The Potential of the C‐Reactive Protein‐Albumin‐ Lymphocyte (CALLY) Index as a Prognostic Biomarker in Colorectal Cancer
Shunsuke Furukawa, Masatsugu Hiraki, Naoya Kimura, Naohiko Kohya, Masashi Sakai, Akashi Ikubo, Ryuichiro Samejima
Abstract
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.