SYSTEMATIC REVIEW article
Front. Oncol.
Sec. Head and Neck Cancer
Prognostic value of the pretreatment pan-immune-inflammation value (PIV) in patients with head and neck squamous cell carcinoma: A systematic review and meta-analysis
Provisionally accepted
Te Li1
Genping Li2*- 1The Seventh People's Hospital of Chongqing, Chongqing, China
- 2First People's Hospital of Chongqing Liangjiang New District, Chongqing, China
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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.
Keywords: Disease-Free Survival, Distal metastasis-free survival, Head and neck squamous cell carcinoma, local recurrence-free survival, overall survival, Pan-Immune-Inflammation Value
Received: 13 Nov 2025; Accepted: 09 Jan 2026.
Copyright: © 2026 Li and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Genping Li
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