Prognostic Utility of the Pan-Immune-Inflammation Value (PIV) in Locally Advanced Cervical Cancer Treated with Concurrent Chemoradiotherapy

Background: Cervical cancer remains a leading cause of cancer-related mortality in women. CCRT is standard for LACC, but its efficacy varies. This study was designed to evaluate the prognostic value of PIV in predicting short-term efficacy and long-term survival in LACC patients receiving CCRT. Methods: We retrospectively analyzed 205 patients with stage IB3–IVA cervical cancer treated with CCRT at the Affiliated Hospital of Jiangnan University (2018–2024). Variables included age, histopathological subtype, FIGO stage, lymph node status, pre-treatment serum SCCA, platelet-to-lymphocyte ratio [PLR], neutrophil-to-lymphocyte ratio [NLR], albumin-to-fibrinogen ratio [AFR], and PIV (calculated as neutrophil × platelet × monocyte counts/lymphocyte count). Short-term efficacy was assessed by the complete response rate (CRR) at 6 months post-treatment. Long-term survival was assessed by overall survival (OS) and progression-free survival (PFS). Results: Multivariate logistic regression identified tumor size ≥ 4 cm, NLR ≥ 3.32, and PIV ≥ 350.15 as independent risk factors for poor short-term response. Multivariate Cox analysis revealed that tumor size ≥ 4 cm, FIGO stage IVA, SCCA ≥ 1.84 ng/mL, and PIV ≥ 350.15 were independent adverse prognostic factors for OS. For PFS, independent predictors included moderate/poor differentiation, FIGO stage IVA, SCCA ≥ 1.84 ng/mL, and PIV ≥ 350.15. Adding PIV to a clinical model (FIGO stage + SCCA) improved the prediction of OS. Conclusions: PIV provides independent prognostic information and may serve as a practical tool for risk stratification and personalized treatment in LACC.