Pan-immune-inflammation value is a novel prognostic biomarker in pT2-4 gastric cancer

Background and objectives: Gastric cancer (GC) is a leading cause of cancer-related mortality worldwide and has a poor prognosis. Novel biomarkers are required to predict the survival of patients with this aggressive disease. Although the pan-immune-inflammation value (PIV) has been associated with outcomes in various malignancies, its prognostic role in GC remains unclear. Materials and methods: Clinical data of 793 patients with pT2-4 GC were retrospectively reviewed and analyzed. An optimal cutoff value was determined using receiver operating characteristic (ROC) curve analysis to stratify patients into high- and low-PIV groups. The prognostic performances of PIV and other immune-inflammatory biomarkers (IIBs) were compared using ROC analysis. Associations between the PIV and clinicopathological characteristics were also assessed. Kaplan-Meier survival curves were constructed for progression-free survival (PFS) and overall survival (OS). Univariate and multivariate Cox regression analyses were performed to determine independent prognostic factors. Results: infection status, a larger tumor size, and an advanced TNM stage. Patients in the high-PIV group, particularly those with stages III and IV disease, had significantly worse PFS and OS. In multivariate analysis, the PIV remained an independent prognostic factor for survival outcomes in patients with pT2-4 GC. Conclusion: This study established PIV as a significant and independent prognostic biomarker for pT2-4 GC. PIV exhibits a more sensitive predictive ability for the tumor burden and systemic inflammation than other evaluated IIBs, which provides potential clinical value for patients with pT2-4 GC.