Significance of Pretreatment Hemoglobin-Albumin-Lymphocyte-Platelet Index for the Prediction of Suboptimal Surgery in Epithelial Ovarian Cancer.

IF 2.1 Q3 ONCOLOGY World Journal of Oncology Pub Date : 2024-04-01 Epub Date: 2024-03-21 DOI:10.14740/wjon1778

Thiti Atjimakul, Nungrutai Saeaib, Thara Tunthanathip, Paramee Thongsuksai

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Abstract

Background: Epithelial ovarian cancer (EOC) is the leading cause of death in gynecological cancers in developed countries. In recent years, there has been a growing need for economical and accurate pretreatment laboratory investigations to assess the prognosis of patients with advanced EOC (AEOC). We aimed to investigate the role of the hemoglobin-albumin-lymphocyte-platelet (HALP) index in suboptimal cytoreduction and oncological outcomes.

Methods: A prognostic prediction model for diagnosing suboptimal cytoreduction for patients with AEOC receiving neoadjuvant chemotherapy (NACT) was developed. Multivariate logistic regression analysis was performed to identify the independent predictors of suboptimal cytoreduction, with a P-value < 0.05, and then transformed into risk-scoring systems. Internal validation was performed using the bootstrapping procedure, and predictive cytoreduction (PSC) scores were compared using non-parametric receiver operating characteristic (ROC) regression. Survival analysis was performed using Kaplan-Meier estimation and Cox proportional regression.

Results: In total, 473 patients were analyzed, and the rate of suboptimal surgery was 43%. A scoring system in predicting suboptimal cytoreduction included age, cancer antigen (CA)-125 level before surgery, performance status, cycles of chemotherapy, peritoneal cancer index, and HALP index ≤ 22.6. The model had good discriminative ability (area under the ROC (AUROC), 0.80; 95% confidence interval (CI), 0.76 - 0.84), outperforming the PSC score (AUROC, 0.75; 95% CI, 0.71 - 0.80). The score was divided into the low-risk (positive predictive value (PPV), 22.4; 95% CI, 17.8 - 27.7), moderate-risk (PPV, 65.9; 95% CI, 56.9 - 74.0), and high-risk (PPV, 90.6; 95% CI, 79.3 - 96.9) groups. The HALP index score of ≤ 22.6 was independently associated with progression-free survival (hazard ratio (HR), 2.92; 95% CI, 1.58 - 5.40) and overall survival (HR, 2.66; 95% CI, 1.57 - 4.49).

Conclusion: The HALP index is a newly predicted factor for suboptimal cytoreduction and oncological outcomes in patients with AEOC after NACT.

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治疗前血红蛋白-白蛋白-淋巴细胞-血小板指数对上皮性卵巢癌次优手术预测的意义

背景：上皮性卵巢癌（EOC上皮性卵巢癌（EOC）是发达国家妇科癌症的主要死因。近年来，人们越来越需要经济、准确的预处理实验室检查来评估晚期卵巢癌（AEOC）患者的预后。我们旨在研究血红蛋白-白蛋白-淋巴细胞-血小板（HALP）指数在次优细胞减灭术和肿瘤预后中的作用：方法：建立了一个预后预测模型，用于诊断接受新辅助化疗（NACT）的AEOC患者的次优细胞减灭术。通过多变量逻辑回归分析确定了P值小于0.05的最佳细胞减灭术的独立预测因素，然后将其转化为风险评分系统。使用引导程序进行内部验证，并使用非参数接收器操作特征（ROC）回归对预测性细胞减灭术（PSC）评分进行比较。采用卡普兰-梅耶估计法和 Cox 比例回归法进行生存分析：共分析了 473 例患者，次优手术率为 43%。预测次优细胞减灭术的评分系统包括年龄、术前癌抗原（CA）-125水平、表现状态、化疗周期、腹膜癌指数和HALP指数≤22.6。该模型具有良好的判别能力（ROC 下面积（AUROC），0.80；95% 置信区间（CI），0.76 - 0.84），优于 PSC 评分（AUROC，0.75；95% CI，0.71 - 0.80）。该评分分为低风险组（阳性预测值 (PPV)，22.4；95% CI，17.8 - 27.7）、中风险组（PPV，65.9；95% CI，56.9 - 74.0）和高风险组（PPV，90.6；95% CI，79.3 - 96.9）。HALP指数得分≤22.6与无进展生存期（危险比（HR），2.92；95% CI，1.58 - 5.40）和总生存期（HR，2.66；95% CI，1.57 - 4.49）独立相关：HALP指数是NACT术后AEOC患者细胞减容效果不理想和肿瘤预后的一个新的预测因素。

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来源期刊

World Journal of Oncology ONCOLOGY-

CiteScore

6.10

自引率

15.40%

发文量

期刊介绍： World Journal of Oncology, bimonthly, publishes original contributions describing basic research and clinical investigation of cancer, on the cellular, molecular, prevention, diagnosis, therapy and prognosis aspects. The submissions can be basic research or clinical investigation oriented. This journal welcomes those submissions focused on the clinical trials of new treatment modalities for cancer, and those submissions focused on molecular or cellular research of the oncology pathogenesis. Case reports submitted for consideration of publication should explore either a novel genomic event/description or a new safety signal from an oncolytic agent. The areas of interested manuscripts are these disciplines: tumor immunology and immunotherapy; cancer molecular pharmacology and chemotherapy; drug sensitivity and resistance; cancer epidemiology; clinical trials; cancer pathology; radiobiology and radiation oncology; solid tumor oncology; hematological malignancies; surgical oncology; pediatric oncology; molecular oncology and cancer genes; gene therapy; cancer endocrinology; cancer metastasis; prevention and diagnosis of cancer; other cancer related subjects. The types of manuscripts accepted are original article, review, editorial, short communication, case report, letter to the editor, book review.