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Clinical Impact of the C-Reactive Protein-Albumin-Lymphocyte Index as a Prognostic Biomarker in Patients With
Teruhisa Sakamoto1, Kei Urakami2, Kentaro Uehira2
1Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, Faculty of Medicine, Tottori University, Yonago, Japan tesakamo@tottori-u.ac.jp.
Background/Aim:
The C-reactive protein-albumin-lymphocyte (CALLY) index is a novel prognostic biomarker that simultaneously evaluates three statuses: nutritional, immunological, and inflammatory. In this study, we aimed to clarify the prognostic significance of the CALLY index compared with that of the cachexia index (CXI), another comprehensive biomarker reflecting the three statuses, for patients with recurrent pancreatic cancer.
Patients And Methods:
This retrospective study enrolled 129 patients diagnosed with recurrence following pancreatectomy for pancreatic cancer. The patients were divided into low CALLY (n=46) and high CALLY (n=83) index groups using a cut-off value of 3.25 for the CALLY index at the time of recurrence to analyze the association between the CALLY index and patient prognosis.
Results:
The post-recurrence overall survival (OS) rate and median duration of survival for the patients in this study were 6.1% and 398 days, respectively. The low CALLY group had a significantly worse 2-year post-recurrence OS than the high CALLY group (p<0.001). When stratified by systemic chemotherapy after recurrence, the low CALLY group also displayed significantly worse 2-year post-recurrence OS than the high CALLY group, both for those treated with systemic chemotherapy (p=0.001) and those not (p<0.001). The discriminative ability of the CALLY index for predicting post-recurrence survival was superior to that of the CXI. Multivariate analysis identified the CALLY index as an independent prognostic factor for patients with recurrent pancreatic cancer (p<0.001). The CALLY index is a useful prognostic factor in patients with recurrent pancreatic cancer.
Conclusion:
At the time of recurrence, patients with a low CALLY index have poor survival compared with those with a high CALLY index. Determining the CALLY index value at the time of recurrence may help to establish optimal treatment strategies to provide a meaningful quality of life for patients with recurrent pancreatic cancer.
