Prognostic value of the postoperative CALLY index in T1/T2 clear cell renal cell carcinoma

Identifying patients with renal cell carcinoma (RCC) at risk of postoperative recurrence remains challenging, particularly in those with early-stage disease. The objective of the present study was to evaluate the prognostic utility of the C-reactive protein (CRP)-albumin-lymphocyte (CALLY) index and other haematological biomarkers in patients with pathologic T1/T2 clear-cell RCC (ccRCC). In total, data from 253 patients with pT1/T2 ccRCC who underwent nephrectomies were retrospectively analysed. Preoperative and postoperative levels of CRP, neutrophil-to-lymphocyte ratio (NLR) and CALLY index were assessed, and cut-off values were determined using receiver operating characteristic curves. Prognostic significance was evaluated using Kaplan-Meier and Cox regression analyses. A postoperative CALLY index of ≤2.163 was significantly associated with shorter progression-free survival [hazard ratio (HR)=3.64] and overall survival (HR=4.98). A preoperative NLR of ≥3.015 also predicted recurrence (HR=2.74). Furthermore, the postoperative CALLY index demonstrated the highest predictive accuracy for overall survival (area under the curve=0.8141). In conclusion, the postoperative CALLY index is a robust and accessible biomarker for recurrence and survival in patients with T1/T2 ccRCC, and may guide postoperative surveillance strategies.