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Prognostic Value of the Haemoglobin-Albumin-Lymphocyte-Platelet Score in Head and Neck Cancer: A Systematic Review
Yu Hsin Lin1,2, Hsin Yi Huang2,3, Wan-Lun Hsu4
1Department of Cancer Center, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
Objectives:
The haemoglobin-albumin-lymphocyte-platelet (HALP) score is an inflammation- and nutrition-related biomarker derived from routine blood tests, but its prognostic value in head and neck cancer (HNC) has not been quantitatively synthesized. This systematic review and meta-analysis aimed to evaluate the association between pretreatment HALP and survival outcomes in HNC.
Methods:
PubMed, Embase and Web of Science were searched to 24 January 2026 for cohort studies reporting hazard ratios (HRs) for survival outcomes by pretreatment HALP in HNC. Reviews, case reports, conference abstracts without full text, and studies lacking survival data were excluded. Random-effects meta-analysis was performed and risk of bias was assessed using QUIPS. The review was prospectively registered in the Open Science Framework.
Results:
Six retrospective cohort studies (1759 patients) were included. Higher pretreatment HALP was associated with improved overall survival (pooled HR 0.52, 95% CI 0.41-0.67; I2 = 17.6%) and disease-free survival (pooled HR 0.60, 95% CI 0.47-0.76; I2 = 0.0%). After excluding the metastatic cohort, the pooled overall survival estimate remained similar (HR 0.56, 95% CI 0.45-0.70; I2 = 0.0%), and leave-one-out analyses showed stable estimates (HR range 0.48-0.56).
Conclusions:
Higher pretreatment HALP is associated with favourable survival in HNC. However, reported cutoff values for HALP have been inconsistent across studies. HALP might be helpful for clinicians in evaluating the prognosis of HNC patients.