Prognostic Significance of the Combination of Preoperative Hemoglobin and Albumin Levels and Lymphocyte and Platelet Counts (HALP) in Patients with Renal Cell Carcinoma After Nephrectomy

Overview

Journal BMC Urol

Publisher Biomed Central

Specialty Urology

Date 2018 Mar 17

PMID 29544476

Citations 44

Authors

Ding Peng

Cui-Jian Zhang

Qi Tang

Lei Zhang

Kai-Wei Yang

Xiao-Teng Yu

Yanqing Gong

Xue-Song Li

Zhi-Song He

Li-Qun Zhou

Affiliations

Soon will be listed here.

Abstract

Background: To evaluate the prognostic significance of the novel index combining preoperative hemoglobin and albumin levels and lymphocyte and platelet counts (HALP) in renal cell carcinoma (RCC) patients.

Methods: We enrolled 1360 patients who underwent nephrectomy in our institution from 2001 to 2010. The cutoff values for HALP, neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio were defined by using X-tile software. Survival was analyzed by the Kaplan-Meier method, with differences analyzed by the log-rank test. Multivariate Cox proportional-hazards model was used to evaluate the prognostic significance of HALP for RCC.

Results: Low HALP was significantly associated with worse clinicopathologic features. Kaplan-Meier and log-rank tests revealed that HALP was strongly correlated with cancer specific survival (P < 0.001) and Cox multivariate analysis demonstrated that preoperative HALP was independent prognostic factor for cancer specific survival (HR = 1.838, 95%CI:1.260-2.681, P = 0.002). On predicting prognosis by nomogram, the risk model including TNM stage, Fuhrman grade and HALP score was more accurate than only use of TNM staging.

Conclusions: HALP was closely associated with clinicopathologic features and was an independent prognostic factor of cancer-specific survival for RCC patients undergoing nephrectomy. A nomogram based on HALP could accurately predict prognosis of RCC.

Citing Articles

Effect of Hemoglobin, Albumin, Lymphocyte Count, and Platelet (HALP) Score on Survival of Patients with Metastatic Thyroid Cancer Treated with Tyrosine Kinase Inhibitors.

Oztop H, Hunutlu F, Ekizoglu S, Gul O, Cander S, Sahin A J Clin Med. 2025; 14(4).

PMID: 40004836 PMC: 11856822. DOI: 10.3390/jcm14041306.

Prognostic Value of Hemoglobin, Albumin, Lymphocyte, Platelet (HALP) Score in Patients with Metastatic Renal Cell Carcinoma Treated with Nivolumab.

Tomcova Z, Obertova J, Chovanec M, Sycova-Mila Z, Stefanikova K, Slachtova E Biomedicines. 2025; 13(2).

PMID: 40002897 PMC: 11852442. DOI: 10.3390/biomedicines13020484.

Hemoglobin, albumin, lymphocyte and platelet (HALP) score for predicting early and late mortality in elderly patients with proximal femur fractures.

Vural A, Dolanbay T, Yagar H PLoS One. 2025; 20(1):e0313842.

PMID: 39787124 PMC: 11717259. DOI: 10.1371/journal.pone.0313842.

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

Li J, Zheng J, Wang P, Lv D Front Immunol. 2025; 15():1483855.

PMID: 39744624 PMC: 11688271. DOI: 10.3389/fimmu.2024.1483855.

Construction and Comparison of Multiple Serum-Based Prognostic Models for Predicting the Prognosis of Acute Exacerbations of Chronic Obstructive Pulmonary Disease.

Wang N, Wang G, Li M, Liu T, Ji W, Hu T J Inflamm Res. 2024; 17:8395-8406.

PMID: 39534059 PMC: 11555031. DOI: 10.2147/JIR.S461961.

References

Sun J, Ning H, Sun J, Qu X . Effect of hypertension on preoperative neutrophil-lymphocyte ratio evaluation of prognosis of renal cell carcinoma. Urol Oncol. 2016; 34(5):239.e9-15. DOI: 10.1016/j.urolonc.2015.12.006. View

Shin J, Suh K, Oh S . Preoperative neutrophil to lymphocyte ratio predicts survival in patients with T1-2N0 colorectal cancer. J Surg Oncol. 2015; 112(6):654-7. DOI: 10.1002/jso.24061. View

Ljungberg B, Bensalah K, Canfield S, Dabestani S, Hofmann F, Hora M . EAU guidelines on renal cell carcinoma: 2014 update. Eur Urol. 2015; 67(5):913-24. DOI: 10.1016/j.eururo.2015.01.005. View

Stenman M, Laurell A, Lindskog M . Prognostic significance of serum albumin in patients with metastatic renal cell carcinoma. Med Oncol. 2014; 31(3):841. DOI: 10.1007/s12032-014-0841-7. View

