{
  "abstract": "Background: Lymph-node metastasis and recurrence dominate outcomes in endometrial carcinoma, yet the strongest predictors are recovered only from the hysterectomy specimen, whereas systemic inflammation, nutritional reserve and skeletal-muscle mass are measurable before surgery. We investigated whether a preoperatively obtainable composite—the HALP–Sarcopenia Combined Index (HS-index)—is associated with nodal metastasis and recurrence.\n\nMethods: We retrospectively studied 195 consecutive women undergoing primary surgery for endometrial carcinoma. The HS-index was specified a priori from the standardised HALP score and skeletal-muscle index (SMI). Nodal metastasis, assessable in the 181 women who underwent lymph-node evaluation, was modelled with logistic regression; recurrence was modelled with Cox proportional-hazards regression. Restricted cubic splines, decision-curve analysis and bootstrap-validated C-statistics were used to characterise the shape and clinical usefulness of the associations.\n\nResults: Nodal metastasis occurred in 30 of 181 women (16.6%) and recurrence in 43 of 195 (22.1%; median follow-up 34 months). Per standard deviation, a higher HS-index was independently associated with lower odds of nodal metastasis (adjusted odds ratio 0.48, 95% CI 0.27–0.85; P = 0.012) and a lower hazard of recurrence (adjusted hazard ratio 0.37, 95% CI 0.25–0.55; P < 0.001) after adjustment for grade, myometrial invasion, lymphovascular space invasion, histological type and adjuvant therapy. Adding the HS-index to a clinicopathological model raised the area under the curve from 0.853 to 0.870, a non-significant increment.\n\nConclusions: A preoperatively available composite of nutrition, inflammation and muscle mass was independently and monotonically associated with nodal metastasis and recurrence. It is best positioned as an exploratory adjunct to, not a substitute for, surgical–pathologic staging, and requires external validation before clinical use.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Medical Record Room, Wuxi Ninth People’s Hospital Affiliated to Soochow University, Wuxi, Jiangsu, 214000, People’s Republic of China",
    "Department of Gynaecology, Wuxi Maternity and Child Health Care Hospital (Affiliated Women’s Hospital of Jiangnan University), Wuxi City, Jiangsu Province, 214000, People’s Republic of China"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Qingqing Zhang"
    },
    {
      "affs": [
        1
      ],
      "name": "Danfeng Guo"
    },
    {
      "affs": [
        1
      ],
      "name": "Dan Li"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/4s1tv81e9w36q.bib",
  "cited_by": 0,
  "doi": "10.2147/ijwh.s647101",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13723243/",
  "id": "4s1tv81e9w36q",
  "issns": [
    "1179-1411"
  ],
  "landing_url": "https://doi.org/10.2147/ijwh.s647101",
  "language": "en",
  "licence": "CC-BY-NC-4.0",
  "licence_label": "CC BY-NC 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Research"
    ],
    [
      "openalex",
      "2729|Endometrial and Cervical Cancer Treatments"
    ]
  ],
  "openalex": "W7223896333",
  "pdf_url": "https://www.dovepress.com/article/download/121428",
  "pmcid": "PMC13723243",
  "pmid": "42967187",
  "published": "2026-10-27",
  "publisher": "Dove Press",
  "ris": "https://research.draconitic.com/paper/4s1tv81e9w36q.ris",
  "sources": [
    {
      "first_seen": "2026-11-04T12:21:52Z",
      "native_id": "PMC13723243",
      "source": "pmc",
      "url": "https://doi.org/10.2147/ijwh.s647101"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2729|Endometrial and Cervical Cancer Treatments",
      "subfield": "reproductive-child"
    }
  ],
  "title": "Integrating Systemic Inflammation, Nutrition and Skeletal Muscle into a Composite Score (the HALP–Sarcopenia Combined Index) for Preoperative Risk Stratification of Lymph-Node Metastasis and Recurrence in Endometrial Carcinoma: A Single-Centre Retrospective Study",
  "title_text": "Integrating Systemic Inflammation, Nutrition and Skeletal Muscle into a Composite Score (the HALP–Sarcopenia Combined Index) for Preoperative Risk Stratification of Lymph-Node Metastasis and Recurrence in Endometrial Carcinoma: A Single-Centre Retrospective Study",
  "type": "peer-reviewed",
  "updated_at": "2026-11-04T12:21:52Z",
  "url": "https://research.draconitic.com/paper/4s1tv81e9w36q",
  "venue": "International Journal of Women's Health",
  "versions": []
}