Clinical feasibility of the preoperative C-reactive protein–albumin–lymphocyte index to predict short- and long-term outcomes of patients with gastric cancer

Abstract

BackgroundGastric cancer (GC) is a major leading cause of cancer-related death worldwide. Systemic inflammation and the nutrition-based score are feasible prognostic markers for malignancies. Emerging evidence has also revealed the C-reactive protein–albumin–lymphocyte (CALLY) index to be a prognostic marker for several cancer types. However, its clinical significance to predict surgical and oncologic outcomes of patients with GC remains unclear. MethodsWe assessed the preoperative CALLY index in 426 patients with GC who received gastrectomy. ResultsA low preoperative CALLY index was significantly correlated to all well-established clinicopathologic factors for disease development, including an advanced T stage, the presence of venous invasion, lymphatic vessel invasion, lymph node metastasis, distant metastasis, and an advanced TNM stage. A low preoperative CALLY index was also an independent prognostic factor for overall survival (hazard ratio [HR], 2.64; 95 % CI, 1.66–4.2; P < .0001) and disease-free survival (HR, 1.76; 95 % CI, 1.01–3.05; P = .045). In addition, a low preoperative CALLY index was an independent predictive factor for postoperative surgical site infection (odds ratio, 2.64; 95 % CI, 1.42–4.89; P = .002). ConclusionThe preoperative CALLY index is valuable for perioperative and oncologic management of patients with GC.