Karakiewicz P, Trinh Q, Lam J, Tostain J, Pantuck A, Belldegrun A . Platelet count and preoperative haemoglobin do not significantly increase the performance of established predictors of renal cell carcinoma-specific mortality. Eur Urol. 2007; 52(5):1428-36. DOI: 10.1016/j.eururo.2007.03.036. View

Hsu J, Liao C, Le P, Chen T, Lin C, Chen J . Prognostic Value of the Preoperative Neutrophil to Lymphocyte Ratio in Resectable Gastric Cancer. Medicine (Baltimore). 2015; 94(39):e1589. PMC: 4616849. DOI: 10.1097/MD.0000000000001589. View

Chang Y, An H, Xu L, Zhu Y, Yang Y, Lin Z . Systemic inflammation score predicts postoperative prognosis of patients with clear-cell renal cell carcinoma. Br J Cancer. 2015; 113(4):626-33. PMC: 4647686. DOI: 10.1038/bjc.2015.241. View

Morgan T, Tang D, Stratton K, Barocas D, Anderson C, Gregg J . Preoperative nutritional status is an important predictor of survival in patients undergoing surgery for renal cell carcinoma. Eur Urol. 2011; 59(6):923-8. PMC: 3085569. DOI: 10.1016/j.eururo.2011.01.034. View

Wang Y, Jin C, Zheng H, Zhou K, Shi B, Zhang Q . A novel prognostic inflammation score predicts outcomes in patients with ovarian cancer. Clin Chim Acta. 2016; 456:163-169. DOI: 10.1016/j.cca.2016.03.013. View

10.

Senbabaoglu Y, Gejman R, Winer A, Liu M, Van Allen E, de Velasco G . Tumor immune microenvironment characterization in clear cell renal cell carcinoma identifies prognostic and immunotherapeutically relevant messenger RNA signatures. Genome Biol. 2016; 17(1):231. PMC: 5114739. DOI: 10.1186/s13059-016-1092-z. View

11.

Kim K, Seo H, Chin J, Son H, Hwang J, Kim Y . Preoperative hypoalbuminemia and anemia as predictors of transfusion in radical nephrectomy for renal cell carcinoma: a retrospective study. BMC Anesthesiol. 2015; 15:103. PMC: 4509698. DOI: 10.1186/s12871-015-0089-6. View

12.

Camp R, Dolled-Filhart M, Rimm D . X-tile: a new bio-informatics tool for biomarker assessment and outcome-based cut-point optimization. Clin Cancer Res. 2004; 10(21):7252-9. DOI: 10.1158/1078-0432.CCR-04-0713. View

13.

Hsieh J, Purdue M, Signoretti S, Swanton C, Albiges L, Schmidinger M . Renal cell carcinoma. Nat Rev Dis Primers. 2017; 3:17009. PMC: 5936048. DOI: 10.1038/nrdp.2017.9. View

14.

Hanahan D, Weinberg R . Hallmarks of cancer: the next generation. Cell. 2011; 144(5):646-74. DOI: 10.1016/j.cell.2011.02.013. View

15.

Best M, Sol N, Kooi I, Tannous J, Westerman B, Rustenburg F . RNA-Seq of Tumor-Educated Platelets Enables Blood-Based Pan-Cancer, Multiclass, and Molecular Pathway Cancer Diagnostics. Cancer Cell. 2015; 28(5):666-676. PMC: 4644263. DOI: 10.1016/j.ccell.2015.09.018. View

16.

Chen X, Xue L, Wang W, Chen H, Zhang W, Liu K . Prognostic significance of the combination of preoperative hemoglobin, albumin, lymphocyte and platelet in patients with gastric carcinoma: a retrospective cohort study. Oncotarget. 2015; 6(38):41370-82. PMC: 4747412. DOI: 10.18632/oncotarget.5629. View

17.

Corcoran A, Kaffenberger S, Clark P, Walton J, Handorf E, Piotrowski Z . Hypoalbuminaemia is associated with mortality in patients undergoing cytoreductive nephrectomy. BJU Int. 2014; 116(3):351-7. DOI: 10.1111/bju.12897. View

18.

Chang Y, Fu Q, Xu L, Zhou L, Liu Z, Yang Y . Prognostic value of preoperative lymphocyte to monocyte ratio in patients with nonmetastatic clear cell renal cell carcinoma. Tumour Biol. 2015; 37(4):4613-20. DOI: 10.1007/s13277-015-4300-7. View

19.

Maccio A, Madeddu C, Gramignano G, Mulas C, Tanca L, Cherchi M . The role of inflammation, iron, and nutritional status in cancer-related anemia: results of a large, prospective, observational study. Haematologica. 2014; 100(1):124-32. PMC: 4281325. DOI: 10.3324/haematol.2014.112813. View

20.

Gunduz S, Mutlu H, Tural D, Yildiz O, Uysal M, Coskun H . Platelet to lymphocyte ratio as a new prognostic for patients with metastatic renal cell cancer. Asia Pac J Clin Oncol. 2015; 11(4):288-92. DOI: 10.1111/ajco.12358. View