Retrospective Cohort Study
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World J Gastroenterol. Jul 21, 2022; 28(27): 3476-3487
Published online Jul 21, 2022. doi: 10.3748/wjg.v28.i27.3476
Prognostic significance of hemoglobin, albumin, lymphocyte, platelet in gastrointestinal stromal tumors: A propensity matched retrospective cohort study
Zhou Zhao, Xiao-Nan Yin, Jian Wang, Xin Chen, Zhao-Lun Cai, Bo Zhang
Zhou Zhao, Xiao-Nan Yin, Jian Wang, Xin Chen, Zhao-Lun Cai, Bo Zhang, Department of Gastrointestinal Surgery, Sichuan University West China Hospital, Chengdu 610041, Sichuan Province, China
Author contributions: All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; and all authors took part in drafting, revising or critically reviewing the article, gave final approval of the version to be published, agreed on the journal to which the article has been submitted and agreed to be accountable for all aspects of the work.
Supported by National Natural Science Foundation of China, No. 81572931; and The 1.3.5 Project for Disciplines of Excellence, West China Hospital, Sichuan University, No. ZYJC18034.
Institutional review board statement: The Institutional Review Board of the West China Hospital of Sichuan University provided approval for this study, No. 1135(2019).
Informed consent statement: This study examined only patients' electronic health records. Each patient had been asked to sign an informed consent form authorizing the use of their electronic health record for scientific research. If the patient had not consented, we were unable to access his/her information in the hospital's information system.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The data that supporting the findings of this study are available from the corresponding author (e-mail: upon reasonable request.
STROBE statement: The authors have read the STROBE Statement – checklist of items, and the manuscript was prepared and revised according to the STROBE Statement – checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Bo Zhang, MD, PhD, Professor, Department of Gastrointestinal Surgery, Sichuan University West China Hospital, No. 37 Guoxue Alley, Wuhou District, Chengdu 610041, Sichuan Province, China.
Received: February 11, 2022
Peer-review started: February 11, 2022
First decision: April 10, 2022
Revised: April 19, 2022
Accepted: June 19, 2022
Article in press: June 19, 2022
Published online: July 21, 2022
Research background

The combination index of hemoglobin, albumin, lymphocyte, and platelet (HALP) has been reported as associated with prognosis in many cancers but not yet in gastrointestinal stromal tumors (GISTs). Therefore, this study aimed to investigate the prognostic value of preoperative HALP in resected GIST patients.

Research motivation

At present, the risk of GIST is mainly based on postoperative pathological indicators. The motivation for this article involved the need to find a convenient, non-invasive, preoperative indicator that will assist in prognostic prediction of GIST.

Research objectives

To investigate the prognostic value of HALP in GIST patients.

Research methods

This retrospective cohort study enrolled patients with GIST using propensity scores matching to explore the relationship between HALP, postoperative clinicopathological data, and the prognostic significance of HALP.

Research results

HALP can be conveniently used preoperatively to assess risk and prognosis of GIST patients. However, the effect of improving nutritional status or immune-inflammatory status on the prognosis of GIST is still unclear and requires further confirmation through clinical studies.

Research conclusions

HALP was associated with postoperative pathological data (i.e. tumor site, tumor size, mitosis, Ki67, National Institutes of Health risk category) and adjuvant therapy. Furthermore, HALP was an independent risk factor for recurrence-free survival in GIST patients who underwent radical resection. This study is the first to report the prognostic significance of HALP in GIST. In this study, HALP was found to be an independent risk factor for GIST patients with R0 resection. Consistent with reports of HALP in other tumors, HALP is also associated with prognosis in GIST. HALP was also found to be an independent risk factor for GIST patients with R0 resection. In clinical practice, convenient and non-invasive preoperative HALP may be used to assist in the prediction of risk and prognosis for GIST patients.

Research perspectives

Through this retrospective cohort study, we found the prognostic significance of HALP in GIST. This study did not evaluate other clinicopathological factors related to prognosis, especially gene mutation status. Subsequent studies should employ a prospective cohort method and incorporate additional factors to further explore the prognostic significance of HALP in GIST patients.