Prognostic significance of the pretreatment pan-immune-inflammation value in cancer patients: an updated meta-analysis of 30 studies

BACKGROUND: The pan-immune-inflammation value (PIV) has been reported as a promising prognostic biomarker in multiple cancers but still remains inconclusive. The objective of this study is to systematically investigate the association of the pretreatment PIV with survival outcomes in cancer patients, based on available literature. METHODS: Online databases including PubMed, Embase and the Web of Science were thoroughly searched for studies evaluating the prognostic role of the pretreatment PIV in cancers from the inception to June 2023. Hazard ratios (HRs) with 95% confidence intervals (CIs) were always assessed using a random-effects model. Statistical analyses were performed using Stata 12.0. RESULTS: Thirty studies were finally included after comprehensively study searching. In total, 8,799 cancer patients were enrolled in this meta-analysis. The pooled results demonstrated that patients in the high PIV group had a significantly poorer overall survival (HR = 2.07; 95%CI: 1.77–2.41; I(2) = 73.0%) and progression-free survival (HR = 1.83; 95%CI: 1.37–2.45; I(2) = 98.2%) than patients in the low PIV group. The prognostic significance of the PIV score on overall survival and progression-free survival was observed across various geographical regions, tumor stages and treatment strategies. Sensitivity analyses supported the stability of the above combined results. CONCLUSION: This meta-analysis demonstrated that the pretreatment PIV could be a non-invasive and efficacious prognostic biomarker for cancer patients.