Mehmet İlHan Sesigüzel

Non-small cell lung cancer (NSCLC) has a high mortality rate, emphasizing the need for reliable preoperative prognostic tools. Recent studies have focused on markers that reflect both inflammatory and nutritional status. This study aimed to evaluate the prognostic value of the hemoglobin, albumin, lymphocyte, and platelet (HALP) score in predicting postoperative outcomes in NSCLC patients. This retrospective observational study included patients diagnosed with NSCLC who underwent curative surgery between January 1, 2019, and January 1, 2024. Preoperative HALP scores were calculated from routine blood tests to assess their potential as independent predictors of survival and long-term outcomes. The study cohort comprised 238 patients, divided into 2 groups: survivors (n = 153, 64.3%) and deceased patients (n = 85, 35.7%). The median HALP score was significantly lower in the deceased group (31.2) compared to survivors (52.3; P < .001). Follow-up duration was also significantly shorter in the deceased group (median 22 months) compared to survivors (median 34 months; P < .001). In the Cox univariate analysis, age ≥ 65 years (hazard ratio [HR] 2.02, 95% confidence intervals [CI] 1.32–3.1, P = .002), positive surgical margins (HR 3.04, 95% CI 1.61–5.76, P = .003), and low HALP scores (HR 5.17, 95% CI 3.33–8.03, P < .001) were significantly associated with decreased survival. However, in the multivariate analysis, positive surgical margins (HR 2.74, 95% CI 1.35–5.56, P = .005) and low HALP scores (HR 5.80, 95% CI 3.6–9.3, P < .001) remained independent predictors of decreased survival, while age ≥ 65 years did not retain significance. These findings suggest that positive surgical margins and low HALP scores are key prognostic factors for survival in NSCLC patients. The HALP score was identified as an independent predictor of postoperative mortality in NSCLC patients. Lower scores were significantly associated with higher mortality, indicating its potential use in both risk assessment and guiding postoperative management.

Background: In this study, we aimed to evaluate the predictive value of the Haller index for recurrence risk in primary spontaneous pneumothorax patients. Methods: Between January 2018 and December 2023, a total of 285 patients (260 males, 25 females; median age: 23 years; range, 17 to 35 years) with primary spontaneous pneumothorax who underwent thoracic computed tomography and followed for at least one year were retrospectively analyzed. The patients were divided into two groups as the non-recurrence group (n=170) and recurrence (n=115) group. The Haller index was calculated from computed tomography scans at presentation and its predictive value for recurrent pneumothorax was estimated. Results: The median age was significantly higher in the non-recurrence group than in the recurrence group (p< 0.001). The median time to recurrence was two (IQR 1-3) months. The diagnostic validity of Haller index for predicting recurrence showed an area under the receiver operating characteristic of 0.824 (95% confidence interval [CI]: 0.775-0.866) (p< 0.001). The optimal cut-off value of Haller index (>2.4) showed a sensitivity of 70.43% (95% CI: 61.2-78.6) and specificity of 76.47% (95% CI: 69.4-82.6). Conclusion: A high Haller index is associated with increased recurrent pneumothorax risk in primary spontaneous pneumothorax patients. Traditionally used for pectus excavatum severity, incorporating Haller index in the management of these patients may help to identify high-risk patients and guide personalized management strategies.