Pretreatment CALLY index as promising novel biomarker in the prediction of surgical and oncological outcomes in esophageal cancer: a multi-center retrospective cohort study

BackgroundEsophageal cancer (EC) is a global health challenge with high mortality rates. The traditional TNM staging system is limited in its ability to provide accurate prognostic predictions. This study aimed to investigate the utility of the C-reactive protein-albumin-lymphocyte (CALLY) index in...

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Main Authors: Peize Meng, Tongtong Gu, Jiayong Xu, Haihua Huang, Hansong Jin, Yuchen Wang, Hang Zhang, Zheng Ruan
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Immunology
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Online Access:https://www.frontiersin.org/articles/10.3389/fimmu.2025.1605067/full
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author Peize Meng
Tongtong Gu
Jiayong Xu
Haihua Huang
Hansong Jin
Yuchen Wang
Hang Zhang
Zheng Ruan
author_facet Peize Meng
Tongtong Gu
Jiayong Xu
Haihua Huang
Hansong Jin
Yuchen Wang
Hang Zhang
Zheng Ruan
author_sort Peize Meng
collection DOAJ
description BackgroundEsophageal cancer (EC) is a global health challenge with high mortality rates. The traditional TNM staging system is limited in its ability to provide accurate prognostic predictions. This study aimed to investigate the utility of the C-reactive protein-albumin-lymphocyte (CALLY) index in the evaluation of mid- to long-term outcomes in patients undergoing esophagectomy.MethodsWe conducted a multi-center retrospective cohort study of 657 EC patients admitted between 2010 to 2024, with 553 patients from Shanghai General Hospital (training cohort) and 104 from Shanghai Sixth People’s Hospital (validation cohort). Associations between the CALLY and overall survival (OS)/disease-free survival (DFS) were evaluated using multivariable-adjusted Cox regression analyses.ResultsPatients with CALLY index > 2.55 were associated with significantly improved OS (adjusted hazard ratio [HR]: 0.55, 95% confidence interval [CI]: 0.43-0.71) and DFS (HR: 0.51, 0.40-0.65), independent of clinical risk factors. Incorporating CALLY index into clinical prediction models significantly enhanced discriminative ability (area under the receiver operating characteristic curve [AUROC] of OS: 0.719-0.752; AUROC of DFS: 0.745-0.788, P < 0.01). In the validation cohort, the same associations were also observed (HR of OS: 0.57, 95% CI: 0.42-0.78; HR of DFS: 0.53, 95% CI: 0.40-0.71). In both cohorts, CALLY index > 2.55 were associated with significantly reduced risk of recurrence.ConclusionsThe CALLY index emerges as a cost-effective prognostic tool integrating inflammation-nutrition-immunity parameters. Its preoperative integration with tumor, node, and metastasis staging and other well-known risk factors might optimize risk stratification and guide personalized therapeutic strategies for EC patients undergoing esophagectomy.
