Prognostic Significance Of The Combination Of Preoperative Hemoglobin、Albumin Levels、Lymphocyte And Platelet Counts In Patients With Locally Advanced Renal Clear Cell Carcinoma

Objective:To evaluate the prognostic significance of the novel index combining preoperative hemoglobin and albumin levels and lymphocyte and platelet counts(HALP)in locally advanced renal clear cell carcinoma patients.Methods:We enrolled 95 patients who underwent nephrectomy in our institution from 2013 to 2018.The cutoff values for HALP,neutrophil-to-lymphocyte ratio(NLR)and lymphocyte-to-monocyte ratio(LMR)were defined by using receiver operating characteristic curve(ROC).The clinical and pathological characteristics were grouped according to the best cutoff values.Chi-square test was used to compare the clinical data of the two groups.Survival was analyzed by the Kaplan–Meier method,with differences analyzed by the log-rank test.Multivariate Cox proportional-hazards model was used to evaluate the prognostic significance of HALP for locally advanced renal clear cell carcinoma.Results: HALP was significantly associated with Fuhrman grade,N stage,anemia,hypoalbuminemia,NLR and LMR.Kaplan-Meier and log-rank tests revealed that HALP was strongly correlated with overall survival(P < 0.05),the Cox multivariate analysis demonstrated that preoperative HALP was independent prognostic factor for overall survival(HR = 1.838,95%CI:1.260–2.681,P < 0.05).On predicting prognosis by Nomogram,the risk model including sex,BMI,Fuhrman grade,NLR and HALP score.Male,low BMI,high Fuhrman grade,high NLR and HALP were associated with poor prognosis.Conclusion: HALP was an independent prognostic factor of overall survival for locally advanced renal clear cell carcinoma patients undergoing nephrectomy and was closely associated with clinicopathologic features.The HALP-based Nomogram risk model provides new ideas for predicting the prognosis of locally advanced renal clear cell carcinoma.