HALP score as a predictor of biochemical recurrence after robot-assisted laparoscopic prostatectomy for localized prostate cancer.

OBJECTIVE: This study aimed to evaluate the predictive value of the HALP score for biochemical recurrence (BCR) (BCR) (defined as PSA > 0.2 ng/mL) in patients with localized prostate cancer (PCa) who underwent robotic-assisted laparoscopic prostatectomy (RALP), with a minimum follow-up of two years. METHODS: The study recorded preoperative variables such as age, body mass index (BMI), serum total PSA, hemoglobin, albumin, lymphocyte, leukocyte, platelet, and neutrophil counts, International Society of Urological Pathology (ISUP) grade, and clinical stage. Serial PSA measurements were taken at various points post-surgery (1, 3, 6, 9, 12, 15, 18, 24 months). BCR was defined as a PSA increase > 0.2 ng/mL. The HALP score was calculated using the formula: Hemoglobin (g/L) × Albumin (g/L) × Lymphocyte Count (/L) ÷ Platelet Count (/L). It was compared between patients who experienced BCR (BCR group) and those who did not (non-BCR group). RESULTS: A total of 798 patients were included, with 133 (16.6%) developing BCR. The BCR group had significantly lower preoperative HALP scores (2.3 ± 1.0 vs. 6.0 ± 2.2, p < 0.001) and higher preoperative PSA levels (12.0 vs. 8.0 ng/mL, p < 0.001). Additionally, albumin levels were lower, and platelet counts higher in the BCR group (both p < 0.001). High-grade tumors (ISUP Grade 3–5) were more frequent in the BCR group (42.2% vs. 6.4%, p < 0.001). CONCLUSION: The HALP score appears to be a promising predictive marker for biochemical recurrence in localized PCa patients post-surgery. As a simple and cost-effective biomarker, it may help identify those at higher risk of recurrence after treatment.