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spelling doaj-art-eb105c76163c46fba36bb7d723b8dbb82025-08-20T01:54:21ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-05-011610.3389/fimmu.2025.16050671605067Pretreatment CALLY index as promising novel biomarker in the prediction of surgical and oncological outcomes in esophageal cancer: a multi-center retrospective cohort studyPeize Meng0Tongtong Gu1Jiayong Xu2Haihua Huang3Hansong Jin4Yuchen Wang5Hang Zhang6Zheng Ruan7Department of Thoracic Surgery, Shanghai General Hospital, Shanghai Jiao Tong University of Medicine, Shanghai, ChinaDepartment of Pharmacy, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Thoracic Surgery, Shanghai General Hospital, Shanghai Jiao Tong University of Medicine, Shanghai, ChinaDepartment of Thoracic Surgery, Shanghai General Hospital, Shanghai Jiao Tong University of Medicine, Shanghai, ChinaDepartment of Thoracic Surgery, Shanghai General Hospital, Shanghai Jiao Tong University of Medicine, Shanghai, ChinaDepartment of Thoracic Surgery, Shanghai General Hospital, Shanghai Jiao Tong University of Medicine, Shanghai, ChinaDepartment of Thoracic Surgery, Shanghai General Hospital, Shanghai Jiao Tong University of Medicine, Shanghai, ChinaDepartment of Thoracic Surgery, Shanghai General Hospital, Shanghai Jiao Tong University of Medicine, Shanghai, ChinaBackgroundEsophageal cancer (EC) is a global health challenge with high mortality rates. The traditional TNM staging system is limited in its ability to provide accurate prognostic predictions. This study aimed to investigate the utility of the C-reactive protein-albumin-lymphocyte (CALLY) index in the evaluation of mid- to long-term outcomes in patients undergoing esophagectomy.MethodsWe conducted a multi-center retrospective cohort study of 657 EC patients admitted between 2010 to 2024, with 553 patients from Shanghai General Hospital (training cohort) and 104 from Shanghai Sixth People’s Hospital (validation cohort). Associations between the CALLY and overall survival (OS)/disease-free survival (DFS) were evaluated using multivariable-adjusted Cox regression analyses.ResultsPatients with CALLY index > 2.55 were associated with significantly improved OS (adjusted hazard ratio [HR]: 0.55, 95% confidence interval [CI]: 0.43-0.71) and DFS (HR: 0.51, 0.40-0.65), independent of clinical risk factors. Incorporating CALLY index into clinical prediction models significantly enhanced discriminative ability (area under the receiver operating characteristic curve [AUROC] of OS: 0.719-0.752; AUROC of DFS: 0.745-0.788, P < 0.01). In the validation cohort, the same associations were also observed (HR of OS: 0.57, 95% CI: 0.42-0.78; HR of DFS: 0.53, 95% CI: 0.40-0.71). In both cohorts, CALLY index > 2.55 were associated with significantly reduced risk of recurrence.ConclusionsThe CALLY index emerges as a cost-effective prognostic tool integrating inflammation-nutrition-immunity parameters. Its preoperative integration with tumor, node, and metastasis staging and other well-known risk factors might optimize risk stratification and guide personalized therapeutic strategies for EC patients undergoing esophagectomy.https://www.frontiersin.org/articles/10.3389/fimmu.2025.1605067/fullC-reactive protein-albumin-lymphocyte indexesophageal cancersurgeryneoadjuvant therapyoverall survivaldisease-free survival
spellingShingle Peize Meng
Tongtong Gu
Jiayong Xu
Haihua Huang
Hansong Jin
Yuchen Wang
Hang Zhang
Zheng Ruan
Pretreatment CALLY index as promising novel biomarker in the prediction of surgical and oncological outcomes in esophageal cancer: a multi-center retrospective cohort study
Frontiers in Immunology
C-reactive protein-albumin-lymphocyte index
esophageal cancer
surgery
neoadjuvant therapy
overall survival
disease-free survival
title Pretreatment CALLY index as promising novel biomarker in the prediction of surgical and oncological outcomes in esophageal cancer: a multi-center retrospective cohort study
title_full Pretreatment CALLY index as promising novel biomarker in the prediction of surgical and oncological outcomes in esophageal cancer: a multi-center retrospective cohort study
title_fullStr Pretreatment CALLY index as promising novel biomarker in the prediction of surgical and oncological outcomes in esophageal cancer: a multi-center retrospective cohort study
title_full_unstemmed Pretreatment CALLY index as promising novel biomarker in the prediction of surgical and oncological outcomes in esophageal cancer: a multi-center retrospective cohort study
title_short Pretreatment CALLY index as promising novel biomarker in the prediction of surgical and oncological outcomes in esophageal cancer: a multi-center retrospective cohort study
title_sort pretreatment cally index as promising novel biomarker in the prediction of surgical and oncological outcomes in esophageal cancer a multi center retrospective cohort study
topic C-reactive protein-albumin-lymphocyte index
esophageal cancer
surgery
neoadjuvant therapy
overall survival
disease-free survival
url https://www.frontiersin.org/articles/10.3389/fimmu.2025.1605067/full
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