ORIGINAL RESEARCH article
Front. Oncol.
Sec. Gynecological Oncology
Predictive value of the systemic immune-inflammation index combined with the prognostic nutritional index for postoperative recurrence in early-stage cervical cancer: evidence from a multicenter cohort study
Anihenimu Abudoukade 1
Shihao Hong 2
Min Jiang 3
Dong yin 4
Burebi Maimaiti 5,1
1. Kashigar Regional First People's Hospital (Kashigar Regional First People's Hospital Affiliated with Sun Yat-Sen University), kashi, China
2. Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, China
3. Jining New Journey Cancer Hospital, jining, China
4. Linyi Hospital of Traditional Chinese Medicine, Linyi, China
5. Organ Transplantation Center, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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Abstract
Background: Growing evidence suggests that immune-inflammatory status and nutritional condition influence cancer prognosis. In this study, a composite score combining the systemic immune ~ inflammation index (SII) and the prognostic nutritional index (PNI) was investigated for its ability to stratify the risk of postoperative recurrence in patients with early-stage cervical cancer (ESCC). Study design: Multicenter cohort study Methods: This multicenter, retrospective study enrolled 403 individuals diagnosed with early-stage cervical squamous cell carcinoma and treated with surgery performed with curative intent. Optimal SII and PNI cut-points were selected based on receiver operating characteristic (ROC) curve analysis and validated using internal bootstrapping (1,000 resamples). Disease-free survival was summarized with Kaplan ~ Meier analysis, whereas prognostic associations were quantified using a multivariable Cox proportional hazards model. Results: ROC-based analyses yielded cutoff values of 580.99 for SII and 49.81 for PNI, which were subsequently used for patient stratification. The combined SII - PNI score showed improved predictive performance compared to individual indices, with an area under the curve (AUC) of 0.743. Survival curves demonstrated a graded increase in postoperative recurrence with rising SII - PNI scores, and intergroup differences reached statistical significance (log-rank P < 0.001). After adjustment for relevant covariates, the combined SII - PNI score remained independently associated with recurrence risk following surgery. Conclusion: Elevated SII - PNI scores were independently associated with an increased probability of postoperative recurrence among patients with early-stage cervical cancer. Although the discriminatory ability is moderate, this combined index holds promise as a cost-effective, complementary tool for refining risk stratification in this population.
Summary
Keywords
Disease-Free Survival, Early-stage cervical cancer, Postoperative recurrence, Prognostic nutritional index, SII-PNI score, systemic immune ~ inflammation index, systemic immune-inflammation index
Received
20 January 2026
Accepted
20 February 2026
Copyright
© 2026 Abudoukade, Hong, Jiang, yin and Maimaiti. 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: Burebi Maimaiti
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