Haemoglobin, albumin, lymphocyte and platelet predicts postoperative survival in pancreatic cancer

World J Gastroenterol. 2020 Feb 28;26(8):828-838. doi: 10.3748/wjg.v26.i8.828.

Abstract

Background: Systemic inflammation and nutrition status play an important role in cancer metastasis. The combined index of hemoglobin, albumin, lymphocyte, and platelet (HALP), consisting of haemoglobin, albumin, lymphocytes, and platelets, is considered as a novel marker to reflect both systemic inflammation and nutrition status. However, no studies have investigated the relationship between HALP and survival of patients with pancreatic cancer following radical resection.

Aim: To evaluate the prognostic value of preoperative HALP in pancreatic cancer patients.

Methods: The preoperative serum levels of hemoglobin, albumin, lymphocyte counts, and platelet counts were routinely detected in 582 pancreatic adenocarcinoma patients who underwent radical resection. The relationship between postoperative survival and the preoperative level of HALP was investigated.

Results: Low levels of HALP were significantly associated with lymph node metastasis (P = 0.002), poor tumor differentiation (P = 0.032), high TNM stage (P = 0.008), female patients (P = 0.005) and tumor location in the head of the pancreas (P < 0.001). Low levels of HALP were associated with early recurrence [7.3 mo vs 16.3 mo, P < 0.001 for recurrence-free survival (RFS)] and short survival [11.5 mo vs 23.6 mo, P < 0.001 for overall survival (OS)] in patients with resected pancreatic adenocarcinoma. A low level of HALP was an independent risk factor for early recurrence and short survival irrespective of sex and tumor location.

Conclusion: Low levels of HALP may be a significant risk factor for RFS and OS in patients with resected pancreatic cancer.

Keywords: HALP; Nutrition status; Pancreatic adenocarcinoma; Postoperative survival; Systemic inflammation.

Publication types

  • Evaluation Study

MeSH terms

  • Adenocarcinoma / blood*
  • Adenocarcinoma / mortality
  • Adenocarcinoma / surgery
  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Platelets*
  • Female
  • Hemoglobins / analysis*
  • Humans
  • Male
  • Middle Aged
  • Nutritional Status
  • Pancreatectomy / mortality*
  • Pancreatic Neoplasms / blood*
  • Pancreatic Neoplasms / mortality
  • Pancreatic Neoplasms / surgery
  • Platelet Count
  • Predictive Value of Tests
  • Preoperative Period
  • Prognosis
  • Proportional Hazards Models
  • Serum Albumin / analysis*
  • Treatment Outcome

Substances

  • Hemoglobins
  • Serum Albumin