Prognostic Value of the Hemoglobin–Albumin–Lymphocyte–Platelet Score, Red Cell Distribution Width, and Neutrophil-to-Lymphocyte Ratio in Metastatic Castration-Resistant Prostate Cancer

Vollständiger Abstract

Worum geht es in dieser Arbeit?

Red cell distribution width (RDW), neutrophil-to-lymphocyte ratio (NLR), and the hemoglobin–albumin–lymphocyte–platelet (HALP) score are easily accessible inflammatory and nutritional biomarkers associated with prognosis in various malignancies; however, their role in metastatic castration-resistant prostate cancer (mCRPC) remains unclear. This study evaluated the prognostic significance of RDW, NLR, and the HALP score in patients with mCRPC treated with androgen receptor pathway inhibitors. In this retrospective study, 47 patients with mCRPC treated with abiraterone or enzalutamide were analyzed. Baseline RDW, NLR, and HALP values were recorded, and progression-free survival (PFS) and overall survival (OS) were evaluated using Kaplan–Meier and Cox regression analyses. Patients with higher HALP scores demonstrated longer median PFS (16.0 vs 10.0 months) and OS (16.0 vs 10.0 months); however, these differences were not statistically significant (PFS: hazard ratio (HR) = 0.681, 95% CI: 0.361–1.284; p = 0.236; OS: HR = 0.566, 95% CI: 0.298–1.078; p = 0.083). Lower NLR values were associated with longer PFS (14.0 vs 9.0 months) and OS (16.0 vs 10.0 months), without statistical significance (PFS: HR = 1.694, 95% CI: 0.903–3.180; p = 0.101; OS: HR = 1.232, 95% CI: 0.654–2.321; p = 0.518). RDW was not associated with PFS but was significantly associated with OS, with better survival in patients with lower RDW (29 vs 9 months; HR = 0.397, 95% CI: 0.207–0.763; p = 0.006). These findings suggest that inflammatory and nutritional biomarkers such as RDW and HALP may provide clinically meaningful prognostic information in mCRPC; however, larger prospective studies are needed to validate these results.