Perioperative HALP and Surgical Outcomes

Esophagectomy is associated with substantial postoperative morbidity despite advances in perioperative care. The Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) score has been proposed as a composite biomarker reflecting nutritional, inflammatory, and immune status; however, its perioperative behavior and clinical significance after esophagectomy remain unclear. This retrospective cohort study evaluates perioperative changes in HALP and examines the associations of preoperative, postoperative day 1, and postoperative day 7 HALP measurements with postoperative complications, including overall and major complications, anastomotic leakage, ICU readmission, and length of hospital stay. The study aims to clarify the potential role of perioperative HALP as a marker of postoperative recovery and adverse clinical outcomes following esophagectomy.

Inclusion Criteria: * Adults aged 18 years or older. * Histologically confirmed esophageal cancer. * Underwent elective esophagectomy with curative intent between June 2020 and March 2025. * Available laboratory data for calculation of the Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) score preoperatively and on postoperative days 1 and 7. * Complete clinical data regarding postoperative outcomes Exclusion Criteria: * Age younger than 18 years. * Benign esophageal disease or surgery performed for indications other than esophageal cancer. * Emergency esophagectomy. * Missing laboratory data required for calculation of the HALP score at any of the predefined time points (preoperative, postoperative day 1, or postoperative day 7). * Incomplete clinical or follow-up data regarding postoperative outcomes.