The Role of HALP Score and Other Inflammatory Indices in Risk Stratification for Testicular Germ Cell Tumors

Objective: Systemic inflammatory and immuno-nutritional indices have emerged as promising tools in cancer prognosis.This study aimed to evaluate the predictive value of hemoglobin, albumin, lymphocyte and platelet (HALP), neutrophil-to-lymphocyte ratio (NLR), systemic immuneinflammation index (SII), C-reactive protein lymphocyte ratio (CLR), inflammatory burden index (IBI), and systemic inflammation response index (SIRI) for advanced-stage disease in testicular germ cell tumors (TGCTs). Materials and Methods:We retrospectively analyzed 143 patients with TGCTs who underwent orchiectomy between 2015 and 2023.Preoperative laboratory values were used to calculate HALP, NLR, SII, CLR, IBI, and SIRI.Associations with clinical stage were examined using Kruskal-Wallis tests, logistic regression, and ROC curve analysis.Results: Higher values of HALP, SII, CLR, NLR, and IBI were significantly associated with advanced clinical stages (p<0.001),while SIRI showed limited predictive value.HALP demonstrated the highest discriminative ability [area under the curve (AUC)=0.742],followed by SII (AUC=0.731)and IBI (AUC=0.676).Multivariable logistic regression identified HALP, CLR, and IBI as independent predictors of advanced disease. Conclusion:HALP, SII, CLR, and IBI are accessible, cost-effective biomarkers with significant potential for risk stratification in TGCTs.These indices may support clinical decision-making by identifying patients at risk for advanced-stage disease.