TY  - JOUR
T1  - Efficacy of the HALP Score in Predicting Progression in Patients Undergoing Radical Cystectomy for Muscle Invasive Bladder Cancer
TT  - Kas İnvaziv Mesane Kanseri Nedeniyle Radikal Sistektomi Uygulanan Hastalarda HALP Skorunun Progresyonu Öngörmedeki Etkinliği
AU  - Kayar, Ridvan
AU  - Kayar, Kemal
AU  - Artuk, İlker
AU  - Demir, Samet
AU  - Tokuç, Emre
AU  - Öztürk, Metin İshak
PY  - 2025
DA  - October
Y2  - 2025
DO  - 10.33719/nju1638712
JF  - The New Journal of Urology
JO  - New J Urol
PB  - Ali İhsan TAŞÇI
WT  - DergiPark
SN  - 3023-6940
SP  - 139
EP  - 148
VL  - 20
IS  - 3
LA  - en
AB  - 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.
KW  - HALP score
KW  - muscle invasive bladder cancer
KW  - progression
KW  - radical cystectomy
N2  - AmaçBu 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.
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UR  - https://doi.org/10.33719/nju1638712
L1  - https://dergipark.org.tr/tr/download/article-file/4604364
ER  -