Scholarlink

Purpose <p>The clinical value of the C-reactive protein–albumin–lymphocyte (CALLY) index, an inflammation- and nutrition-based biomarker, in unresectable or recurrent gastric cancer (URGC) remains unclear. This study evaluated its prognostic significance in patients receiving first-line fluoropyrimidine-based chemotherapy.</p> Methods <p>This multicenter retrospective study included 201 URGC patients treated with fluoropyrimidine-based combination chemotherapy between 2017 and 2023. Patients with HER2-positive tumors, monotherapy, or non-fluoropyrimidine regimens were excluded from the analysis. The CALLY index was calculated using pretreatment laboratory values, and the optimal cutoff was calculated by receiver operating characteristic (ROC) analysis. We compared the survival outcomes and clinical characteristics between the high- and low-CALLY groups.</p> Results <p>The optimal CALLY index cutoff was 1.7, indicating the highest prognostic performance. The low-CALLY group had higher rates of unresectable primary tumors and Eastern Cooperative Oncology Group Performance Status (ECOG PS) ≥ 1. Despite a comparable incidence of grade ≥ 3 adverse events, third-line therapy was administered more frequently in the high-CALLY group. Median overall survival was significantly shorter in the low-CALLY group (11.4 vs. 20.5 months, respectively; <i>p</i> &lt; 0.001). On multivariate analysis, a low CALLY index (hazard ratio [HR] 1.591, <i>p</i> = 0.004), ECOG PS ≥ 1 (HR 1.648, <i>p</i> = 0.002), and peritoneal dissemination (HR 1.530, <i>p</i> = 0.042) were independent predictors of poor survival.</p> Conclusions <p>The CALLY index is a strong independent prognostic biomarker for URGC patients treated with first-line fluoropyrimidine–based chemotherapy. It reflects tumor-induced inflammation and host immune–nutritional status, providing a simple, objective tool for pretreatment risk stratification.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Prognostic significance of the C-reactive protein–albumin–lymphocyte index in patients with unresectable or recurrent gastric cancer treated with First-line fluoropyrimidine-based chemotherapy

  • 期刊论文

  • 发表日期：

    2026年4月10日

查看全文
  • Tomoyuki Matsunaga,
  • Hiroaki Saito,
  • Yoji Fukumoto,
  • Hirohiko Kuroda,
  • Kenjiro Taniguchi,
  • Sadamu Takahashi,
  • Tomohiro Osaki,
  • Akemi Iwamoto,
  • Kenji Fukuda,
  • Shota Shimizu,
  • Yuji Shishido,
  • Kozo Miyatani,
  • Teruhisa Sakamoto,
  • Yoshiyuki Fujiwara

摘要

Purpose

The clinical value of the C-reactive protein–albumin–lymphocyte (CALLY) index, an inflammation- and nutrition-based biomarker, in unresectable or recurrent gastric cancer (URGC) remains unclear. This study evaluated its prognostic significance in patients receiving first-line fluoropyrimidine-based chemotherapy.

Methods

This multicenter retrospective study included 201 URGC patients treated with fluoropyrimidine-based combination chemotherapy between 2017 and 2023. Patients with HER2-positive tumors, monotherapy, or non-fluoropyrimidine regimens were excluded from the analysis. The CALLY index was calculated using pretreatment laboratory values, and the optimal cutoff was calculated by receiver operating characteristic (ROC) analysis. We compared the survival outcomes and clinical characteristics between the high- and low-CALLY groups.

Results

The optimal CALLY index cutoff was 1.7, indicating the highest prognostic performance. The low-CALLY group had higher rates of unresectable primary tumors and Eastern Cooperative Oncology Group Performance Status (ECOG PS) ≥ 1. Despite a comparable incidence of grade ≥ 3 adverse events, third-line therapy was administered more frequently in the high-CALLY group. Median overall survival was significantly shorter in the low-CALLY group (11.4 vs. 20.5 months, respectively; p < 0.001). On multivariate analysis, a low CALLY index (hazard ratio [HR] 1.591, p = 0.004), ECOG PS ≥ 1 (HR 1.648, p = 0.002), and peritoneal dissemination (HR 1.530, p = 0.042) were independent predictors of poor survival.

Conclusions

The CALLY index is a strong independent prognostic biomarker for URGC patients treated with first-line fluoropyrimidine–based chemotherapy. It reflects tumor-induced inflammation and host immune–nutritional status, providing a simple, objective tool for pretreatment risk stratification.