Prognostic impact of the hemoglobin-albumin-lymphocyte-platelet score in patients with oral cavity cancer undergoing surgery

Prognostic significance of preoperative Naples prognostic score for disease-free and overall survival in oral cavity squamous cell carcinoma post-surgery

BACKGROUND

Oral cavity squamous cell carcinoma (OCSCC) is a common malignancy with high morbidity and mortality. This research seeks to assess the correlation between Naples Prognostic Score (NPS) and survival outcomes in patients with OCSCC who are receiving surgical treatment, highlighting its potential as a prognostic tool for predicting patient outcomes.

METHODS

This retrospective study included 589 OCSCC patients from two large regional medical centers in central China, treated between February 2008 and September 2019. Inclusion criteria mandated confirmed OCSCC diagnosis, age ≥ 18 years, and radical surgery, while patients with distant metastasis, multiple tumors, or insufficient data were excluded. Data on 29 clinicopathological variables, including demographic details, tumor characteristics, and nutritional/inflammatory markers, were collected. The statistical approach included both univariate and multivariate Cox regression models to determine factors associated with disease-free survival (DFS) and overall survival (OS). Additionally, Kaplan-Meier survival analysis was employed to evaluate the effect of adjuvant radiotherapy on survival in various NPS subgroups.

RESULTS

Surgical margin status, ENE, NPS, age-adjusted Charlson comorbidity index (ACCI), and American Joint Committee on Cancer (AJCC) stage were identified as independent prognostic factors for DFS. Similarly, Eastern Cooperative Oncology Group Performance Status (ECOG PS), surgical margin status, extranodal extension (ENE), NPS, ACCI, and AJCC stage were found to be independent prognostic factors for OS. A higher NPS was associated with a poorer prognosis. In AJCC stage III-IVb patients with NPS 1-2, adjuvant radiotherapy significantly improved both DFS and OS. Likewise, in AJCC stage III-IVb patients with NPS 3-4, adjuvant radiotherapy was associated with better DFS and OS outcomes. However, no significant impact of adjuvant radiotherapy was observed in patients with AJCC stage I-II or in those with NPS 0, regardless of stage. This underscores the importance of NPS in stratifying patients for adjuvant therapy.

CONCLUSION

The Naples Prognostic Score is a beneficial prognostic indicator for survival in OCSCC patients. Its integration into clinical practice may assist in risk stratification and treatment decision-making, particularly for those undergoing adjuvant radiotherapy.

HALP (Hemoglobin, Albumin, Lymphocyte, and Platelet) Score and Its Companions in Papillary Thyroid Cancer: Can They Predict Central Lymph Node Metastasis?

Background Papillary thyroid cancer (PTC) is one of the most common cancers with a favorable prognosis. The prognosis is most commonly associated with lymph node metastasis. We investigated whether there is a relationship between the hemoglobin, albumin, lymphocyte, and platelet (HALP) score and PTC central region lymph node metastasis in the preoperative period. NLR (neutrophil/lymphocyte ratio), PLR (platelet/lymphocyte ratio), MLR (monocyte/lymphocyte ratio), PIV (pan-immune-inflammation value), PNI (prognostic nutritional index), SII (systemic immune-inflammation index) were analyzed as other predictive factors for PTC central region lymph node metastasis. Methods The data of 235 patients who were operated on for PTC and underwent additional central neck dissection in our clinic were analyzed retrospectively. The effect of the HALP score, NLR, PLR, MLR, PIV, PNI, and SII values on PTC central region lymph node metastasis was analyzed with univariate and multiple logistic regression analyses. Results The HALP score, NLR, PLR, MLR, PIV, PNI, and SII had no statistically significant effect on the number of positive lymph nodes in the central region, lymphatic invasion, vascular invasion, extra-thyroidal invasion in PTC (p>0.050 for each). For PTC, stage progression was associated with a decrease in preoperative PNI (OR=0.871; p=0.019). Conclusion There was a significant negative correlation between PNI and the stage of the PTC. No significant correlation was found between the HALP score and prognostic predictors of papillary PTC central lymph node metastasis. This may be related to the fact that PTC is a type of cancer that does not affect biochemical parameters much.

