Hemoglobin, albumin, lymphocyte, and platelet score as a predictor of prognosis in metastatic gastric cancer

Table 1 Clinicopathological characteristics of 147 metastatic gastric cancer patients

Features	Frequency, n (%)
Gender
Female	37 (25.2)
Male	110 (74.8)
ECOG PS
0	32 (21.8)
1	83 (56.5)
2	32 (21.8)
Comorbidity
No	74 (50.3)
Yes	73 (49.7)
Smoking
No	69 (46.9)
Yes	78 (53.1)
Surgery
No	90 (61.2)
Yes	57 (38.8)
Type of surgery
No	90 (61.2)
Total gastrectomy	41 (27.9)
Subtotal gstrectomy	16 (10.9)
Patology
Adenocarcinom	128 (87.1)
Signet ring cell carcinom	15 (10.2)
Musinoz adenocarcinom	2 (1.4)
Mix carcinom	2 (1.4)
Diferantiation
Well	5 (3.4)
Moderate	74 (50.3)
Poorly	53 (36.1)
Signet ring cell carcinoma	15 (10.2)
Surgical margin
No operation	90 (61.2)
Positive	6 (4.1)
Negative	51 (34.7)
Tumor location
Fundus, cardia	48 (32.7)
Korpus	56 (38.1)
Antrum, pylor	43 (29.3)
De novo metastasis
No	44 (29.9)
Yes	103 (70.1)
Age group
≤ 63	74 (50.3)
> 63	73 (49.7)

ECOG PS: Eastern Cooperative Oncology Group Performance status.

Table 2 Distribution of patients according to hemoglobin, albumin, lymphocyte, and platelet score in subgroups

Features	HALP low, n (%)	HALP high, n (%)	P value
Gender			0.816
Female	23 (25.8)	14 (24.2)
Male	66 (74.2)	44 (75.9)
ECOG PS			0.02
0	16 (18)	16 (27.6)
1	47 (52.8)	36 (62.1)
2	26 (29.2)	6 (10.3)
Comorbidity			0.008
No	37 (41.6)	37 (63.8)
Yes	52 (58.4)	21 (36.2)
Smoking			0.679
No	43 (48.3)	26 (44.8)
Yes	46 (51.7)	32 (55.2)
Surgery			0.804
No	56 (62.9)	34 (58.6)
Yes	33 (37.1)	24 (41.4)
Type of surgery			0.783
No	55 (61.8)	34 (58.6)
Total gastrectomy	23 (25.8)	18 (31)
Subtotal gastrectomy	10 (11.2)	6 (10.3)
Patology			0.18
Adenocarcinom	79 (88.8)	49 (84.5)
Signet ring cell carcinom	8 (9)	7 (12.1)
Musinoz adenocarcinom	2 (2.2)	0 (0)
Mix carcinom	0 (0)	2 (3.4)
Diferantiation			0.045
Well	1 (1.1)	4 (6.9)
Moderate	42 (47.2)	32 (55.2)
Poorly	38 (42.7)	14 (24.1)
Signet ring cell carcinoma	8 (9)	8 (13.8)
Tumor location			0.142
Fundus, cardia	25 (28.1)	23 (39.7)
Corpus	33 (37.1)	23 (39.7)
Antrum, pylor	31 (34.8)	12 (20.7)
De novo metastasis			0.894
No	27 (30.3)	17 (29.3)
Yes	62 (69.7)	41 (70.7)

ECOG PS: Eastern Cooperative Oncology Group Performance status; HALP: Hemoglobin, albumin, lymphocyte and platelet.

Table 3 Analysis of prognostic factors in terms of overall survival

Features	Median (months)	Univariate analysis		Multivariate analysis
		HR (95%CI)	P value	HR (95%CI)	P value
HALP groups
HALP low	7.5	0.59 (0.41-0.85)	0.004	Reference	0.001
HALP high	10.4			0.53 (0.36-0.78)
NLR groups
NLR low	9.1	1.10 (0.78-1.56)	0.582
NLR high	8.0
PLR groups
PLR low	8.6	1.18 (0.83-1.68)	0.350
PLR high	8.4
Age groups
≤ 63	10.2	1.96 (1.37-2.8)	0.000	Reference	0.060
> 63	6.9			1.47 (0.98-2.19)
ECOG PS
0-1	9.1	1.57 (1.04-2.36)	0.030	Reference	0.850
2	6.9			1.04 (0.66-1.64)
Comorbidity
No	10.2	1.67 (1.18-2.36)	0.004	Reference	0.303
Yes	6.2			1.22 (0.84-1.78)
Diferantiation
Well-moderate	8.6	1.10 (0.78-1.53)	0.600
Poorly-Signet ring cell	8.4
Second line CT
No	4.9	0.24 (0.16-0.35)	0.000	Reference	< 0.001
Yes	15.4			0.23 (0.16-0.34)
De novo metastasis
No	9.2	0.94 (0.65-1.37)	0.754
Yes	8.2
Gender
Female	9.1	1.53 (1.03-2.28)	0.035	Reference	0.051
Male	8.2			1.52 (0.99-2.31)
Tumor location
Fundus, cardia	7.5		0.056
Corpus	8.8			-	-
Antrum, pylor	9.2

CI: Confidence interval; CT: Chemotherapy; HALP: Hemoglobin, albumin, lymphocyte and platelet; HR: Hazard ratio; NLR: Neutrophil/lenfocyte ratio; PLR: Platelet/lenfocyte ratio.