Current Oncology
Evaluating the Prognostic Significance of the H-Index and Systemic Inflammatory Parameters in IDH-Wildtype Glioblastoma Survival
By Havva Yeşil Çınkır, Bekir Demirel and Ercan Gumusburun.
Abstract
Background
IDH-wildtype Glioblastoma is characterized by an aggressive clinical course. This study aimed to evaluate the prognostic value of the H-index, the hemoglobin-albumin-lymphocyte-platelet (HALP) score and the aggregate index of systemic inflammation (AISI).
Methods
We retrospectively analyzed 136 patients who underwent frontline chemoradiotherapy.
Results
Optimal cut-offs were 20.94 for HALP, 2.29 for H-index, and 989.64 for AISI. A high H-index was associated with shorter overall survival (OS) in univariate analysis (p = 0.007) and showed the highest time-dependent AUC for OS among the three indices. In multivariable Cox models, comorbidities (p = 0.043), subtotal resection (p < 0.001), corticosteroid use (p = 0.040), and a low HALP score (p = 0.012) were associated with poor OS, whereas the associations for a high H-index (p = 0.084) and a high AISI (p = 0.036) did not meet the Bonferroni-adjusted significance threshold. In a sensitivity analysis restricted to patients not receiving corticosteroids (n = 80), H-index-based stratification remained associated with OS (median 14.4 vs. 24.9 months, log-rank p = 0.025), whereas the association for AISI was not retained.