Prognostic significance of the preoperative C-reactive protein-albumin-lymphocyte (CALLY) index on outcomes after gastrectomy for gastric cancer

• Published in: Surgery today (Tokyo, Japan) Vol. 54; no. 8; pp. 943 - 952
• Main Authors: Fukushima, Naoko, Masuda, Takahiro, Tsuboi, Kazuto, Takahashi, Keita, Yuda, Masami, Fujisaki, Muneharu, Ikegami, Toru, Yano, Fumiaki, Eto, Ken
• Format: Journal Article
• Language: English
• Published: Singapore Springer Nature Singapore 01.08.2024
• Subjects: Aged; Biomarkers - blood; Blood Loss, Surgical - statistics & numerical data; C-Reactive Protein - analysis; Female; Gastrectomy - methods; Humans; Lymphocytes; Male; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Staging; Original Article; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Preoperative Period; Prognosis; Serum Albumin - analysis; Stomach Neoplasms - mortality; Stomach Neoplasms - pathology; Stomach Neoplasms - surgery; Surgery; Surgical Oncology; Survival Rate; Treatment Outcome; C-reactive protein-albumin-lymphocyte index; Systemic inflammatory response; Gastrectomy; Gastric cancer
• ISSN: 0941-1291; 1436-2813; 1436-2813
• DOI: 10.1007/s00595-024-02813-1

Purpose Systemic inflammatory response markers are reported to be prognostic for patients with cancer. The C-reactive protein (CRP)-albumin-lymphocyte (CALLY) index has been established as an immuno-nutritional scoring system. The aim of this study was to clarify the impact of the preoperative CALLY index on the outcome of patients undergoing gastrectomy for gastric cancer. Methods We analyzed the data of 826 patients who underwent gastrectomy for stage I, II, or III gastric cancer between 2010 and 2017. The CALLY index was defined as (albumin × lymphocyte)/(CRP × 10 4 ). Results The cut-off of the CALLY index was 2. The 147 patients with a preoperative CALLY index < 2 had significantly worse overall survival (OS) and relapse-free survival (RFS) than those with a CALLY index ≥ 2 (P < 0.01, P < 0.01, respectively). Multivariate analysis identified that a CALLY index < 2 (P = 0.02), intraoperative blood loss (P < 0.01), and stage II or III disease (P < 0.01) were independent and significant predictors of worse RFS. A CALLY index < 2 (P = 0.01), intraoperative blood loss (P < 0.01), postoperative complications (P = 0.02), and stage II or III disease (P < 0.01) were independent and significant predictors of worse OS. Conclusion The preoperative CALLY index was independently associated with a poor prognosis for patients after gastrectomy for gastric cancer.