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. 2018 Jan 15;8(1):794.
doi: 10.1038/s41598-018-19146-y.

Prognostic significance of HALP (hemoglobin, albumin, lymphocyte and platelet) in patients with bladder cancer after radical cystectomy

Ding Peng  1   2   3   4 , Cui-Jian Zhang  1   2   3   4 , Yan-Qing Gong  5   6   7   8 , Han Hao  1   2   3   4 , Bao Guan  1   2   3   4 , Xue-Song Li  9   10   11   12 , Li-Qun Zhou  13   14   15   16
Affiliations

Prognostic significance of HALP (hemoglobin, albumin, lymphocyte and platelet) in patients with bladder cancer after radical cystectomy

Ding Peng et al. Sci Rep. .

Abstract

The outcome of bladder cancer after radical cystectomy is heterogeneous. We aim to evaluate the prognostic value of HALP (hemoglobin, albumin, lymphocyte and platelet) and explore novel prognostic indexes for patients with bladder cancer after radical cystectomy. In this retrospective study, 516 patients with bladder cancer after radical cystectomy were included. The median follow-up was 37 months (2 to 99 mo). Risk factors of decreased overall survival were older age, high TNM stage, high American Society of Anesthesiologists (ASA) grade and low HALP score. The predictive accuracy was better with HALP-based nomogram than TNM stage (C- index 0.76 ± 0.039 vs. 0.708 ± 0.041). By combining ASA grade and HALP, we created a novel index-HALPA score and found it an independent risk factor for decreased survival (HALPA score = 1, HR 1.624, 95% CI 1.139-2.314, P = 0.007; HALPA score = 2, HR 3.471, 95% CI: 1.861-6.472, P < 0.001).The present study identified the prognostic value of HALP and provided a novel index HALPA score for bladder cancer after radical cystectomy.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Cut off value for HALP by X-tile software.
Figure 2
Figure 2
Kaplan-Meier curves for overall survival in patients with bladder cancer according to anemia level, (A) hypoalbuminemia level, (B) platelet to lymphocyte rate (PLR), (C) and HALP (D).
Figure 3
Figure 3
Nomogram for 3-year and 5-year survival.
Figure 4
Figure 4
Calibration curves for 3-year (A) and 5-year (B) survival.
Figure 5
Figure 5
Kaplan-Meier curves for all patients (A), NMIBC patients (B), MIBC patients (C) by HALPA score.
See this image and copyright information in PMC

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