Abstract
Systemic inflammation is increasingly recognized as a key determinant of cancer outcomes, and composite blood-based indices may provide clinically useful prognostic information. The systemic immune-inflammatory index (SII), integrating neutrophil, lymphocyte, and platelet counts, reflects the balance between tumor-promoting inflammation, and antitumor immunity. In this meta-analysis, we synthesized evidence from 14 longitudinal studies including 2,820 patients with cervical cancer to evaluate the association between pretreatment SII and survival outcomes. Using random-effects models, elevated SII was consistently associated with poorer overall survival and progression-free survival across diverse clinical settings, treatment modalities, and analytic approaches, with particularly strong associations observed in Asian populations. Conceptually, these findings highlight the prognostic relevance of systemic immune-inflammatory status in cervical cancer progression. Given its low cost, accessibility, and reproducibility, SII may represent a practical tool for risk stratification and treatment planning, while underscoring the need for prospective studies to define standardized thresholds and clinical utility.