Prognostic value of pan-immune-inflammation index in hepatocellular carcinoma compared with albumin-bilirubin and model for end-stage liver disease sodium

Table 1 Baseline characteristics of the study population (n = 97), n (%)

Variable
Age, years	Median 68 (range: 27-87)
Sex
Female	20 (20.6)
Male	77 (79.4)
ECOG performance status
0	31 (32.0)
1	41 (42.3)
2	13 (13.4)
3	11 (11.3)
4	1 (1.0)
Etiology
Hepatitis B	53 (54.6)
Hepatitis C	8 (8.3)
Alcohol-related	15 (15.5)
Non-alcoholic	21 (21.6)
Cirrhosis
Absent	59 (60.8)
Present	38 (39.2)
BCLC stage
A	30 (30.9)
B	14 (14.4)
C	34 (35.1)
D	19 (19.6)
Tumor number
Single	28 (28.9)
2-3 lesions	20 (20.6)
Multiple (≥ 4)	49 (50.5)
Vascular invasion
Absent	63 (64.9)
Present	34 (35.1)
Treatment modality
Liver transplantation	4 (4.1)
Surgical resection	22 (22.7)
TACE/TARE	9 (9.3)
Sorafenib	33 (34.0)
Atezolizumab + bevacizumab	3 (3.1)
Best supportive care	18 (18.6)
Radiofrequency ablation	7 (7.2)
FOLFOX	1 (1.0)

ECOG: Eastern Cooperative Oncology Group; BCLC: Barcelona Clinic Liver Cancer staging system; TACE: Transarterial chemoembolization; TARE: Transarterial radioembolization.

Table 2 Laboratory parameters and prognostic scores

Variable	Median (range)
Albumin (g/L)	37 (20-50)
Total bilirubin (mg/dL)	0.9 (0.2-11.0)
Neutrophil count (/μL)	4300 (1350-16790)
Lymphocyte count (/μL)	1500 (430-5140)
Monocyte count (/μL)	600 (40-1200)
Platelet count (× 103/μL)	175 (35-703)
AFP (ng/mL)	72 (0-34.890)
ALBI score	-2.36 (-3.70 to -0.67)
MELD-Na score	8.65 (3.11-28.92)
PIV score	347.3 (14-11320)

AFP: Alpha-fetoprotein; MELD-Na: Model for end-stage liver disease-sodium; ALBI: Albumin-bilirubin; PIV: Pan-immune-inflammation value.

Table 3 Univariate Cox regression analysis for overall survival

Variable	HR	95%CI	P value
Age (high vs low)	1.36	0.80-2.33	0.247
Sex (male vs female)	0.67	0.36-1.25	0.205
ECOG performance status (≥ 2 vs 0-1)	3.60	2.05-6.33	< 0.001
BCLC stage (C-D vs A-B)	7.32	3.69-14.52	< 0.001
Cirrhosis (present vs absent)	1.73	1.00-2.99	0.048
Treatment modality (non-curative vs curative)	9.46	3.73-24.00	< 0.001
ALBI grade (2-3 vs 1)	2.66	1.47-4.79	0.001
MELD-Na (high vs low)	2.82	1.62-4.89	< 0.001
PIV (high vs low)	2.83	1.65-4.86	< 0.001
Etiology (viral vs nonviral)	0.85	0.48-1.49	0.573

HR: Hazard ratio; CI: Confidence interval; ECOG: Eastern Cooperative Oncology Group; BCLC: Barcelona Clinic Liver Cancer staging system; MELD-Na: Model for end-stage liver disease-sodium; ALBI: Albumin-bilirubin; PIV: Pan-immune-inflammation value.

Table 4 Multivariate Cox regression analysis for overall survival

Variable	HR	95%CI	P value
ECOG performance status (≥ 2 vs 0-1)	2.91	1.63-5.19	< 0.001
PIV (high vs low)	2.01	1.14-3.52	0.016
Cirrhosis (present vs absent)	1.20	0.66-2.18	0.538
ALBI grade (2-3 vs 1)	1.82	0.95-3.48	0.071

HR: Hazard ratio; CI: Confidence interval; ECOG: Eastern Cooperative Oncology Group; ALBI: Albumin-bilirubin; PIV: Pan-immune-inflammation value.

Table 5 Receiver operating characteristic analysis of prognostic scores for predicting overall survival

Prognostic score	AUC	95%CI	P value	Cut-off value
PIV	0.794	0.705-0.883	< 0.001	486.9
ALBI score	0.781	0.689-0.872	< 0.001	-2.12
AFP	0.712	0.609-0.815	< 0.001	91
MELD-Na score	0.699	0.593-0.805	0.001	8.3

AUC: Area under the curve; CI: Confidence interval; AFP: Alpha-fetoprotein; MELD-Na: Model for end-stage liver disease-sodium; ALBI: Albumin-bilirubin; PIV: Pan-immune-inflammation value.

Table 6 Kaplan-Meier survival estimates according to pan-immune-inflammation value groups

PIV group	Mean survival (months)	Median survival (months)	95%CI (median)
Low PIV	21.6	30	21.5-38.5
High PIV	11.1	5	0.6-9.4
Overall	17.9	13	8.8-17.2

The P value was calculated using the log-rank test (P < 0.001). CI: Confidence interval; PIV: Pan-immune-inflammation value.