Prognostic and predictive significance of the pan-immune-inflammation value in endometrial cancer patients undergoing adjuvant therapy.

Background: The pan-immune-inflammation value (PIV) has been associated with survival outcomes across various cancer types. This study investigates the association between PIV and overall and progression-free survival in endometrial cancer patients receiving adjuvant chemotherapy.

Materials And Methods: A retrospective analysis was conducted on 138 endometrial cancer patients treated at our center between January 2014 and January 2024. Eligible patients received adjuvant chemotherapy following surgery and had preoperative blood tests available for PIV calculation. PIV was calculated as neutrophil count × platelet count × monocyte count/lymphocyte count. Survival outcomes were analyzed using Kaplan-Meier and Cox regression methods.

Results: The median PIV was 352 [interquartile range (IQR): 199-600], with higher scores significantly associated with advanced International Federation of Gynecology and Obstetrics (FIGO) stage (p = 0.007) and extensive lymphovascular invasion (LVI) (p = 0.03). Multivariate analysis identified PIV [hazard ratio (HR): 1.001, p = 0.015], FIGO stage III-IV (HR: 5.957, p < 0.001), adjuvant radiotherapy (HR: 0.288, p = 0.002), and extensive LVI (HR: 2.295, p = 0.014) as independent prognostic factors for overall survival (OS). A PIV greater than 350 was linked to a 3.2-fold increase in mortality risk (p < 0.001). Additionally, radiotherapy in conjunction with adjuvant chemotherapy significantly improved OS in patients with a high PIV (> 350), but not in those with a low PIV (≤ 350).

Conclusion: The PIV score is a significant prognostic marker for survival in endometrial cancer patients receiving adjuvant chemotherapy. Patients with a high PIV score may benefit from the addition of radiotherapy to their treatment regimen. Further studies are needed to validate the PIV score as a predictive marker for adjuvant radiotherapy in this population.