Efficacy of the HALP Score in Predicting Progression in Patients Undergoing Radical Cystectomy for Muscle Invasive Bladder Cancer

Year 2025, Volume: 20 Issue: 3, 139 - 148, 20.10.2025

Ridvan Kayar , Kemal Kayar , İlker Artuk , Samet Demir , Emre Tokuç , Metin İshak Öztürk

https://doi.org/10.33719/nju1638712

Abstract

Objective: This study investigated the prognostic value of the HALP score, comprising haemoglobin, albumin, lymphocyte, and platelet parameters, on progression and progression-free survival (PFS) in patients undergoing radical cystectomy (RC) for non-metastatic muscle-invasive bladder cancer (MIBC).
Material and Methods: A retrospective analysis was conducted on 134 MIBC patients who underwent RC between February 2014 and January 2024. The HALP score was calculated using the formula: HALP = (haemoglobin × albumin × lymphocytes) / platelets. Associations between HALP score, clinicopathological parameters, progression, and PFS were assessed via Kaplan-Meier survival analysis, ROC curve analysis, and multivariate logistic regression.
Results: The median HALP score was significantly lower in patients with disease progression (29.19 [IQR: 19.17–41.81]) compared to those without progression (37.55 [IQR: 29.61–52.25]; p = 0.021). Patients with a HALP score <36.38 had a mean PFS of 68.8 months (95% CI: 52.6–85.1), compared to 82.4 months (95% CI: 66.5–98.2) in patients with a HALP score ≥36.38 (p=0.021). ROC analysis yielded an AUC of 0.619 (95% CI: 0.518–0.721) for predicting progression, with sensitivity and specificity of 54.9% and 55.4%, respectively. Perineural invasion (PNI) emerged as an independent prognostic factor for progression (OR=2.56, 95% CI: 1.011–6.482, p=0.047), and low preoperative albumin levels significantly increased progression risk (p=0.032).
Conclusions: Although the HALP score is a statistically significant prognostic marker for predicting progression in patients with MIBC, it has limited predictive power. Our results demonstrate the potential of the HALP score as a helpful tool in individualised treatment approaches. However, the prognostic value of the HALP score needs to be confirmed in prospective and multicentre studies in larger patient populations.

Keywords

HALP score , muscle invasive bladder cancer , progression , radical cystectomy

Ethical Statement

Our study was approved by the Scientific Research Ethics Committee of Haydarpaşa Numune Training and Research Hospital on December 17, 2024, with decision number HNEAH-GOAEK/KK/2024/159.

Supporting Institution

This research received no specific grant from any funding agency in the public, commercial,or not-for-profit sectors.

Kas İnvaziv Mesane Kanseri Nedeniyle Radikal Sistektomi Uygulanan Hastalarda HALP Skorunun Progresyonu Öngörmedeki Etkinliği

Abstract

Amaç
Bu çalışmada, metastatik olmayan kas invaziv mesane kanseri (KİMK) nedeniyle radikal sistektomi (RS) uygulanan hastalarda hemoglobin, albümin, lenfosit ve trombosit parametrelerinden oluşan HALP skorunun progresyon ve progresyonsuz sağkalım (PFS) üzerindeki prognostik değeri araştırıldı.
Yöntemler:
Şubat 2014 ve Ocak 2024 tarihleri arasında RS uygulanan 134 KİMK hastası üzerinde retrospektif bir analiz yapıldı. HALP skoru şu formül kullanılarak hesaplandı: HALP = (hemoglobin × albümin × lenfositler) / trombositler. HALP skoru, klinikopatolojik parametreler, progresyon ve PFS arasındaki ilişkiler Kaplan-Meier sağkalım analizi, ROC eğrisi analizi ve çok değişkenli lojistik regresyon ile değerlendirilmiştir.
Bulgular:
Ortalama HALP skoru 39.83 ± 22.54 idi. HALP skoru <36.38 olan hastalarda ortalama PFS 68.8 ay (%95 GA: 52.6-85.1) iken, HALP skoru ≥36.38 olan hastalarda 82.4 ay (%95 GA: 66.5-98.2) idi (p=0.021). ROC analizi, progresyonu öngörmek için sırasıyla %54,9 ve %55,4 duyarlılık ve özgüllük ile 0,619 AUC (%95 CI: 0,518-0,721) vermiştir. Perinöral invazyon (PNİ) progresyon için bağımsız bir prognostik faktör olarak ortaya çıkmıştır (OR=2.56, %95 GA: 1.011-6.482, p=0.047) ve düşük preoperatif albümin düzeyleri progresyon riskini önemli ölçüde artırmıştır (p=0.032).
Sonuçlar:
HALP skoru KİMK'li hastalarda progresyonu öngörmede istatistiksel olarak anlamlı bir prognostik belirteç olmasına rağmen, sınırlı tahmin gücüne sahiptir. Sonuçlarımız, HALP skorunun bireyselleştirilmiş tedavi yaklaşımlarında yardımcı bir araç olma potansiyelini göstermektedir. Bununla birlikte, HALP skorunun prognostik değerinin daha geniş hasta popülasyonlarında prospektif ve çok merkezli çalışmalarla doğrulanması gerekmektedir.

Keywords

Kas İnvaziv Mesane Kanseri , Radikal Sistektomi , HALP Skoru , Progresyon

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