Prognostic significance of the pan-immune-inflammatory value (PIV) in gastric cancer: a retrospective cohort study

Peripheral blood cell parameters are used as prognostic markers in gastric cancer. In this study, we evaluated the prognostic significance of the Pan-Immune-Inflammatory Value (PIV), calculated as (neutrophil × platelet × monocyte) / lymphocyte counts, in patients with gastric cancer. The study included 120 patients with gastric adenocarcinoma who were followed at the Department of Medical Oncology, Sultan Abdulhamid Han Training and Research Hospital, University of Health Sciences, between September 2017 and December 2024. PIV was calculated from pre-treatment complete blood counts. Associations between PIV and overall survival (OS), progression-free survival (PFS), and treatment response were analyzed. In our study, receiver operating characteristic (ROC) analysis was performed to determine the optimal cut-off value for PIV to achieve prognostic discrimination. Survival analyses were performed using the Kaplan–Meier method, and differences between groups were compared with the log-rank test. Univariate and multivariate Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Logistic regression analysis was performed to identify independent predictors of treatment response. The optimal cut-off value for PIV was 334.8, and 49.2% of patients had a PIV above this value. Patients with a high PIV (≥ 334.8) had significantly poorer PFS (HR = 1.975; 95% CI: 1.046–3.730; p = 0.036) and OS (HR = 2.286; 95% CI: 1.332–3.924; p = 0.003) compared with those in the low PIV group. A significant association was observed between PIV and treatment response. Patients with low PIV had significantly higher response rates than those with high PIV. Our study suggests that PIV can be considered a prognostic parameter for overall survival in patients with gastric adenocarcinoma.