Chalabıyev Elvin, Ismayılov Rashad, Kus Fatih, Akyıldız Arif, Guven Deniz Can, Yıldırım Hasan Cagri, Kırmızıgul Beril, Koksal Baris, Kavgacı Gozde, Arık Zafer
Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Türkiye.
Department of Internal Medicine, Hacettepe University Medical School, Ankara, Türkiye.
Rep Pract Oncol Radiother. 2025 Jun 7;30(2):202-209. doi: 10.5603/rpor.105859. eCollection 2025.
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.
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.
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).
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.
全免疫炎症值（PIV）与多种癌症类型的生存结果相关。本研究调查了接受辅助化疗的子宫内膜癌患者中PIV与总生存期和无进展生存期之间的关联。
对2014年1月至2024年1月在本中心接受治疗的138例子宫内膜癌患者进行回顾性分析。符合条件的患者在手术后接受辅助化疗，并进行了术前血液检查以计算PIV。PIV的计算方法为中性粒细胞计数×血小板计数×单核细胞计数/淋巴细胞计数。使用Kaplan-Meier和Cox回归方法分析生存结果。
PIV的中位数为352[四分位间距（IQR）：199 - 600]，得分越高与国际妇产科联盟（FIGO）晚期分期（p = 0.007）和广泛的淋巴血管浸润（LVI）（p = 0.03）显著相关。多变量分析确定PIV[风险比（HR）：1.001，p = 0.015]、FIGO III-IV期（HR：5.957，p < 0.001）、辅助放疗（HR：0.288，p = 0.002）和广泛的LVI（HR：2.295，p = 0.014）是总生存期（OS）的独立预后因素。PIV大于350与死亡风险增加3.2倍相关（p < 0.001）。此外，放疗联合辅助化疗显著改善了PIV高（> 350）患者的OS，但对PIV低（≤ 350）的患者没有改善。
PIV评分是接受辅助化疗的子宫内膜癌患者生存的重要预后标志物。PIV评分高的患者可能从在其治疗方案中添加放疗中获益。需要进一步研究以验证PIV评分作为该人群辅助放疗预测标志物的有效性。