Prognostic significance of hemoglobin, albumin, lymphocyte and platelet score in solid tumors: a pooled study

Objective

The high hemoglobin, albumin, lymphocyte, and platelet (HALP) score has been reported to be a good prognostic indicator for several malignancies. However, more evidence is needed before it can be introduced into clinical practice. Here, we systematically evaluated the predictive value of HALP for survival outcomes in patients with solid tumors.

Methods

This study was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Assessing the Methodological Quality of Systematic Reviews (AMSTAR) Guidelines. In March 2024, an electronic literature search was performed for articles regarding the prognostic role of HALP in solid tumors. Data from studies with reported risk ratios (HRs) and 95% confidence intervals (CIs) were pooled in a meta-analysis. Study bias was assessed using the QUIPS tool.

Results

Of the 729 articles reviewed, 45 cohorts including data from 17,049 patients with cancer were included in the pooled analysis. The pooled results demonstrated that elevated HALP score was significantly associated with favorable overall survival (HR = 0.60, 95% CI 0.54-0.67, p < 0.01), cancer-specific survival (HR = 0.53, 95% CI 0.44- 0.64, p < 0.01), progression-free survival (HR = 0.62, 95% CI 0.54-0.72, p < 0.01), recurrence-free survival (HR = 0.48, 95% CI 0.30-0.77, p < 0.01), and disease-free survival (HR = 0.72, 95% CI 0.57-0.82, p < 0.01). Subgroup analyses based on various confounding factors further revealed the consistent prognostic impact of HALP on overall survival in patients with solid tumors.

Conclusions

Our findings suggest that high HALP is associated with better survival outcomes in patients. The HALP score is a potential prognostic biomarker in solid tumors, but it needs to be further studied whether it can improve the established prognostic model.

Analyzing HALP and PNI scores as prognostic factors in metastatic head and neck cancers

OBJECTIVE

This study investigates the prognostic significance of Hemoglobin, Albumin, Lymphocyte, Platelet (HALP) score and Prognostic Nutritional Index (PNI) in metastatic head and neck cancers.

METHODS

Retrospective analysis was conducted on data obtained from January 2014 to June 2022 for 68 patients using rigorous statistical methods. HALP and PNI scores, derived from routine laboratory parameters, were categorized into low and high groups using respective median values. Prognostic significance was determined through Kaplan-Meier survival analyses and Cox proportional hazards regression using IBM SPSS Statistics.

RESULTS

Of the 68 patients (80.9% male, median age 57), 39 (57.4%) had laryngeal cancer. When stratified by low and high HALP scores, the median overall survival (OS) was 5.9 and 16.4 months, respectively (P < 0.001), while the median progression-free survival (PFS) was 5.7 months and 8.2 months, respectively (P: 0.016). In the low and high PNI score groups, the median OS was 7 and 13.2 months (P < 0.001), with median PFS of 5.6 months and 8.2 months (P: 0.002), respectively. In the multivariate analysis, while the HALP score did not reach statistical significance in terms of PFS, the PNI score and age groups were found to be statistically significant. In terms of OS, higher HALP score and PNI scores were significantly associated with longer OS.

CONCLUSION

In this study, the HALP score and PNI score were found to be a prognostic factor in patients with metastatic head and neck cancer.

Prognostic importance of modified geriatric nutritional risk index in oral cavity squamous cell carcinoma

We probed the associations of preoperative modified geriatric nutritional risk index (mGNRI) values with prognosis in patients receiving surgery for oral cavity squamous cell carcinoma (OCSCC). This retrospective study analyzed the clinical data of 333 patients with OCSCC and undergoing surgery between 2008 and 2017. The preoperative mGNRI was calculated using the following formula: (14.89/C-reactive protein level) + 41.7 × (actual body weight/ideal body weight). We executed receiver operating characteristic curve analyses to derive the optimal mGNRI cutoff and employed Kaplan-Meier survival curves and Cox proportional hazard model to probe the associations of the mGNRI with overall survival (OS) and disease-free survival (DFS). The optimal mGNRI cutoff was derived to be 73.3. We noted the 5-year OS and DFS rates to be significantly higher in the high-mGNRI group than in the low-mGNRI group (both p < 0.001). A preoperative mGNRI below 73.3 was independently associated with unfavorable DFS and OS. A mGNRI-based nomogram was constructed to provide accurate OS predictions (concordance index, 0.781). Hence, preoperative mGNRI is a valuable and cost-effective prognostic biomarker in patients with OCSCC. Our nomogram facilitates the practical use of mGNRI and offers individualized predictions of OS.

