Prognostic impact of the CALLY index in patients with resectable pancreatic cancer

Background: The prognostic significance of the preoperative C-reactive protein-albumin-lymphocyte (CALLY) index has been reported in various cancers.However, its role in pancreatic cancer remains unclear.Methods: A cohort of 307 patients with resectable pancreatic cancer (RPC) who underwent curative surgery without neoadjuvant therapy, between July 2012 and December 2019, was analyzed.The CALLY index was defined as (albumin lymphocytes)/ (C-reactive protein 10 4 ).The cutoff value of the CALLY index was determined according to receiver operating characteristics analysis using survival status at 3-year follow-up.The association of the CALLY index with disease-free survival (DFS) and overall survival (OS) was investigated using univariate and multivariate analyses.Results: The median CALLY index was 4.5, with an interquartile range of 1.4-12.3.The cutoff value of the CALLY index was set at 3.0, dividing patients into a CALLY-high group (> 3.0; n = 180) and a CALLY-low group ( 3.0; n = 127).The DFS and OS were significantly worse in the CALLY-low group versus the CALLY-high group (p < 0.001 and p < 0.001, respectively).Multivariate analysis, using preoperative clinicopathological variables, revealed a CALLY index 3.0 as an independent prognostic factor for DFS (hazard ratio [HR] 1.43, p = 0.041) and OS (HR 1.56, p = 0.012).Conclusions: In RPC, survival outcomes were significantly stratified by the CALLY index = 3.0, with < 3 being a significantly poor prognostic factor for DFS and OS.The CALLY index may be useful in predicting long-term survival in patients with RPC.