The Combined Value of the Prognostic Nutritional Index and Pan‐Immune‐Inflammation Value in Predicting Neoadjuvant Chemotherapy and Survival in Locally Advanced Colon Cancer: A Retrospective Study
Zihao Chen, Jiangyu Li, Ruoxi Gao, Lei Liang, Jun Yang, Ting ZhaoABSTRACT
Background
The pan‐immune inflammation value (PIV) and prognostic nutritional index (PNI) are established markers of systemic inflammatory/immune status and nutritional status, respectively. The potential synergistic effect of combining these indices remains unexplored. This study aimed to evaluate the utility of a novel combined PIV‐PNI score for predicting chemosensitivity and survival outcomes in patients with locally advanced colon cancer (LACC) undergoing neoadjuvant chemotherapy (NACT), within a cohort from the Yunnan Plateau region.
Methods
We conducted a retrospective analysis of 241 LACC patients who received NACT followed by radical resection. Tumor response was classified according to AJCC/CAP guidelines, with patients stratified into a TRG3 (minimal or no pathological response) group ( n = 40) and a non‐TRG3 group ( n = 201). Pre‐treatment PIV and PNI were measured, with optimal cut‐off values identified by receiver operating characteristic (ROC) curve analysis. The PIV‐PNI score was calculated as follows: a score of 2 indicated high PIV and low PNI; a score of 1 indicated either high PIV or low PNI alone; and a score of 0 indicated neither.
Results
The PIV‐PNI score was significantly higher in the TRG3 group compared to the non‐TRG3 group ( p < 0.0001). The optimal cut‐off values for PIV and PNI via ROC analysis were ≥ 218.7 and ≤ 50.6, respectively. A higher PIV‐PNI score was associated with inferior survival outcomes. Multivariate analysis identified the PIV‐PNI score as an independent prognostic factor for both overall survival and disease‐free survival.
Conclusions
The PIV‐PNI score, a low‐cost and readily available composite index, demonstrates significant clinical utility as a predictive marker for tumor response to NACT and prognosis in LACC patients.
Novelty and Impact of the Work
PIV–PNI score, which integrates systemic inflammation and immunonutritional status, demonstrates strong predictive value for chemosensitivity and long‐term survival, offering a clinically accessible tool to guide personalized treatment strategies in the neoadjuvant setting.