Introduction:

Prognosis in cancer patients is a combination of tumor characteristics and immunobiology. While a variety of hemogram parameters have been examined, HALP scores have demonstrated some of the most significant prognostic value across a variety of cancers. The purpose of this study is to examine the prognostic value of HALP scores in patients with bladder cancer (BCa) undergoing radical cystectomy (RC).

Methods:

We utilized our prospective, IRB-approved cystectomy database and identified patients who underwent RC between 2007 and 2024. Patients with incomplete CBC and CMP data were excluded from analysis. Patients were stratified into four quartiles (Q1-Q4), and the first quartile was used as a reference (Table 1). Associations of HALP scores with recurrence-free survival (RFS) and overall survival (OS) were assessed with univariate and multivariate Cox regression models.

Results:

The cohort included 1,098 patients who had CBC and CMP data within 60 days prior to RC, and HALP scores were calculated using the formula Hb×Alb×(#Lymph÷Pt). Cohort demographics and postoperative outcomes are shown in Table 1. Of note, patients in HALP Q1 and Q2 experienced significantly more 30- and 90-day complications (p=0.02, p=0.01) and had more severe 90-day complications (p=0.02) compared to higher HALP quartiles (Clavien-Dindo classification). Survival analyses are shown in Table 2. Patients in HALP Q3 and Q4 had improved OS (HR=0.575, p=0.0004; HR=0.673, p=0.01) as compared to Q1 quartile. Additionally, patients in HALP Q3 had improved RFS (HR=0.648, p=0.01).

Conclusion:

HALP scores are a significant marker for predicting postoperative complications and overall survival in patients undergoing RC for BCa. HALP scores could be used for further risk stratification and for optimizing overall fitness before surgery.

Funding: N/A