Is the CALLY Index the Best Tool for Predicting Survival in Patients with Primary Soft Tissue Sarcomas?

Background/Objectives: To elucidate the role of the CALLY index in 172 adult patients with primary soft tissue sarcoma (STS) and to evaluate whether the CALLY index is superior to the modified Glasgow prognostic score (mGPS) and prognostic nutrition index (PNI). Methods: The study cohort included 100 men and 72 women with a mean age of 63 years. Receiver operating characteristic (ROC) curve analysis was performed to determine the threshold value of the CALLY index for identifying the risk of identifying oncological events at 2 years. Results: ROC analysis identified 2.07 as the threshold of the CALLY index for predicting the risk of identifying oncological events at 2 years. The 5-year disease-specific survival (DSS) rate was 50.9% in patients with a lower CALLY index compared to 84% in those with a higher CALLY index. All patients with mGPS scores of 1 or 2 had lower CALLY indices, whereas all patients with a higher CALLY index had an mGPS score of 0. Patients with a lower CALLY index and mGPS of 0 had better DSS than those with a lower CALLY index and mGPS of 1 or 2. No substantial differences in DSS and disease-free survival (DFS) were observed between patients with a higher CALLY index and those with a lower CALLY index and an mGPS of 0. Conclusions: The CALLY index is a useful marker for predicting oncological outcomes in patients with primary STS. In particular, the CALLY index was a statistically significant prognostic variable for survival in patients with UPS and DDLPS individually. However, we suggest that the mGPS remains a reliable system for identifying patients with primary STSs who are at a high risk of death and relapse because we showed the significant difference for survival and event-free survival between the patients with mGPS of 1 and 2.