Prognostic Impact of C-reactive Protein-albumin-lymphocyte Index in Elderly Patients with Colorectal Cancer.

OBJECTIVES

This study aimed to assess the prognostic impact of the C-reactive protein-albumin-lymphocyte index in older patients with colorectal cancer and to evaluate the superiority of this new system.

METHODS

Of the patients who received initial treatment for colorectal cancer at our hospital between 2014 and 2021 (n=269), older patients aged ≥65 years who had undergone curative resection for colorectal cancer during the study period were included. We retrospectively investigated the relationship between the preoperative C-reactive protein-albumin-lymphocyte index and overall and recurrence-free survival rates. Univariate and multivariate analyses were performed to identify the independent prognostic factors after curative resection in older patients with colorectal cancer.

RESULTS

One-hundred-seventy-eight patients underwent initial curative resection during the study period. The median survival times for patients with C-reactive protein-albumin-lymphocyte (CALLY) indices <1.2 and ≥1.2 were 42.6 and 68.3 months, respectively (p=0.01). Multivariate analysis identified the following independent risk factors associated with poor prognosis: age ≥75 years (hazard ratio 1.64, 95% confidence interval 1.03-2.62, p=0.03), T stage 3 or 4 (hazard ratio 1.66, 95% confidence interval 1.06-2.61, p=0.02), laparotomy surgical approach (hazard ratio 2.09, 95% confidence interval 1.29-3.38, p<0.01), and C-reactive protein-albumin-lymphocyte index <1.2 (hazard ratio 1.75, 95% confidence interval 1.05-2.92, p=0.03).

CONCLUSIONS

Our study suggests that the CALLY index is an independent prognostic factor in older patients with colorectal cancer and may facilitate multidisciplinary decision-making.