Combination of Preoperative Haemoglobin and Albumin Levels and Lymphocyte and Platelet Counts (HALP) in Patients with Oesophageal Cancer

BACKGROUND

It has been previously established that the Haemoglobin, Albumin, Lymphocyte, and Platelet (HALP) score has prognostic significance in many types of malignant tumors. In oesophageal cancer, the prognostic value of the HALP score is currently uncertain. Our aim in this study was to identify the prognostic significance of the HALP score in patients with curative resected oesophageal cancer.

METHODS

This is a retrospective cohort study conducted with data obtained from the hospital records. Patients who underwent curative resection due to oesophageal cancer between 2015 and 2019 were included in the study. The HALP value was calculated by dividing the multiplication of haemoglobin (g / L), albumin (g / L), and lymphocyte (/ L) by the platelet counts (/ L). Receiver Operating Characteristic (ROC) analysis was performed and the ROC curve was generated to create a cutoff value for the HALP score. Two groups, Group 1 (HALP low) and Group 2 (HALP high), were formed. Demographic characteristics, clinical characteristics, tumoral characteristics, postoperative results, and mean survival of the patients were compared in the groups.

RESULTS

We divided the 43 patients into two groups based on their HALP score values. Group 1 consisted of 26 patients; Group 2 consisted of 18 patients. The mean age was similar in the groups (61 vs. 63 p: 0.625). Male sex was dominant in both groups (69.2 % vs. 77.8 % p: 0.393). The tumor was most commonly located in the lower oesophagus (69.2 % vs. 77.8 % p: 0.044). Tumor diameter was larger in Group 1 (5.3 cm vs. 3.55 cm p: 0.000). Histological type distribution (p: 0.380) and degree of differentiation distribution (p: 0.065) were similar in the groups. Respiratory complications were more common in Group 1 (30.8 % vs. 11.1 %, p: 0.007). Anastomotic leak (p: 0.133) and wound complication (p: 0.439) were similar in the groups. The mean survival time (17 months vs. 28 months, p: 0.095) and 1-year survival rates (53.8 % vs. 66.7 %) were lower in Group 1, but there was no difference statistically. The HALP score [HR (95 % - Cl) 3.200 (0.909 - 11.268), p: 0.47] was not an independent risk factor in univariate and multivariate analysis for survival. Having the patients age of > 65 years (p: 0.004), differentiation (p: 0.024), and stage 3 disease (p: 0.016) were independent risk factors.

CONCLUSIONS

HALP score is associated with tumoral characteristics and postoperative respiratory complications in patients with oesophageal cancer who underwent curative resection. A low HALP score is associated with decreased survival rates. However, it cannot be used as a prognostic factor alone.