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. 2022 Nov 18;7(3):503-511.
doi: 10.1002/ags3.12637. eCollection 2023 May.

The impact of C-reactive protein-albumin-lymphocyte (CALLY) index on the prognosis of patients with distal cholangiocarcinoma following pancreaticoduodenectomy

Masashi Tsunematsu  1 , Koichiro Haruki  1 , Tomohiko Taniai  1 , Yoshiaki Tanji  1 , Yoshihiro Shirai  1 , Kenei Furukawa  1 , Tadashi Uwagawa  1 , Shinji Onda  1 , Mitsuru Yanagaki  1 , Teruyuki Usuba  2 , Yukio Nakabayashi  3 , Tomoyoshi Okamoto  4 , Toru Ikegami  1
Affiliations

The impact of C-reactive protein-albumin-lymphocyte (CALLY) index on the prognosis of patients with distal cholangiocarcinoma following pancreaticoduodenectomy

Masashi Tsunematsu et al. Ann Gastroenterol Surg. .

Abstract

Aim: The C-reactive protein (CRP)-albumin-lymphocyte (CALLY) index is a novel inflammation-based biomarker, which has been associated with long-term outcomes in patients with hepatocellular carcinoma. We aimed to investigate whether the CALLY index can predict the prognosis for distal cholangiocarcinoma after pancreaticoduodenectomy.

Methods: The study comprised 143 patients who had undergone primary pancreaticoduodenectomy for distal cholangiocarcinoma between 2002 to 2019. The CALLY index was defined as (albumin × lymphocyte)/ (CRP × 104). We investigated the association of CALLY index with disease-free survival and overall survival by univariate and multivariate analyses.

Results: Eighty-seven (61%) patients had a preoperative CALLY index <3.5. In multivariate analysis, obstructive jaundice drainage (P < .01), poorly differentiated tumor (P < .01), and CALLY index<3.5 (P = .02) were independent predictors of disease-free survival, while obstructive jaundice drainage (P < .01), poorly differentiated tumor (P < .01), and CALLY index <3.5 (P = .02) were independent predictors of overall survival.

Conclusion: The CALLY index may be an independent and significant indicator of poor long-term outcomes in patients with distal cholangiocarcinoma after pancreaticoduodenectomy, suggesting the importance of comprehensive assessment for inflammatory status.

Keywords: CALLY index; distal cholangiocarcinoma; pancreaticoduodenectomy.

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Figures

FIGURE 1
FIGURE 1
Receiver operating characteristic (ROC) curve of C‐reactive protein‐albumin‐lymphocyte (CALLY) index for survival status at the 3‐year follow‐up (area under ROC = 0.63, 95% confidence interval 0.54–0.73). The cutoff value of the CALLY index was 3.5 (sensitivity = 53.3%, specificity = 75.6%)
FIGURE 2
FIGURE 2
Kaplan–Meier curves of disease‐free survival (A) and overall survival (B) after pancreaticoduodenectomy for distal cholangiocarcinoma. The C‐reactive protein‐albumin‐lymphocyte (CALLY) index <3.5 was associated with worse disease‐free survival (P < .01) and overall survival (P < .01)
FIGURE 3
FIGURE 3
Kaplan–Meier curves of disease‐free survival (A) and overall survival (B) after pancreaticoduodenectomy for distal cholangiocarcinoma in the external validation analyses the C‐reactive protein‐albumin‐lymphocyte (CALLY) index<3.5 was associated with worse disease‐free survival (P = .03) and overall survival (P < .01)
See this image and copyright information in PMC

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