The C-reactive protein-albumin-lymphocyte (CALLY) index is a useful predictor of postoperative complications in patients with a colonic stent for obstructive colorectal cancer: a Japanese multicenter study

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2024年8月23日

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Toshio Shiraishi,
Takashi Nonaka,
Tetsuro Tominaga,
Yuma Takamura,
Kaido Oishi,
Shintaro Hashimoto,
Keisuke Noda,
Rika Ono,
Makoto Hisanaga,
Hiroaki Takeshita,
Mitsutoshi Ishii,
Shosaburo Oyama,
Kazuhide Ishimaru,
Masaki Kunizaki,
Terumitsu Sawai,
Keitaro Matsumoto

摘要

Purpose

The C-reactive protein-albumin-lymphocyte (CALLY) index is a novel score that offers a good reflection of nutritional status, inflammatory response, and immune system status. The CALLY index is reported to correlate with the prognosis of various carcinomas. The purpose of the present study was to investigate the association between the CALLY index and the short-term prognosis of obstructive colorectal cancer managed with a colonic stent.

Methods

The subjects of this retrospective study were 263 patients who underwent colorectal resection after colonic stenting for obstructive colorectal cancer between 2016 and 2023. Patients were classified into a group with a low CALLY index (CALLY-L group, n = 85) and a group with a high (CALLY-H group, n = 178) CALLY index.

Results

The CALLY-L group had greater blood loss (53 mL vs 20 mL, p = 0.002) and higher poor performance status (PS3; 20% vs 10.1%, p = 0.033), open surgery (21.2% vs 7.3%, p = 0.001), distant metastases (41.2% vs 20.8%, p = 0.01), and postoperative complications (30.6% vs. 18.5%, p = 0.039) than the CALLY-H group. Multivariate analysis identified a prolonged operative time (odds ratio 1.983, 95% confidence interval 1.013–3.881; p = 0.045), greater blood loss (odds ratio 2.572, 95% confidence interval 1.291–5.129; p = 0.007) and a low CALLY index (odds ratio 1.961, 95% confidence interval 1.013–3.795; p = 0.045) as independent predictors of complications.

Conclusion

The CALLY index may be a useful predictor of postoperative complications of obstructive colorectal cancer.