Clinical significance of the C-reactive protein-albumin-lymphocyte index in older patients with colorectal cancer.

PURPOSE: This study aimed to investigate the association between the C-reactive protein-albumin-lymphocyte (CALLY) index and long-term prognosis and postoperative complications in older patients with colorectal cancer (CRC).

METHODS

Three hundred three patients with pathological stage (pStage) I-III CRC who underwent curative surgery at our institution between 2015 and 2022 were retrospectively analyzed. Patients aged ≥ 75 years were defined as older.

RESULTS

In the overall cohort, a low CALLY index was an independent prognostic factor (hazard ratio (HR) = 2.42, 95% confidence interval (CI): 1.31-4.47, p = 0.004). The age-stratified analysis revealed that a low CALLY index was associated with a worse prognosis and was an independent prognostic factor in older patients (HR = 3.46, 95% CI: 1.44-8.30, p = 0.005), whereas no independent prognostic significance was observed in non-older patients. Moreover, although the CALLY index was not associated with postoperative complications in non-older patients, a low CALLY index was an independent risk factor for postoperative complications in older patients (odds ratio = 3.93, 95% CI 1.49-10.3, p = 0.005).

CONCLUSION

The CALLY index is a valuable predictor of both short- and long-term outcomes in patients with pStage I-III CRC, with a particularly strong impact on older patients aged ≥ 75 years.