HALP is a novel marker for predicting overall survival in patients with malignant soft tissue sarcoma: a retrospective study
Seiji Shimomura, Ryu Terauchi, Toshiharu Shirai, Naoki Mizoshiri, Yuki Mori, Yusei Katsuyama, Daichi Hayashi, Ryosuke Nishi, Kenji TakahashiAbstract
Background
Malignant soft tissue sarcomas (STSs) are rare, aggressive tumors with diverse subtypes and variable prognoses. Current prognostic markers, such as tumor size and grade, do not sufficiently predict postoperative outcomes. Therefore, this study aimed to assess the prognostic significance of the hemoglobin, albumin, lymphocyte, platelet (HALP) score, an integrated immunonutritional marker, for predicting overall survival (OS) in patients with extremity and trunk STSs.
Methods
We analysed 99 patients with primary STS who underwent wide excision. The primary endpoint was OS. Systemic inflammatory and nutritional indices, including HALP, were evaluated using pre-treatment blood samples. OS was analysed using Kaplan–Meier curves and Cox proportional hazards models. Receiver operating characteristic curve analysis was used to determine the prognostic value of the HALP score.
Results
Twenty-nine deaths occurred during a median follow-up of 83.6 months. Three- and five-year OS were 82.1% and 74.2%, respectively. Lower HALP was associated with worse OS (hazard ratio 3.89, 95% confidence interval 1.66–9.13; P = 0.002). In multivariable analysis, a low HALP score (≤39.4) remained independently associated with worse OS (hazard ratio 3.17, 95% confidence interval 1.33–7.54; P = 0.011). The 5-year time-dependent AUC for HALP was 0.763, which was numerically higher than those of the other inflammatory and nutritional indices; however, the differences were not statistically significant.
Conclusions
The HALP score stratified patients with STS by risk of adverse postoperative outcomes and may serve as a practical and accessible exploratory prognostic marker. Prospective validation is required before HALP can be incorporated into prognostic models or used to guide treatment decisions.