Prognostic Value of the Hemoglobin Albumin Lymphocyte Platelet Score in Extrapulmonary Neuroendocrine Carcinomas

Prognostic Value of the Hemoglobin Albumin Lymphocyte Platelet Score in Extrapulmonary Neuroendocrine Carcinomas Aim: Extrapulmonary neuroendocrine carcinomas (EPNECs) are rare and aggressive malignancies characterized by poor prognosis.The hemoglobin, albumin, lymphocyte, platelet (HALP) score is an immunonutritional index that has shown prognostic value in various cancers.However, its significance in EPNECs remains unclear.Methods: This retrospective study included 48 patients with metastatic EPNECs treated at a single institution between 2018 and 2023.Baseline HALP scores were calculated from laboratory values obtained before systemic treatment.Patients were categorized into low (19.54)and high (>19.54)HALP groups based on receiver operating characteristic curve analysis.Associations between HALP score and survival outcomes, overall survival (OS) and progression-free survival (PFS), were assessed using Kaplan-Meier and Cox regression methods.Results: The median OS was 7.8 months.Although the HALP score was not a statistically significant predictor of OS (p=0.072),patients with low HALP scores demonstrated a numerical trend toward shorter survival.Elevated lactate dehydrogenase (LDH) levels and absence of chemotherapy were significantly associated with poorer OS.Chemotherapy was confirmed as an independent prognostic factor in multivariate analysis (p=0.001).No significant association was found between HALP scores and PFS.Conclusion: While the HALP score did not show statistically significant prognostic impact in this cohort, the observed trends suggest potential clinical relevance.Further prospective studies are needed to validate its utility in EPNEC and to explore whether immunonutritional factors may inform treatment decisions.