Prognostic utility of HALP score in predicting post-chemotherapy recurrence in testicular cancer: A retrospective cohort study

Objective: The hemoglobin, albumin, lymphocyte, and platelet (HALP) score is an inflammation – and nutrition-based biomarkerassociated with prognosis in various malignancies. Its role in predicting post-chemotherapy recurrence in testicular germ cell tumors(TGCT) remains unclear. This study evaluated the prognostic value of the HALP score after cisplatin-based chemotherapy and itsadditional contribution beyond clinical staging.Patients and Methods: This retrospective cohort included 91 TGCT patients treated with orchiectomy and cisplatin-based chemotherapybetween 2015 and 2023. Clinical, pathological, and hematologic data were collected. HALP, neutrophil-to-lymphocyte ratio (NLR),and systemic immune-inflammation index (SII) were calculated from pre-treatment laboratory values. Recurrence-free survival(RFS) was analyzed using Kaplan–Meier and Cox regression models. Receiver operating characteristic (ROC) analysis determined theoptimal HALP cut-off.Results: Recurrence occurred in 14 patients (15.4%). Patients with recurrence had significantly lower baseline HALP scores. Theoptimal HALP cut-off was 53.615 (AUC=0.699). Higher HALP scores were associated with improved 3 – and 5-year RFS. HALP, NLR,SII, and advanced stage were significant in univariate analyses; however, only stage remained independently predictive in multivariatemodels.Conclusion: Lower pre-treatment HALP scores were associated with increased recurrence risk and inferior long-term RFS. HALP mayprovide complementary prognostic information within stage-defined groups.