Prognostic Significance and Clinical Robustness of the HALP Score in Super-Elderly Patients Undergoing Curative Gastrectomy for Gastric Cancer: A Multicenter Retrospective Cohort Study.
10 affiliations
- 1Division of Digestive Surgery, Department of Surgery Kyoto Prefectural University of Medicine Kyoto Japan.
- 2Department of Surgery North Medical Center Kyoto Prefectural University of Medicine Kyoto Japan.
- 3Department of Digestive Surgery Japanese Red Cross Kyoto Daini Hospital Kyoto Japan.
- 4Department of Surgery Kyoto Chubu Medical Center Kyoto Japan.
- 5Department of Surgery Fukuchiyama City Hospital Kyoto Japan.
- 6Department of Surgery Kyoto Saiseikai Hospital Kyoto Japan.
- 7Department of Surgery Ayabe City Hospital Kyoto Japan.
- 8Department of Surgery National Hospital Organization Maizuru Medical Center Kyoto Japan.
- 9Department of Surgery Maizuru Kyosai Hospital Kyoto Japan.
- 10Department of Surgery Japanese Red Cross Society Maizuru, Hospital Kyoto Japan.
Abstract
Background
Management of super-elderly patients (aged ≥ 80 years) with gastric cancer (GC) has become an increasingly important clinical issue. We aimed to evaluate the prognostic significance of preoperative "hemoglobin, albumin, lymphocyte, and platelet" (HALP) scores, which may reflect both tumor- and host-related conditions, in super-elderly patients with GC.Methods
This study included 507 super-elderly patients who underwent curative gastrectomy for GC at 10 hospitals. HALP scores were calculated as follows: hemoglobin × albumin × lymphocytes/platelets. We evaluated the prognostic significance and clinical robustness of the HALP score.Results
Preoperative HALP scores ranged from 1.628 to 289.201 (median, 50.795), and the optimal cutoff value for predicting overall survival (OS) was 42.382, based on receiver operating characteristic curve analysis. Multivariate analysis identified that male sex, high preoperative carcinoembryonic antigen levels, poor performance status, pT3/4, pN(+), and low HALP scores (hazard ratio [HR], 2.23; 95% confidence interval, 1.63-3.04; p < 0.001) were independent risk factors for poor OS. We demonstrated the robustness of the prognostic significance of the HALP score using quartile, continuous variable, leave-one-center-out, and subgroup analyses. In addition, a low HALP score was independently associated with worse cancer-specific survival (HR, 2.08) and other-cause mortality (HR, 2.39), suggesting that the HALP score may reflect both tumor- and host-related conditions in super-elderly patients with GC.Conclusion
The HALP score appears to be a clinically useful and robust prognostic biomarker that may contribute to prognostic stratification and clinical decision-making in super-elderly patients with GC undergoing curative gastrectomy.
Related
- CT-Defined Low Skeletal Muscle Mass, Prognostic Nutritional Index, and Anemia in Relation to In-Hospital Major Morbidity After Gastrectomy for Gastric Carcinoma: A Retrospective Cohort Study
- Prognostic Significance of Response Dynamics in Atezolizumab plus Bevacizumab-Treated Hepatocellular Carcinoma: A Multicenter Real-World Validation Study.
- Prognostic significance of indocyanine green fluorescence patterns in resected hepatocellular carcinoma: a retrospective analysis of prospectively collected data.
- Prognostic significance of tumor budding and poorly differentiated clusters in colorectal cancer : A retrospective study
- Lymph Node Regression Improves Prognostic Stratification in Esophageal Squamous Cell Carcinoma Receiving Neoadjuvant Chemoimmunotherapy: A Multicenter Retrospective Cohort Study.
BibTeX
@article{inoue2026prognostic,
title = {{Prognostic Significance and Clinical Robustness of the HALP Score in Super-Elderly Patients Undergoing Curative Gastrectomy for Gastric Cancer: A Multicenter Retrospective Cohort Study.}},
author = {Hiroyuki Inoue and Takeshi Kubota and Toshiyuki Kosuga and Keiji Nishibeppu and Shutaro Sumiyoshi and Junichi Hamada and Kazuya Takabatake and Keita Katsurahara and Yosuke Ariyoshi and Koji Miyagawa and Sojin Sai and Yoshiki Itokawa and Tomoya Hatakeyama and Fumiaki Ochi and Hirotaka Konishi and Hitoshi Fujiwara and Atsushi Shiozaki},
journal = {Annals of gastroenterological surgery},
year = {2026},
month = oct,
doi = {10.1002/ags3.70300},
url = {https://europepmc.org/article/MED/42927056},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Prognostic Significance and Clinical Robustness of the HALP Score in Super-Elderly Patients Undergoing Curative Gastrectomy for Gastric Cancer: A Multicenter Retrospective Cohort Study.
AU - Hiroyuki Inoue
AU - Takeshi Kubota
AU - Toshiyuki Kosuga
AU - Keiji Nishibeppu
AU - Shutaro Sumiyoshi
AU - Junichi Hamada
AU - Kazuya Takabatake
AU - Keita Katsurahara
AU - Yosuke Ariyoshi
AU - Koji Miyagawa
AU - Sojin Sai
AU - Yoshiki Itokawa
AU - Tomoya Hatakeyama
AU - Fumiaki Ochi
AU - Hirotaka Konishi
AU - Hitoshi Fujiwara
AU - Atsushi Shiozaki
PY - 2026
DA - 2026/10/23
JO - Annals of gastroenterological surgery
DO - 10.1002/ags3.70300
UR - https://europepmc.org/article/MED/42927056
AB - Background Management of super-elderly patients (aged ≥ 80 years) with gastric cancer (GC) has become an increasingly important clinical issue. We aimed to evaluate the prognostic significance of preoperative "hemoglobin, albumin, lymphocyte, and platelet" (HALP) scores, which may reflect both tumor- and host-related conditions, in super-elderly patients with GC.Methods This study included 507 super-elderly patients who underwent curative gastrectomy for GC at 10 hospitals. HALP scores were calculated as follows: hemoglobin × albumin × lymphocytes/platelets. We evaluated the prognostic significance and clinical robustness of the HALP score.Results Preoperative HALP scores ranged from 1.628 to 289.201 (median, 50.795), and the optimal cutoff value for predicting overall survival (OS) was 42.382, based on receiver operating characteristic curve analysis. Multivariate analysis identified that male sex, high preoperative carcinoembryonic antigen levels, poor performance status, pT3/4, pN(+), and low HALP scores (hazard ratio [HR], 2.23; 95% confidence interval, 1.63-3.04; p < 0.001) were independent risk factors for poor OS. We demonstrated the robustness of the prognostic significance of the HALP score using quartile, continuous variable, leave-one-center-out, and subgroup analyses. In addition, a low HALP score was independently associated with worse cancer-specific survival (HR, 2.08) and other-cause mortality (HR, 2.39), suggesting that the HALP score may reflect both tumor- and host-related conditions in super-elderly patients with GC.Conclusion The HALP score appears to be a clinically useful and robust prognostic biomarker that may contribute to prognostic stratification and clinical decision-making in super-elderly patients with GC undergoing curative gastrectomy.
SN - 2475-0328
ER -