Evidence map›Paper›PMID 41731142›Full record

ArticleSurgical endoscopy2026

The CALLY index as a comprehensive inflammation-nutrition-immunity marker for prognosis in gastric cancer surgery.

Guanghao Liu, Shuai Zhao, Mingyu Xia, Kai Zheng, Dailong Lu, Houchen Zhu, Daorong Wang

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Article in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

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2citing papers in PubMed, 1 pooled it
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3 · Its place in the literature

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2 citing papers in PubMed, 1 synthesis or guideline pooled it.

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5 · Who and what money

Authors and funding

7 authors.

Guanghao LiuNorthern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, China.
Shuai ZhaoClinical Teaching Hospital of Medical School, Northern Jiangsu People's Hospital, Nanjing University, Yangzhou, China.
Mingyu XiaThe Yangzhou Clinical Medical College of Xuzhou Medical University, Yangzhou, China.
Kai ZhengNorthern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, China.
Dailong LuNorthern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, China.
Houchen ZhuThe Yangzhou Clinical Medical College of Xuzhou Medical University, Yangzhou, China.
Daorong WangNorthern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, China. wdaorong666@sina.com.

Funding

National Natural Science Foundation of China 82373014
6 · The paper itself

Abstract

backgroundReliable preoperative prognostic tools that comprehensively reflect host-related factors remain limited for gastric cancer (GC). The C-reactive protein-albumin-lymphocyte (CALLY) index integrates systemic inflammation, nutritional status, and immune competence. We evaluated its prognostic performance compared with commonly used inflammation-nutrition indices.

methodsWe conducted a single-center retrospective cohort study of consecutive patients undergoing curative gastrectomy for gastric adenocarcinoma, with temporal validation. Preoperative laboratory parameters obtained within 1 week before surgery were used to calculate the CALLY index. Outcomes included overall survival (OS), disease-free survival (DFS), and 30 day postoperative morbidity. Discrimination was assessed using receiver operating characteristic (ROC) analysis; survival outcomes were analyzed using Kaplan-Meier methods and multivariable Cox regression; postoperative morbidity was evaluated using multivariable logistic regression.

resultsThe development cohort included 992 patients, and the temporal validation cohort included 302 patients. In the development cohort, the optimal CALLY cutoff was 2.61. For 5 year OS, the CALLY index showed the highest discriminative ability (AUC = 0.708), comparable to mGPS (AUC = 0.705) and superior to other indices (AUC ≤ 0.675). A low CALLY index was significantly associated with poorer OS and DFS (both p < 0.001) and remained independently prognostic after multivariable adjustment (OS HR 1.56, 95% CI 1.20-2.03; DFS HR 1.48, 95% CI 1.16-1.90). Low CALLY was also independently associated with increased risks of overall and severe postoperative complications, with consistent directions observed in the validation cohort.

conclusionsThe preoperative CALLY index independently predicts long-term survival and short-term postoperative morbidity in patients with GC undergoing curative gastrectomy. Compared with conventional inflammation-nutrition scores, CALLY shows comparable-to-slightly better and more consistent prognostic performance across endpoints, although absolute gains in discrimination are modest. Prospective multicenter validation with standardized assays, prespecified analyses, and recalibration is warranted.

Indexed as

AdenocarcinomaC-Reactive ProteinGastrectomyInflammationSerum AlbuminStomach NeoplasmsAgedBiomarkersFemaleHumansLymphocyte CountMaleMiddle AgedNutritional StatusPostoperative ComplicationsPrognosisBiomarkersC-Reactive ProteinSerum AlbuminCALLY indexGastric cancerPostoperative complicationsPreoperative risk assessmentPrognosis

Identifiers

PMID41731142

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.