Abstract
BACKGROUND: Preliminary studies suggest that pan-immune-inflammation value (PIV) has the potential to serve as a prognostic tool for lung cancer. However, existing studies are limited by inconsistent findings regarding the impact of high PIV on patient outcomes. To provide a more comprehensive assessment, we conducted a meta-analysis to clarify the prognostic value of PIV in lung cancer. METHODS: Two researchers independently searched the PubMed, Cochrane, Embase, and Web of Science databases for studies evaluating the associations between PIV and prognoses in lung cancer patients (up to July 15, 2025). Studies were included if they reported high versus low PIV and provided hazard ratios (HRs) with 95% confidence intervals (CIs) for overall survival (OS), progression-free survival (PFS), etc. Study quality was assessed using the Newcastle-Ottawa Scale (NOS). Pooled HRs and 95% CIs were calculated to determine the associations between PIV and patient prognosis. RESULTS: A total of ten studies comprising 1,969 patients were included. Meta-analyses demonstrated that high PIV was significantly associated with OS (HR =2.86, 95% CI: 2.23-3.65, P<0.001) and PFS (HR =2.06, 95% CI: 1.65-2.59, P<0.001) in lung cancer patients. In non-small cell lung cancer (NSCLC) patients, high PIV was significantly associated with worse OS (HR =2.76, 95% CI: 2.14-3.56, P<0.001) and PFS (HR =1.94, 95% CI: 1.55-2.42, P<0.001). In small cell lung cancer (SCLC) patients, even stronger associations were observed for OS (HR =3.47, 95% CI: 2.21-5.44, P<0.001) and PFS (HR =2.33, 95% CI: 1.63-3.33, P<0.001). Subgroup analyses further confirmed that PIV served as a critical prognostic marker for both OS and PFS. All studies were of high quality according to the NOS. CONCLUSIONS: PIV can serve as an independent prognostic biomarker for survival outcomes in lung cancer patients. Therefore, incorporating PIV into prognostic assessments may provide additional support for individualized treatment decision-making.