ORIGINAL RESEARCH article
Front. Oncol.
Sec. Surgical Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1505485
This article is part of the Research TopicComprehensive Treatment Strategy for Improving Surgical Resection Rate of Retroperitoneal SarcomasView all 11 articles
Development and Validation of a Comprehensive Hematological Scoring System (CHSS) for Predicting Overall Survival in Patients with Soft Tissue Sarcomas: A Comparison with NLR and PLR
Provisionally accepted
- 1Luoyang Orthopedic Traumatological Hospital, Luoyang, Henan Province, China
- 2First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
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Background: Soft tissue sarcomas (STS) are rare malignancies with high relapse/metastasis risks and limited treatment efficacy. Current biomarkers like neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) lack comprehensive prognostic value due to their reliance on limited hematological parameters.Methods: This retrospective study analyzed 206 STS patients (2016–2023) to develop a Composite Hematological Scoring System (CHSS) integrating 19 pretreatment markers. LASSO regression selected key variables (glucose, CRP, LDL-C, HDL-C, albumin, platelets, hemoglobin, lymphocytes), weighted by coefficients. CHSS’s prognostic performance was compared to NLR/PLR via Kaplan-Meier, time-dependent ROC, and Cox regression analyses. A nomogram combining CHSS with clinical variables was validated using C-index, calibration, and decision curves.Results: CHSS outperformed NLR/PLR in predicting overall survival (OS) across all timepoints. High CHSS patients had significantly worse OS (HR=6.197, P<0.001). Multivariate analysis confirmed CHSS, age, tumor size, and FNCLCC grade as independent predictors. The CHSS-based nomogram achieved a C-index of 0.79, with accurate 3-/5-year OS calibration.Conclusion: CHSS integrates inflammation, metabolism, and nutrition markers to provide superior prognostic stratification for STS patients compared to NLR/PLR. Its integration into a nomogram supports personalized management, though multicenter validation is needed.
Keywords: Soft Tissue Sarcoma (STS), Comprehensive Hematological Scoring System (CHSS), neutrophil-to-lymphocyte ratio (NLR), Platelet-to-lymphocyte ratio (PLR), prognosis
Received: 02 Oct 2024; Accepted: 07 May 2025.
Copyright: © 2025 Qiu, Liu, Chai, Liu, Li and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yan Zhang, First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan Province, China
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