Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) Score As a Predictor of Prognosis After Hepatectomy

Background/Aim: The hemoglobin, albumin, lymphocyte, and platelet (HALP) score is an immune-nutritional assessment score that is a prognostic indicator for several malignant tumors. This study aimed to investigate its prognostic value in patients who underwent hepatectomy for hepatocellular carcinoma. Patients and Methods: Data of 685 patients with hepatocellular carcinoma who underwent hepatectomy at Kurume University between 2006 and 2021 were retrospectively analyzed. The patients were classified into high and low HALP score groups based on a cut-off HALP score determined using a receiver operating characteristic curve. To minimize bias, 1:1 propensity score matching was performed. Kaplan-Meier curves were used to estimate survival time, and data were evaluated using the log-rank test. Univariate and multivariate analyses were performed using Cox hazard or logistic regression models for assessing survival time and postoperative outcomes, respectively. Results: Low HALP scores were significantly associated with poor overall survival (p=0.0066). Univariate and multivariate analyses revealed that the HALP score independently predicted overall survival (p=0.005). However, the HALP score was not significantly related to recurrence-free survival or postoperative outcomes. Conclusion: The HALP score is a simple inexpensive tool for predicting prognosis after hepatectomy for hepatocellular carcinoma.