Hemoglobin, albumin, lymphocyte, and platelet score and neutrophil-to-lymphocyte ratio are novel significant prognostic factors for patients with small-cell lung cancer undergoing chemotherapy

ABSTRACT

Objective: The hemoglobin, albumin, lymphocyte, and platelet (HALP) score, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) are the important prognostic markers in some tumor types. This study aimed to evaluate the prognostic impact of pretreatment using HALP, NLR, and PLR for patients with small-cell lung cancer (SCLC), who were undergoing chemotherapy. Materials and Methods: In this retrospective study, 335 patients with SCLC were included between 2016 and 2018. The cutoff values for HALP, NLR, and PLR were defined using X-tile software. Survival was analyzed by the Kaplan–Meier method, with differences analyzed through the log-rank test. The multivariate Cox proportional hazard model was used to evaluate the prognostic significance of HALP, NLR, and PLR for SCLC. Results: The median follow-up period was 27.1 months (range 0.5–46.2 months). Based on the Kaplan–Meier curve analysis, it was noticed that the low pretreatment HALP (≤18.6), high pretreatment NLR (>2.4), and high PLR (>191.6) were significantly associated with worse overall survival (OS) (P = 0.009, 0.001, and 0.033, respectively). Cox multivariate analysis demonstrated that low pretreatment HALP and high pretreatment NLR were the independent prognostic factors for worse OS (hazard ratio [HR] = 1.468, 95% confidence interval [CI] 1.004–2.146, P = 0.047; HR = 0.722, 95% CI 0.542–0.960, P = 0.025, respectively). Conclusion: HALP and NLR were the independent prognostic factors of OS for SCLC patients undergoing chemotherapy