Background The prognostic significance of the pan-immune-inflammation value (PIV) in head and neck squamous cell carcinoma has been comprehensively documented. Nevertheless, its exact role remains ambiguous. The objective of this study is to perform a systematic exploration of the correlation between the pretreatment PIV and survival outcomes in this population. Methods An extensive and systematic search of the literature was conducted through electronic databases, including Web of Science, PubMed, and Embase. The search period covered from inception to October 1, 2025. The primary endpoint was survival outcomes. Hazard ratios (HRs) and their 95% confidence intervals (CIs) for survival outcomes were retrieved. A random-effects model was employed to integrate the pooled findings. This meta-analysis was prospectively registered with PROSPERO (CRD420251170558). Results A total of twelve studies, encompassing 5,056 patients, were included. The pooled results revealed that patients in the high PIV group exhibited significantly inferior overall survival (12 studies; HR = 2.62; 95% CI: 2.00 – 3.44; I² = 74%) and disease-free survival (9 studies; HR = 2.34; 95% CI: 1.69 - 3.26; I² = 79%) when compared to those in the low PIV group. Subgroup analyses buttressed the prognostic significance of PIV for overall survival and disease-free survival across diverse geographical regions, tumor stages, and treatment strategies. Moreover, evidence aggregated from limited studies indicated that a higher PIV was associated with a worse distal metastasis-free survival (3 studies; HR = 2.04; 95% CI: 1.13 - 3.67; P = 0.02; I² = 94%) and a marginally poorer local recurrence-free survival (3 studies; HR = 1.20; 95% CI: 1.00 - 1.44; P = 0.05; I² = 0%). Conclusions Our findings indicate that the pretreatment PIV has the potential to serve as a valuable biomarker for predicting the survival outcomes of patients with head and neck squamous cell carcinoma. Systematic review registration https://www.crd.york.ac.uk/prospero/ , identifier CRD420251170558.
Li et al. (2026) studied this question.