# Evaluation of the relationship between pan-immune inflammation value and prognostic factors in germ-cell testicular cancer: analysis of stage, lymph node involvement, and metastasis

## TL;DR

This study shows that a blood-based inflammation score called PIV is linked to more advanced stages and worse outcomes in testicular cancer patients.

## Contribution

The study introduces PIV as a novel preoperative marker for predicting disease progression in germ cell testicular cancer.

## Key findings

- Higher PIV scores correlate with metastasis and lymph node involvement in testicular cancer.
- PIV scores increase with higher tumor stages and risk groups in germ cell testicular tumors.
- PIV is a cost-effective tool for predicting advanced disease at diagnosis.

## Abstract

To evaluate the association between the preoperative pan-immune inflammation value (PIV) and prognostic factors, including stage, lymph node involvement, and metastasis, in patients who underwent radical orchiectomy for germ cell testicular tumors.

Data from 178 patients who underwent radical orchiectomy for testicular tumors between January 2014 and January 2024 were retrospectively reviewed. Preoperative serum tumor markers, hematologic parameters, and histopathological findings were recorded. Tumor staging was determined based on radiological imaging and serum tumor markers. The PIV was calculated using the formula: (monocyte count × neutrophil count × platelet count) / lymphocyte count. Optimal cut-off values for PIV were determined using ROC curve analysis. The association between the PIV score and clinicopathological variables was analyzed.

The mean age of the patients was 32.34 ± 9.62 years. The mean PIV score in patients with metastasis and retroperitoneal lymph node invasion (RPLNI) was significantly higher than in those without metastasis or RPLNI (p = 0.01 and p = 0.04, respectively). The PIV score increased progressively with higher tumor T, N, and M stages. Additionally, a statistically significant increase in PIV scores was observed among patients classified into higher International Germ Cell Cancer Collaborative Group risk groups (p = 0.01).

Higher PIV scores are significantly associated with tumor stage, lymph node involvement, and metastasis in patients with germ cell testicular tumors. The PIV score appears to be a useful and cost-effective preoperative marker for predicting advanced disease in testicular tumors at the time of diagnosis.