Host-related indexes in head and neck cancer

PURPOSE OF REVIEW

Peripheral blood host-related indexes have been widely studied in cancer patients. Several authors have shown the prognostic capacity of these indexes in head and neck cancer. Therefore, there has been an increasing interest in this topic recently.

RECENT FINDINGS

The main variables analyzed and used to create these host-related indexes are peripheral blood leukocytes - including neutrophils, monocytes and lymphocytes - albumin and hemoglobin levels. Other factors with proven prognostic capacity in some studies are: platelets, C-reactive protein, and BMI. Among all the combined indexes, the neutrophil-to-lymphocyte ratio has been the most accepted and used worldwide. Nonetheless, there are other indexes which group multiple of these factors that have shown better prognostic capacity, and are promising in the near future.

SUMMARY

Host-related indexes are ideal biomarkers to be used on our daily-basis. There is enough evidence to start considering them when assessing patients with head and neck cancer.

Prognostic utility of preoperative platelet-to-albumin ratio in surgically treated oral cavity cancer patients

BACKGROUND

This study aimed to explore the prognostic utility of the preoperative platelet-to-albumin ratio (PAR) among patients with oral cavity squamous cell carcinoma (OSCC).

METHODS

We retrospectively reviewed of 355 patients with surgically-treated OSCC between 2008 and 2017. The optimal PAR cutoff for patient stratification was determined through X-tile analysis. Prognostic variables for disease-free survival (DFS) and overall survival (OS) were identified using Cox proportional hazards models. We developed a PAR-based nomogram to predict personalized OS.

RESULTS

We determined the optimal PAR cutoff to be 7.45. A PAR of ≥7.45 was an independent negative prognostic factor for DFS and OS (hazard ratio = 1.748 and 2.386; p = 0.005 and p < 0.001, respectively). The developed nomogram demonstrates the practical utility of PAR and accurately predicts personalized OS.

CONCLUSIONS

The preoperative PAR is a promising and cost-effective prognostic biomarker for patients with surgically-treated OSCC; the PAR-based nanogram accurately predicts OS for such patients.

Clinical value of hemoglobin, albumin, lymphocyte, and platelet indexes in predicting lymph node metastasis and recurrence of endometrial cancer: a retrospective study

Objective

To study the clinical importance of hemoglobin, albumin, lymphocyte, and platelet (HALP) indexes in predicting lymph node metastasis and recurrence of endometrial cancer.

Methods

From July 2016 to July 2020, 158 patients suffering from endometrial cancer who visited the gynecology department of General Hospital of Ningxia Medical University from were collected. Employing the X-Tiles program, the ideal HALP cut-off value was established, and the patients were separated into low and high HALP groups. Univariate and multivariate analysis were used to determine the relationship between HALP score and lymph node metastasis and recurrence of endometrial cancer.

Results

The optimal cut-off value of HALP score was established to be 22.2 using X-Tiles software, and the patients were separated into high HALP group (HALP score > 22.2, with 43 cases) and low HALP group (HALP score ≤ 22.2, 115 cases). Endometrial cancer patients' HALP scores were strongly connected with differentiation, the degree of myometrial invasion, and lymph node metastasis (P < 0.05), although not with age, menopausal status, or stage (P > 0.05). Multivariate logistic regression analysis revealed that the HALP score (OR = 2.087) was the influencing factor for lymph node metastasis (P < 0.05). The ROC curve suggested that the AUC of HALP score in predicting lymph node metastasis was 0.871, which had high diagnostic value. When compared to patients without recurrence, HALP scores of patients with recurrence were considerably lower (P < 0.05). Multivariate logistic regression analysis showed that HALP score (OR = 2.216) was the influencing factor for the occurrence of lymph node metastasis (P < 0.05). The ROC curve suggested that the AUC of HALP score in predicting relapse was 0.855, with high diagnostic value.

Conclusion

The HALP score shows good predictive performance in predicting lymph node metastasis and recurrence of endometrial cancer, and has high clinical value, which helps in improving the accuracy and effectiveness of clinical diagnosis and prognosis research.