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The Potential of the C-Reactive Protein-Albumin-Lymphocyte (CALLY) Index as a Prognostic Biomarker in Colorectal
Shunsuke Furukawa1, Masatsugu Hiraki1, Naoya Kimura1
1Department of Surgery, Japanese Red Cross Society Karatsu Red Cross Hospital, Karatsu, Japan.
Background/Aim:
The C-reactive protein (CRP)-albumin-lymphocyte (CALLY) index is an innovative immunonutritional biomarker calculated from CRP, serum albumin, and lymphocyte count levels. This study aimed to determine the significance of the preoperative CALLY index as a prognostic biomarker in patients with stage II-III colorectal cancer who underwent colorectal surgery.
Patients And Methods:
This retrospective study included 223 patients who underwent colorectal surgery for stage II-III colorectal cancer. The CALLY index was calculated as follows: (albumin × lymphocyte)/(CRP × 104). The patients were divided into CALLY-high group (n=112) and CALLY-low group (n=111) according to the preoperative CALLY index. The associations between the preoperative CALLY index and recurrence-free survival (RFS) and overall survival (OS) were evaluated.
Results:
The cutoff value of the CALLY index was 3.41. The Kaplan-Meier survival curves for both RFS and OS in patients with stage II-III colorectal cancer demonstrated worse outcomes in the CALLY-low group than in the CALLY-high group (p=0.062 and p=0.008, respectively). A subgroup analysis of both stage II and stage III showed that patients in the CALLY-low group who did not receive postoperative adjuvant chemotherapy had the worst RFS and OS.
Conclusion:
The preoperative CALLY index may serve as a prognostic biomarker in patients with colorectal cancer. Additionally, a low CALLY index may indicate a poorer prognosis, particularly in patients who did not receive postoperative adjuvant chemotherapy.
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