Prognostic Value of the HALP Score in Metastatic Urothelial Carcinoma Treated With First-Line Platinum-Based Chemotherapy

Abstract

Objective: Metastatic urothelial carcinoma (mUC) demonstrates substantial clinical heterogeneity, and outcomes may vary despite similar treatment approaches. The hemoglobin, albumin, lymphocyte, and platelet (HALP) score has emerged as a potential prognostic biomarker reflecting nutritional, inflammatory, and immune status. This study evaluated the prognostic significance of HALP in patients with mUC treated with first-line platinum-based chemotherapy.

Materials and Methods: We retrospectively evaluated patients with metastatic or unresectable urothelial carcinoma who received first-line platinum-based chemotherapy at a single center between january 2015 and december 2023. HALP scores were calculated using baseline laboratory parameters obtained before treatment initiation. Patients were stratified according to the median HALP value. Overall survival (OS) was the primary endpoint, and progression-free survival (PFS) was the secondary end point. Survival analyses were performed using the Kaplan – Meier and Cox regression methods.

Results: A total of 118 patients were included. The median HALP value was 24; 64 patients were classified as low HALP and 54 as high HALP. Patients with low HALP had significantly poorer outcomes. Median PFS was 4.90 months in the low HALP group and 7.67 months in the high HALP group. Median OS was 5.82 and 20.33 months, respectively (p<0.001). In multivariable analysis, low HALP and age ≥ 65 years remained independently associated with worse OS.

Conclusion: Low HALP score was associated with worse survival outcomes in patients with mUC receiving first-line platinum-based chemotherapy. As an easily obtainable laboratory-based index, HALP may provide additional prognostic information beyond conventional clinical factors.

Keywords

• metatatic urothelial carcinoma
• inflammation
• HALP score
• prognosis
• overall survival
• platinum-based chemotherapy

Project Number

N/A

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