patient cohort and to demonstrate the prognostic significance of PIV. A total of 2,500 patients who were followed in the Medical Oncology Clinic of Alanya Training and Research Hospital between 2021 and 2024 were screened, and 1285 patients meeting the eligibility criteria were retrospectively included in the study. PIV was calculated using the formula (neutrophil × monocyte × platelet) / lymphocyte. Patients were classified into low and high PIV groups according to their values. Overall survival was evaluated using the Kaplan–Meier method, and comparisons between groups were performed with the Pearson χ² test. The independent prognostic value of PIV was analyzed using a multivariable Cox regression model, and the optimal cut-off value was determined through ROC curve analysis. The median OS was 115 months in the low-PIV group and 17 months in the high-PIV group (p<0.001). High PIV levels were significantly associated with an increased risk of mortality (HR=2.50; 95% CI: 2.00–3.14; p<0.001). In addition, PIV levels were markedly higher in patients with advanced-stage disease. ROC analysis identified an optimal cut-off value of 585.21 for OS, while sensitivity analysis based on the median value suggested 410 as an alternative threshold. In conclusion, this study demonstrated that PIV is an independent prognostic biomarker in a large pan-cancer cohort. As a parameter derived from routine complete blood count, PIV is easily accessible, cost-effective, and practical for clinical use. The findings also highlight the increasing importance oinflammation-based biomarkers in cancer management. Further studies involving larger and more diverse patient populations with long-term follow-up are needed to validate these results and to better define the clinical role of PIV in oncological practice. Keywords: Pan-immune-inflammation value (PIV), prognostic factor, overall survival (OS), pan-cancer