Abstract
BackgroundTo 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.MethodsWe 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.ResultsLow 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.ConclusionsHALP 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.
Highlights
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
Further studies found that the combination of those factors in an index such as the prognostic nutritional index (PNI), combining albumin level and lymphocyte count, or the neutrophil-tolymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR) or platelet-to-lymphocyte ratio (PLR) could more accurately predict prognosis than a single index [9,10,11,12]
In this study, we evaluated the prognostic significance of the novel index HALP combining hemoglobin and albumin levels and lymphocyte and platelet counts in RCC patients undergoing nephrectomy
Summary
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. Hematologic parameters including albumin and hemoglobin levels and lymphocytes, Peng et al BMC Urology (2018) 18:20 neutrophils and platelets counts are acquired laboratory data reflecting inflammation and nutrition status and have been extensively studied. Numerous studies have reported the prognostic value of serum albumin and hemoglobin levels and lymphocyte and platelet counts for various cancers, including RCC [5,6,7,8]. Further studies found that the combination of those factors in an index such as the prognostic nutritional index (PNI), combining albumin level and lymphocyte count, or the neutrophil-tolymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR) or platelet-to-lymphocyte ratio (PLR) could more accurately predict prognosis than a single index [9,10,11,12]
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