Novel Prognostic Factors in Tumors of the Ampulla of Vater: The Lymph Node Ratio and Hemoglobin Albumin Lymphocyte Platelet (HALP) Score
Elif Yüce1, Evren Fidan21Department of Medical Oncology, Karaman Training and Research Hospital, Karaman, Türkiye, 2Department of Medical Oncology, Karadeniz Technical University Faculty of Medicine, Trabzon, Türkiye
Objectives: Tumors of the ampulla-of-Vater are rare, and accurate prognosis is essential. We examined the significance of the hemoglobin-albumin-lymphocyte-platelet (HALP) score and lymph-node-ratio (LNR). Methods: Thirty-four patients in 2003-2018 were examined retrospectively. Results: Twelve women and 22 men were enrolled. Tumors were ?2 cm in 11 (32.4%) and >2 cm in 17 (50%). Seven (38.9%) were in the LNR 1 (<0.1) group and 11 (61.1%) in the LNR 2 (?0.1) group. Fifteen (62.5%) of the 24 operated patients received adjuvant-therapy, with recurrence in 12 (50%). Overall survival (OS) was significantly shorter with carcinoembryonic-antigen (CEA) elevation at diagnosis compared to normal CEA (mean OS 27.1 vs. 89.8 months, p:0.029). OS was longer in stages 1–2 than 3–4 (mean OS 100.5 vs. 46.7 months, p:0.03), but shorter in patients with tumors >2 cm compared to tumors ?2 cm (mean OS 53.2 vs. 90 months, p:0.059). No significant difference in OS emerged between the LNR 1 and 2 groups (114.8 vs. 82.9 months). No significant difference emerged in OS, disease-free, or progressionfree-survival for HALP. Conclusion: Pre-operative CEA elevation, Stages 3–4, and tumor sizes exceeding 2 cm result in poor prognosis. The LNR and HALP have no effect on prognosis. Keywords: Tumors of the ampulla of Vater, hemoglobin-albumin-lymphocyte-platelet (HALP) score, lymph node ratio (LNR)
Cite This Article
Yüce E, Fidan E. Novel Prognostic Factors in Tumors of the Ampulla of Vater: The Lymph Node Ratio and Hemoglobin Albumin Lymphocyte Platelet (HALP) Score. EJMI. 2023; 7(3): 224-230
Corresponding Author: Elif Yüce