The Relationship Between the HALP Score and Gastric Cancer Prognosis
HALP Score in Gastric Cancer
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https://doi.org/10.5281/zenodo.10019807Keywords:
Gastric cancer, HALP score, mortality, prognosisAbstract
Background: Gastric adenocarcinoma is the fifth most common malignancy worldwide and the third leading cause of cancer-related deaths. As most patients are diagnosed in the advanced stage of the disease, the prognosis is dismal. Therefore, researchers have developed various scoring systems to predict prognostic factors. One of these is the HALP scale, which consists of hemoglobin, albumin, lymphocytes and platelets. This study aims to assess the utility of the HALP score as a prognostic tool in predicting the clinical outcomes of patients with gastric adenocarcinoma.
Methods: A retrospective review of patients who underwent gastrectomy for gastric cancer between 2018 and 2021 in the Department of Surgical Oncology, Gulhane Medical School Training and Research Hospital, University of Health Sciences. A total of 158 patients who underwent surgery for the diagnosis of gastric adenocarcinoma were included in the study. Hemoglobin, albumin, lymphocytes and platelet values were obtained from patient files. HALP scores were calculated and correlations with clinicopathologic factors were investigated.
Results: We found a significant negative correlation between the HALP score and T stage and N stage. Increasing the HALP score increases the likelihood of early-stage disease (p = 0.008 and p = 0.001). We found a significant negative correlation between the HALP score and the number of metastatic lymph nodes and tumor diameter ( p < 0.001 and p < 0.001). One unit increase in HALP score leads to a 4.7 unit decrease in tumor diameter and a 14.8 unit decrease in metastatic lymph node count.
Conclusion: This study provides insights into the potential utility of the HALP score in predicting clinical outcomes for gastric cancer patients. While these findings are promising, research with large patient data is essential to validate the prognostic value of the HALP score and determine its clinical applicability. The HALP score may assist clinicians in risk stratification and therapeutic decision-making, and ultimately contributing to improved patient outcomes in the management of gastric cancer.
References
World Health Organization. International Agency for Research on Cancer. GLOBOCAN 2020: Stomach cancer fact sheet, 2020.
Ma J, Shen H, Kapesa L, Zeng S. Lauren classification and individualized chemotherapy in gastric cancer. Oncol Lett. 2016;11(5):2959-2964. doi:10.3892/ol.2016.4337
Dicken BJ, Bigam DL, Cass C, Mackey JR, Joy AA, Hamilton SM. Gastric adenocarcinoma: review and considerations for future directions. Ann Surg. 2005;241(1):27-39. doi:10.1097/01.sla.0000149300.28588.23
Szász AM, Lánczky A, Nagy Á, et al. Cross-validation of survival associated biomarkers in gastric cancer using transcriptomic data of 1,065 patients. Oncotarget. 2016;7(31):49322-49333. doi:10.18632/oncotarget.10337
Chen XL, Xue L, Wang W, Chen HN, Zhang WH, Liu K, Chen XZ, Yang K, Zhang B, Chen ZX, Chen JP, Zhou ZG, Hu JK. Prognostic significance of the combination of preoperative hemoglobin, albumin, lymphocyte and platelet in patients with gastric carcinoma: a retrospective cohort study. Oncotarget. 2015; 6:41370–82. 10.18632/oncotarget.5629.
Wang X, He Q, Liang H, et al. A novel robust nomogram based on preoperative hemoglobin and albumin levels and lymphocyte and platelet counts (HALP) for predicting lymph node metastasis of gastric cancer. J Gastrointest Oncol. 2021;12(6):2706-2718. doi:10.21037/jgo-21-507
Xu SS, Li S, Xu HX, et al. Haemoglobin, albumin, lymphocyte and platelet predicts postoperative survival in pancreatic cancer. World J Gastroenterol. 2020;26(8):828-838. doi:10.3748/wjg.v26.i8.828
Sun L, Guan A, Jin Y, et al. Comparison of Prognostic Value of Red Cell-Related Parameters of Biliary Tract Cancer After Surgical Resection and Integration of a Prognostic Nomogram: A Retrospective Study. Adv Ther. 2021;38(2):1227-1244. doi:10.1007/s12325-020-01595-5
Knight K, Wade S, Balducci L. Prevalence and outcomes of anemia in cancer: a systematic review of the literature. Am J Med. 2004;116 Suppl 7A:11S-26S. doi:10.1016/j.amjmed.2003.12.008
Gay LJ, Felding-Habermann B. Contribution of platelets to tumour metastasis. Nat Rev Cancer. 2011;11(2):123-134. doi:10.1038/nrc3004
Thomas MR, Storey RF. The role of platelets in inflammation. Thromb Haemost. 2015;114(3):449-458. doi:10.1160/TH14-12-1067
Madu AJ, Ughasoro MD. Anaemia of Chronic Disease: An In-Depth Review. Med Princ Pract. 2017;26(1):1-9. doi:10.1159/000452104
McCranor BJ, Kim MJ, Cruz NM, et al. Interleukin-6 directly impairs the erythroid development of human TF-1 erythroleukemic cells [published correction appears in Blood Cells Mol Dis. 2014 Apr;52(4):236]. Blood Cells Mol Dis. 2014;52(2-3):126-133. doi:10.1016/j.bcmd.2013.09.004
Nemeth E, Valore EV, Territo M, Schiller G, Lichtenstein A, Ganz T. Hepcidin, a putative mediator of anemia of inflammation, is a type II acute-phase protein. Blood. 2003;101(7):2461-2463. doi:10.1182/blood-2002-10-3235
Raj DS. Role of interleukin-6 in the anemia of chronic disease. Semin Arthritis Rheum. 2009; 38:382–88. 10.1016/j.semarthrit.2008.01.006.
Eckart A, Struja T, Kutz A, et al. Relationship of Nutritional Status, Inflammation, and Serum Albumin Levels During Acute Illness: A Prospective Study. Am J Med. 2020;133(6):713-722.e7. doi:10.1016/j.amjmed.2019.10.031
Sheinenzon A, Shehadeh M, Michelis R, Shaoul E, Ronen O. Serum albumin levels and inflammation. Int J Biol Macromol. 2021;184:857-862. doi:10.1016/j.ijbiomac.2021.06.140
McMillan DC. The systemic inflammation-based Glasgow Prognostic Score: a decade of experience in patients with cancer. Cancer Treat Rev. 2013;39(5):534-540. doi:10.1016/j.ctrv.2012.08.003
Liu XY, Zhang X, Ruan GT, et al. One-Year Mortality in Patients with Cancer Cachexia: Association with Albumin and Total Protein. Cancer Manag Res. 2021;13:6775-6783. Published 2021 Aug 29. doi:10.2147/CMAR.S318728
Ostroumov D, Fekete-Drimusz N, Saborowski M, Kühnel F, Woller N. CD4 and CD8 T lymphocyte interplay in controlling tumor growth. Cell Mol Life Sci. 2018;75(4):689-713. doi:10.1007/s00018-017-2686-7
Farag CM, Antar R, Akosman S, Ng M, Whalen MJ. What is hemoglobin, albumin, lymphocyte, platelet (HALP) score? A comprehensive literature review of HALP's prognostic ability in different cancer types. Oncotarget. 2023;14:153-172. Published 2023 Feb 25. doi:10.18632/oncotarget.28367
Che K, Liu F, Wu N, Liu Q, Yuan L, Wei J. Individualized prediction of survival benefits from perioperative chemoradiotherapy for patients with resectable gastric cancer. Cancer Med. 2020;9(19):7137-7150. doi:10.1002/cam4.3350
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