Prognostic value of the hemoglobin, albumin, lymphocyte, and platelet score in nonmetastatic renal cell carcinoma after nephrectomy
Zheng Huang, Dan Chen
The hemoglobin, albumin, lymphocytes, and platelets (HALP) score is a comprehensive indicator that reflects the body’s systemic nutritional and immune-inflammatory status. Previous studies have found HALP score to be a strong predictor of several cancers. However, its predictive efficacy in nonmetastatic renal cell carcinoma (RCC) has been poorly studied. Patients diagnosed with nonmetastatic RCC who underwent nephrectomy at West China Hospital of Sichuan University between 2009 and 2013 were included in this study. The relationship between the HALP score and overall survival (OS) was initially observed using restricted cubic splines (RCS), with the cutoff value determined through the Maximally Selected Log-Rank Statistic. Logistic regression was utilized to explore the correlation between the HALP score and clinicopathological factors. Propensity score matching (PSM) was then employed to balance baseline characteristics of the groups. Finally, Cox regression analysis was conducted to assess the independent prognostic value of the HALP score. A total of 1164 patients were included. The cutoff score for the HALP score was determined to be 38.3. Logistic regression found that a lower HALP score was associated with poor clinicopathological factors, specifically worse Eastern Cooperative Oncology Group (ECOG) status, larger tumor size, advanced pT stage, and high Fuhrman grade. After PSM, Cox regression analysis confirmed the independent predictive value of a higher HALP score for better OS (HR = 0.50, 95% CI 0.34–0.75,