Prognostic value of pan-immune-inflammation in breast cancer patients with lymph node metastasis and neoadjuvant therapy

This study aimed to evaluate the prognostic value of the pan-immune-inflammation value (PIV) in breast cancer patients with lymph node metastasis receiving neoadjuvant therapy. A total of 144 patients treated at our hospital between January 2019 and December 2022 were retrospectively analyzed. PIV was calculated from baseline blood counts obtained before neoadjuvant chemotherapy. Using X-tile software, the optimal cutoff value of 187 was identified, and patients were classified into high (≥187) and low (<187) PIV groups. Progression-free survival (PFS) was assessed using the Kaplan-Meier method and log-rank test, and multivariate Cox regression was performed to determine independent prognostic factors. Predictive accuracy was further evaluated with receiver operating characteristic curves. Patients with high-PIV values had significantly shorter PFS compared with those in the low-PIV group (P = .002). Multivariate Cox regression confirmed PIV as an independent prognostic factor. Receiver operating characteristic curve analysis showed that PIV had good predictive performance for 1-, 2-, and 3-year PFS, with AUCs of 0.867, 0.802, and 0.853, respectively. PIV was associated with prognosis in breast cancer patients with lymph node metastasis undergoing neoadjuvant therapy and demonstrated favorable predictive performance in this study. Nevertheless, as this was a single-center retrospective analysis with limited sample size, further validation in larger prospective multicenter studies is necessary before clinical application.