The predictive value of Hemoglobin-Albumin-Lymphocyte-Platelet score for maximal cytoreduction surgery in advanced-stage epithelial ovarian cancer.
The Hemoglobin-Albumin-Lymphocyte-Platelet score has shown prognostic value across various cancers; however, its utility in predicting cytoreductive outcomes in advanced epithelial ovarian cancer remains unclear. The aim of this study was to determine whether the preoperative Hemoglobin-Albumin-Lymphocyte-Platelet score predicts maximal cytoreduction at primary cytoreductive surgery.
In this single-center study, we analyzed data from 140 patients with epithelial ovarian cancer who underwent primary cytoreductive surgery at our clinic. Patients were categorized by residual disease: maximal cytoreduction (no macroscopic residual disease, n=104), optimal cytoreduction (n=19), and suboptimal cytoreduction (n=17). Preoperative Hemoglobin-Albumin-Lymphocyte-Platelet, CA-125, and clinical variables were compared across groups. Discrimination for maximal cytoreduction was assessed using receiver operating characteristic analysis.
The maximal cytoreduction group had higher preoperative hemoglobin and lymphocyte counts, lower platelet counts, and lower CA-125 levels (p<0.005). Median Hemoglobin-Albumin-Lymphocyte-Platelet was significantly higher in maximal cytoreduction vs. optimal cytoreduction vs. suboptimal cytoreduction (35.37 vs. 21.10 vs. 20.19; all p<0.001). For predicting maximal cytoreduction, the Hemoglobin-Albumin-Lymphocyte-Platelet cutoff of 24.96 yielded a sensitivity of 71.4% and a specificity of 71.4% (area under the curve: 0.792; p<0.001). A CA-125 cutoff of 260.50 IU/mL provided a sensitivity of 71.4% and a specificity of 65.7% (area under the curve: 0.758; p<0.001).
The preoperative Hemoglobin-Albumin-Lymphocyte-Platelet score demonstrates good discrimination for predicting maximal cytoreduction in advanced epithelial ovarian cancer and appears to perform at least comparably to CA-125. Given that patients selected for neoadjuvant chemotherapy were excluded, these performance estimates apply to a surgically selected population. Given its low cost and universal availability, Hemoglobin-Albumin-Lymphocyte-Platelet may support preoperative selection and counseling before cytoreductive surgery.
In this single-center study, we analyzed data from 140 patients with epithelial ovarian cancer who underwent primary cytoreductive surgery at our clinic. Patients were categorized by residual disease: maximal cytoreduction (no macroscopic residual disease, n=104), optimal cytoreduction (n=19), and suboptimal cytoreduction (n=17). Preoperative Hemoglobin-Albumin-Lymphocyte-Platelet, CA-125, and clinical variables were compared across groups. Discrimination for maximal cytoreduction was assessed using receiver operating characteristic analysis.
The maximal cytoreduction group had higher preoperative hemoglobin and lymphocyte counts, lower platelet counts, and lower CA-125 levels (p<0.005). Median Hemoglobin-Albumin-Lymphocyte-Platelet was significantly higher in maximal cytoreduction vs. optimal cytoreduction vs. suboptimal cytoreduction (35.37 vs. 21.10 vs. 20.19; all p<0.001). For predicting maximal cytoreduction, the Hemoglobin-Albumin-Lymphocyte-Platelet cutoff of 24.96 yielded a sensitivity of 71.4% and a specificity of 71.4% (area under the curve: 0.792; p<0.001). A CA-125 cutoff of 260.50 IU/mL provided a sensitivity of 71.4% and a specificity of 65.7% (area under the curve: 0.758; p<0.001).
The preoperative Hemoglobin-Albumin-Lymphocyte-Platelet score demonstrates good discrimination for predicting maximal cytoreduction in advanced epithelial ovarian cancer and appears to perform at least comparably to CA-125. Given that patients selected for neoadjuvant chemotherapy were excluded, these performance estimates apply to a surgically selected population. Given its low cost and universal availability, Hemoglobin-Albumin-Lymphocyte-Platelet may support preoperative selection and counseling before cytoreductive surgery.
Authors
Ege Ege, Öncü Öncü, Öztürk Öztürk, Köksal Köksal, Hanedan Hanedan, Korkmaz Korkmaz
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