The Hemoglobin, Albumin, Lymphocyte and Platelet (HALP) Score as an Independent Prognostic Factor for Esophageal Cancer Patients who Received Curative Treatment

Background/Aim: Esophageal cancer (EC) is a malignant tumor with poor prognosis. Prognostic factors that may be used in the treatment and management of EC are important. The purpose of this study was to evaluate the impact of the hemoglobin, albumin, lymphocyte, and platelet (HALP) score on the long-term oncological prognosis of patients with EC who have undergone curative treatment. Patients and Methods: Patients with EC who underwent curative resection at Yokohama City University between 2000 and 2020 were included. Clinical data were retrospectively retrieved from medical records and analyzed. The HALP score was determined as follows: HALP=[hemoglobin (g/l)xalbumin (g/l)xlymphocytes (/l)]/platelets (/l). Kaplan-Meier method and Cox regression model were used to assess the overall (OS) and recurrence-free survival (RFS) and to evaluate the prognostic value of the HALP score. Results: In total, 180 patients were included in this study. They were classified into the HALP-low (n=110) and HALP- high (n=70) groups using a cutoff value of 40. The 5-year OS rate was 46.9% in the HALP-low group and 66.0% in the HALP-high group (p=0.012). The 5-year RFS rate was 31.1% in the HALP-low group and 51.4% in the HALP-high group (p=0.006). The HALP score was found to be an independent prognostic factor for OS [odds ratio (OR)=1.954, 95% confidence interval (CI)=1.157-3.299, p=0.012] and RFS (OR=1.852, 95% CI=1.197-2.866, p=0.006). Conclusion: The HALP score is a factor that predicts the oncological prognosis in patients with EC who have undergone radical resection.