The Clinical Impact of Hemoglobin, Albumin, Lymphocyte, Platelet (HALP) in Gastric Cancer Patients Who Receive Curative Treatment.

BACKGROUND/AIM: We hypothesized that the hemoglobin, albumin, lymphocyte, and platelet (HALP) score may be a promising marker for the treatment and management of gastric cancer (GC). To test this hypothesis, we evaluated the clinical impact of the HALP score in patients with GC who received curative treatment. PATIENTS AND METHODS: Consecutive patients who underwent curative resection for GC at the Yokohama City University between 2005 and 2020 were selected based on their medical records. The HALP score was calculated as follows: HALP=Hemoglobin (g/l) × albumin (g/l) × lymphocytes (109/l)/platelets (109/l). RESULTS: The 3-year and 5-year overall survival (OS) rates were 88.6% and 85.8%, respectively, in patients with HALP scores of >40, and 70.3% and 57.2% in patients with HALP scores of ≤40. There were significant differences between the groups analyzed (p<0.001). In univariate analysis, age, T status, lymph node metastasis status, HALP score, lymphovascular invasion status, pathological type, and postoperative complication status were identified as significant prognostic factors for OS. In multivariate analysis, the HALP score remained a significant prognostic factor for OS [hazard ratio (HR)=2.679; 95% confidence interval (CI)=1.455-4.934, p=0.002]. Similar results were observed in the analysis of recurrence-free survival. In addition, the HALP score status affects the postoperative clinical course, including the occurrence of postoperative anastomotic leakage and the introduction of postoperative adjuvant chemotherapy. CONCLUSION: The HALP score affects both short- and long-term oncological outcomes. Thus, the HALP score may be a promising prognostic factor for the treatment and management of GC.

Global Immune-Nutrition-Information Index Is Independent Prognostic Factor for Gastric Cancer Patients Who Received Curative Treatment.

Background/Aim: The aim of the present study was to evaluate the clinical impact of the Global Immune-Nutrition-Information Index (GINI) in patients with gastric cancer (GC) who received curative treatment and to clarify the potential of the GINI as a biomarker. Patients and Methods: Patients who underwent curative resection for GC at Yokohama City University between 2005 and 2020 were selected based on their medical records. The GINI was calculated as follows: GINI=[C-reactive protein × platelet × monocyte × neutrophil]/[albumin × lymphocyte]. Results: A total of 258 patients were included in this study. Of these, 169 patients were categorized into the GINI-low group and 89 into the GINI-high group using a cut-off value of 1,730. The three- and five-year overall survival (OS) rates were 86.4% and 78.4%, respectively, in the GINI-low group, and 66.4% and 58.3% in the GINI-high group (p<0.001). In a multivariate analysis for OS, the GINI was identified as an independent prognostic factor [hazard ratio (HR)=1.772; 95% confidence interval (CI)=1.053-2.979, p=0.031]. Similar results were observed for RFS. In addition, the GINI affected the perioperative clinical course, including postoperative surgical complications and postoperative adjuvant treatment. Conclusion: The GINI is a promising biomarker for the treatment and management of GC.

The Systemic Immune-inflammation Index Is an Independent Prognostic Factor for Gastric Cancer Patients Who Receive Curative Treatment.

BACKGROUND/AIM: Systemic immune-inflammation index (SII) was developed and evaluated for various malignancies. This study evaluated the clinical impact of the SII in patients with gastric cancer (GC) who received curative treatment. PATIENTS AND METHODS: Patients who underwent curative resection for GC at Yokohama City University between 2005 and 2020 were chosen consecutively based on their medical records. SII was calculated as follows: platelet (cell/mm3 ×103)× neutrophil (cell/mm3)/lymphocyte (cell/mm3). Three measurements were obtained preoperatively. RESULTS: In total, 258 patients were enrolled in this study. Based on the 3- and 5-year survival rates and previous studies, we set the cutoff value of the SII to 550. The 258 patients were classified into the SII-low (n=152) and SII-high (n=106) groups, respectively. The 3- and 5-year overall survival (OS) rates were 82.6% and 78.7%, respectively, in the SII-low group and 74.5% and 61.9%, respectively, in the SII-high group. There were significant differences between the two groups (p<0.001). In the multivariate analysis of factors associated with OS, the SII was identified as an independent prognostic factor (hazard ratio=1.816; 95% confidence interval=1.075-3.069, p=0.026). Similar results were observed for recurrence-free survival. In addition, the incidence of postoperative surgical complications was 30.9% in the SII-low group and 45.2% in the SII-high group (p=0.019). CONCLUSION: The SII was an independent prognostic factor for GC. Thus, the SII may be a promising biomarker for the treatment and management of GC.