Department of General Surgery, Faculty of Medicine, Mersin University, Mersin, Turkey.
Department of Radiology, Faculty of Medicine, Mersin University, Mersin, Turkey.
Pancreatology. 2023 Aug;23(5):530-536. doi: 10.1016/j.pan.2023.05.006. Epub 2023 May 16.
Sarcopenia and HALP (Hemoglobin, Albumin, Lymphocyte, and Platelet) scores are factors commonly associated with postoperative outcomes used in cancer patients. This study aims to evaluate the effect of these two prognostic factors on postoperative outcomes in operated pancreatic cancer patients and their correlation with each other.
The study is a single-center, retrospective study conducted with 179 patients diagnosed with pancreatic adenocarcinoma after pancreatoduodenectomy (PD) between January 2012 and January 2022. The Psoas muscular index (PMI) and HALP scores of the patients were calculated. Cut-off values were determined in order to determine the nutritional status of the patients and to group them. The cut-off value of the HALP score was determined according to survival status. In addition, the clinical data and pathological findings of tumors were collected. These two parameters were evaluated in terms of length of hospital stay, postoperative complication rates, fistula development, and overall survival, and their correlations with each other were examined.
Of the patients, 74 (41.3%) were female, and 105 (58.7%) were male. According to PMI cut-off values, 83 (46.4%) patients were in the sarcopenia group. According to the HALP score cut-off values, 77 (43.1%) patients were in the low HALP group. Sarcopenia and Low HALP group had a higher risk of death (respectively Hazard ratio:5.67, CI:3.58-8.98, Hazard ratio:5.95, CI: 3.72-9.52) (p < 0.001). There was a moderate correlation between PMI and HALP score (rs = 0.34, p = 0.01). The correlation in these values was higher in the female gender.
In line with the data obtained from our study, HALP score and sarcopenia are among the important parameters used to evaluate postoperative complications and provide information about survival. Patients with a low HALP score and sarcopenic have an increased likelihood of developing postoperative complications and a lower survival.
肌少症和 HALP（血红蛋白、白蛋白、淋巴细胞和血小板）评分是与癌症患者术后结局相关的常用因素。本研究旨在评估这两个预后因素对接受胰十二指肠切除术（PD）的胰腺癌患者术后结局的影响及其相互之间的相关性。
本研究是一项单中心、回顾性研究，共纳入 179 例 2012 年 1 月至 2022 年 1 月期间接受 PD 治疗的胰腺腺癌患者。计算患者的腰大肌指数（PMI）和 HALP 评分。确定临界值以确定患者的营养状况并对其进行分组。根据生存状况确定 HALP 评分的临界值。此外，还收集了患者的临床数据和肿瘤病理发现。评估这两个参数在住院时间、术后并发症发生率、瘘管形成和总生存期方面的差异，并检查它们之间的相关性。
患者中，74 例（41.3%）为女性，105 例（58.7%）为男性。根据 PMI 截断值，83 例（46.4%）患者为肌少症组。根据 HALP 评分截断值，77 例（43.1%）患者为低 HALP 组。肌少症和低 HALP 组的死亡风险更高（风险比：5.67，CI：3.58-8.98，风险比：5.95，CI：3.72-9.52）（p<0.001）。PMI 和 HALP 评分之间存在中度相关性（rs=0.34，p=0.01）。在女性中，这些值之间的相关性更高。
与我们研究获得的数据一致，HALP 评分和肌少症是评估术后并发症和提供生存信息的重要参数。低 HALP 评分和肌少症患者发生术后并发症和生存时间较短的可能性更高。
