{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T15:49:32Z","timestamp":1792511372551,"version":"4.5.0"},"reference-count":38,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T00:00:00Z","timestamp":1765929600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Grade 4 adult-type diffuse gliomas remain the most aggressive primary central nervous system malignancies, with limited prognostic tools beyond molecular classification. This study introduces the HALLMOUNT score, a multidimensional prognostic index integrating hematologic, biochemical, and clinical parameters to capture the interplay between tumor biology and systemic host response. Materials and Methods: A total of 227 patients with histologically confirmed grade 4 adult-type diffuse glioma were retrospectively analyzed. The HALLMOUNT score incorporated nine pretreatment variables: hemoglobin, albumin, lactate dehydrogenase (LDH), lymphocyte, monocyte, Eastern Cooperative Oncology Group (ECOG) performance status, uric acid, neutrophil, and thrombocyte counts. Receiver operating characteristic (ROC) analyses determined optimal cut-offs, and Cox regression models evaluated prognostic performance for overall (OS) and progression-free survival (PFS). Results: High HALLMOUNT scores (\u22652.5) were significantly associated with older age, comorbidities, poor ECOG status, isocitrate dehydrogenase (IDH)-wild phenotype, lower resection rates, and reduced treatment responses. ROC analysis showed predictive accuracy comparable to CAR and PIV (AUC = 0.650). High scores independently predicted inferior OS (HR = 2.78, p &lt; 0.001) and PFS (HR = 2.76, p &lt; 0.001). Conclusions: The HALLMOUNT score provides a simple, cost-effective, and biologically grounded biomarker reflecting both tumor aggressiveness and host vulnerability. It enables refined risk stratification, supports individualized therapeutic planning, and warrants prospective validation in molecularly defined and multicenter cohorts.<\/jats:p>","DOI":"10.3390\/medicina61122232","type":"journal-article","created":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T13:42:52Z","timestamp":1765978972000},"page":"2232","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The HALLMOUNT Score: Development of a Novel Multidimensional Prognostic Model for Solid Tumors, with Initial Clinical Application in Grade 4 Adult-Type Diffuse Gliomas"],"prefix":"10.3390","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6654-3815","authenticated-orcid":false,"given":"Ahmet","family":"Unlu","sequence":"first","affiliation":[{"name":"Department of Clinical Oncology, University of Health Sciences, Antalya Education and Research Hospital, 07100 Antalya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8749-9825","authenticated-orcid":false,"given":"Asim Armagan","family":"Aydin","sequence":"additional","affiliation":[{"name":"Department of Clinical Oncology, University of Health Sciences, Antalya Education and Research Hospital, 07100 Antalya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0290-8787","authenticated-orcid":false,"given":"Banu","family":"Ozturk","sequence":"additional","affiliation":[{"name":"Department of Clinical Oncology, University of Health Sciences, Antalya Education and Research Hospital, 07100 Antalya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1497-7827","authenticated-orcid":false,"given":"Cezmi Cagri","family":"Turk","sequence":"additional","affiliation":[{"name":"A Department of Neurosurgery, University of Health Sciences, Antalya Education and Research Hospital, 07100 Antalya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustafa","family":"Yildiz","sequence":"additional","affiliation":[{"name":"Department of Clinical Oncology, University of Health Sciences, Antalya Education and Research Hospital, 07100 Antalya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1231","DOI":"10.1093\/neuonc\/noab106","article-title":"The 2021 WHO Classification of Tumors of the Central Nervous System: A summary","volume":"23","author":"Louis","year":"2021","journal-title":"Neuro Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1001\/jama.2023.0023","article-title":"Glioblastoma and Other Primary Brain Malignancies in Adults","volume":"329","author":"Schaff","year":"2023","journal-title":"JAMA"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Simi\u0144ska, D., Korbecki, J., Kojder, K., Kapczuk, P., Fabia\u0144ska, M., Gutowska, I., Machoy-Mokrzy\u0144ska, A., Chlubek, D., and Baranowska-Bosiacka, I. 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