# Prognostic value of the C-reactive protein-albumin-lymphocyte index versus traditional inflammatory markers after radical resection of colorectal cancer: a retrospective cohort study

## TL;DR

A new index combining inflammation, nutrition, and immune markers better predicts survival in colorectal cancer patients after surgery compared to traditional markers.

## Contribution

The CALLY index is introduced as a novel composite biomarker for improved prognostic prediction in colorectal cancer.

## Key findings

- The CALLY index had a higher AUC (0.789) compared to NLR (0.664), LMR (0.655), and PLR (0.647).
- High CALLY index was associated with significantly better 5-year overall survival (83.5% vs. 12.9%).

## Abstract

To compare the prognostic value between the C-reactive protein-albumin-lymphocyte index (CALLY) and traditional inflammatory markers [including the neutrophil-to-lymphocyte ratio (NLR), the lymphocyte-to-monocyte ratio (LMR), and the platelet-to-lymphocyte ratio (PLR)] after radical resection of colorectal cancer (CRC).

A total of 152 CRC patients who underwent radical resection in Baotou Central Hospital from January 2016 to December 2019 were selected and studied retrospectively. The clinicopathological traits of the patients were collected and analyzed, and their survival outcomes were followed up. The prognostic value of the CALLY index and classical CRC prognostic factors was compared through the concordance index (CI) and the area under the receiver operating characteristic curve (AUC). The COX risk regression model was used for multivariate analysis to evaluate the impact of different indicators on prognosis.

The AUC of the CALLY index was 0.789 (95%CI: 0.703–0.875, P < 0.001), which was significantly higher than that of NLR (0.664, 95%CI: 0.574–0.754), LMR (0.655, 95%CI: 0.559–0.751), and PLR (0.647, 95%CI: 0.553–0.740). The 5-year overall survival (OS) rate in the high CALLY group (≥ 1.045) was significantly better than that in the low CALLY group (83.5% vs. 12.9%, P < 0.001). Multivariate analysis showed that the CALLY index (HR = 0.124; 95%CI 0.060–0.255; P < 0.05) was an independent prognostic factor. Moreover, an increased CALLY index was associated with a better prognosis, suggesting this indicator is a protective factor of post-surgical prognosis in CRC patients.

By integrating inflammation, nutrition, and immune status, the CALLY index performs significantly better than traditional single indicators in postoperative prognostic prediction in CRC patients. It can serve as a reliable tool for postoperative prognostic evaluation of CRC and provide incremental value for clinical risk stratification.