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Journals / Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi / 2026 / Volume: 13 Issue: 2

Prognostic Value of the Hemoglobin–Albumin–Lymphocyte–Platelet Score, Red Cell Distribution Width, and Neutrophil-to-Lymphocyte Ratio in Metastatic Castration-Resistant Prostate Cancer

Metastatik Kastrasyona Dirençli Prostat Kanserinde Hemoglobin–Albümin–Lenfosit–Trombosit Skoru, Kırmızı Hücre Dağılım Genişliği ve Nötrofil-Lenfosit Oranının Prognostik Değeri

İsmail Kırlı(MUĞLA SITKI KOÇMAN ÜNİVERSİTESİ, TIP FAKÜLTESİ)0000-0001-9502-5574
Ozgur Tanriverdi(Muğla Sıtkı Koçman Üniversitesi)0000-0002-0598-7284
Ali Alkan(Muğla Sıtkı Koçman Üniversitesi)0000-0002-8253-5046
Pages
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Publication Date
2026-08-27
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AI Summary & Key Takeaways

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⚡ TL;DR(Too Long; Didn't Read)

Baseline RDW, NLR, and HALP values were recorded, and progression-free survival (PFS) and overall survival (OS) were evaluated using Kaplan–Meier and Cox regression analyses.

📌 3 Key Takeaways

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Objective & Hypothesis:Red cell distribution width (RDW), neutrophil-to-lymphocyte ratio (NLR), and the hemoglobin–albumin–lymphocyte–platelet (HALP) score are easily accessible inflammatory and nutritional biomarkers associated with prognosis in various malignancies; however, their role in metastatic castration-resistant prostate cancer (mCRPC) remains unclear.
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Key Findings & Data:In this retrospective study, 47 patients with mCRPC treated with abiraterone or enzalutamide were analyzed.
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Conclusion & Impact:Baseline RDW, NLR, and HALP values were recorded, and progression-free survival (PFS) and overall survival (OS) were evaluated using Kaplan–Meier and Cox regression analyses.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:HALP · Inflammatory biomarkers · Metastatic castration resistant prostate cancer

Abstract

Red cell distribution width (RDW), neutrophil-to-lymphocyte ratio (NLR), and the hemoglobin–albumin–lymphocyte–platelet (HALP) score are easily accessible inflammatory and nutritional biomarkers associated with prognosis in various malignancies; however, their role in metastatic castration-resistant prostate cancer (mCRPC) remains unclear. This study evaluated the prognostic significance of RDW, NLR, and the HALP score in patients with mCRPC treated with androgen receptor pathway inhibitors. In this retrospective study, 47 patients with mCRPC treated with abiraterone or enzalutamide were analyzed. Baseline RDW, NLR, and HALP values were recorded, and progression-free survival (PFS) and overall survival (OS) were evaluated using Kaplan–Meier and Cox regression analyses. Patients with higher HALP scores demonstrated longer median PFS (16.0 vs 10.0 months) and OS (16.0 vs 10.0 months); however, these differences were not statistically significant (PFS: hazard ratio (HR) = 0.681, 95% CI: 0.361–1.284; p = 0.236; OS: HR = 0.566, 95% CI: 0.298–1.078; p = 0.083). Lower NLR values were associated with longer PFS (14.0 vs 9.0 months) and OS (16.0 vs 10.0 months), without statistical significance (PFS: HR = 1.694, 95% CI: 0.903–3.180; p = 0.101; OS: HR = 1.232, 95% CI: 0.654–2.321; p = 0.518). RDW was not associated with PFS but was significantly associated with OS, with better survival in patients with lower RDW (29 vs 9 months; HR = 0.397, 95% CI: 0.207–0.763; p = 0.006). These findings suggest that inflammatory and nutritional biomarkers such as RDW and HALP may provide clinically meaningful prognostic information in mCRPC; however, larger prospective studies are needed to validate these results.

Özet

Kırmızı hücre dağılım genişliği (RDW), nötrofil-lenfosit oranı (NLR) ve hemoglobin–albümin–lenfosit–trombosit (HALP) skoru, çeşitli malignitelerde prognoz ile ilişkili, kolay erişilebilir inflamatuvar ve nütrisyonel biyobelirteçlerdir; ancak metastatik kastrasyona dirençli prostat kanserindeki (mCRPC) rolleri net değildir. Bu çalışmada, androjen reseptör yolak inhibitörleri ile tedavi edilen mCRPC hastalarında RDW, NLR ve HALP skorunun prognostik öneminin değerlendirilmesi amaçlanmıştır. Bu retrospektif çalışmada, androjen reseptör yolak inhibitörleri (abirateron veya enzalutamid) ile tedavi edilen 47 mCRPC hastası analiz edildi. Tedavi öncesi RDW, NLR ve HALP değerleri kaydedildi; progresyonsuz sağkalım (PFS) ve genel sağkalım (OS) Kaplan–Meier yöntemi ve tek değişkenli Cox regresyon analizi ile değerlendirildi. Yüksek HALP skoruna sahip hastalarda medyan PFS (16,0 vs 10,0 ay) ve OS (16,0 vs 10,0 ay) daha uzun olmakla birlikte bu farklar istatistiksel olarak anlamlı değildi (PFS: tehlike oranı (HR) = 0,681, %95 GA: 0,361–1,284; p = 0,236; OS: HR = 0,566, %95 GA: 0,298–1,078; p = 0,083). Düşük NLR değerleri daha uzun PFS (14,0 vs 9,0 ay) ve OS (16,0 vs 10,0 ay) ile ilişkili olmakla birlikte istatistiksel anlamlılık saptanmadı (PFS: HR = 1,694, %95 GA: 0,903–3,180; p = 0,101; OS: HR = 1,232, %95 GA: 0,654–2,321; p = 0,518). RDW, PFS ile ilişkili bulunmazken, OS ile anlamlı ilişki gösterdi ve düşük RDW değerlerine sahip hastalarda daha iyi sağkalım gözlendi (29 vs 9 ay; HR = 0,397, %95 GA: 0,207–0,763; p = 0,006). Bu bulgular, RDW ve HALP gibi inflamatuvar ve nütrisyonel biyobelirteçlerin, mCRPC hastalarında klinik olarak anlamlı prognostik bilgiler sağlayabileceğini düşündürmektedir; ancak bu sonuçların doğrulanması için daha geniş kapsamlı prospektif çalışmalara ihtiyaç vardır.

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Cite This Article

Kırlı, İ., Tanriverdi, O., Alkan, A. (2026). Prognostic Value of the Hemoglobin–Albumin–Lymphocyte–Platelet Score, Red Cell Distribution Width, and Neutrophil-to-Lymphocyte Ratio in Metastatic Castration-Resistant Prostate Cancer. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi, Volume: 13 Issue: 2. https://doi.org/10.47572/muskutd.1915453

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