Prognostic Value of CRP-Albumin-Lymphocyte (CALLY) Index in Colorectal Cancer Survival: A Multicenter Retrospective Cohort Study.

Background: Colorectal cancer (CRC) has become one of the major health burdens in the world with high mortality rates, especially at the advanced stages. The C-reactive protein (CRP)-albumin-lymphocyte (CALLY) index is a novel multidimensional biomarker combining systemic inflammation, nutritional status, and immune function. This study evaluated the association between the CALLY index and overall survival (OS) as well as recurrence-free survival (RFS) in colorectal cancer (CRC) patients.

Methods: In this retrospective, multicenter cohort study, the medical characteristics of 1447 CRC patients who were treated at one of the medical centers affiliated with two universities of medical sciences between 2012 and 2022 were examined. Patients were divided into two groups based on the CALLY index: ≥ 2 (945 patients) and < 2 (502 patients). Demographic characteristics, tumor characteristics, and pathological findings of the patients were extracted by referring to the patient records.

Results: The 5-year OS rate for patients with a CALLY index ≥ 2 was 80.3%, compared to 64.9% for those with a CALLY index < 2 (log-rank test = 68.2, P = 0.001). The multivariate analysis showed that the CALLY index was significantly associated with OS rate of patients, and OS rate was significantly higher in patients with a CALLY index ≥ 2 than in patients with a CALLY index < 2 (HR 0.84, 95% CI 0.73-0.95, P = 0.001). Also, based on these results, the patients' age, mean BMI, tumor size, T stage, TNM stage, presence of metastasis, tumor location, number of involved lymph nodes, colon diseases, adjuvant chemotherapy, platelet level, and pathological tumor differentiation were all significantly associated with survival in CRC patients (P < 0.05).

Conclusion: Our study demonstrated that a higher CALLY index is significantly correlated with improved survival outcomes and a reduced risk of recurrence in CRC patients. CALLY index can be helpful as a criterion for predicting the prognosis of patients with CRC.