Prognostic value of the preoperative CRP–albumin–lymphocyte index for survival and recurrence in patients with breast cancer after surgery: a multicenter retrospective cohort study

The C-reactive protein (CRP) albumin-lymphocyte (CALLY) index is an integrated biomarker that reflects systemic inflammation, nutritional status, and immune function. The prognostic value of this index has been investigated in several cancers, but its prognostic significance in breast cancer (BC) remains unclear. The aim of this study was to evaluate the association between the CALLY index and overall survival (OS) as well as recurrence-free survival (RFS) in patients with BC. In this multicenter retrospective cohort study, we reviewed the medical records of 861 female patients with BC who underwent curative surgery at three tertiary care centers between 2011 and 2022. We calculated the CALLY index using preoperative serum CRP, albumin, and lymphocyte count. Based on the CALLY index, patients were classified into low (< 2.5; n = 295) and high (≥ 2.5; n = 566) CALLY groups. OS and RFS were estimated using the Kaplan-Meier survival method. Cox proportional hazards models were used to assess the independent prognostic impact of the CALLY index. The high-CALLY group showed significantly better 5-year OS (82.2% vs. 67.6%; p < 0.001) and RFS (77.4% vs. 60.4%; p < 0.001), compared with the low-CALLY group. Multivariable Cox regression analysis showed that a high CALLY index was significantly associated with improved 5-year OS (HR: 0.82, 95% CI: 0.67–0.97, P: 0.004) and RFS (HR: 0.80, 95% CI: 0.65–0.95, P: 0.001). The CALLY index was an independent predictor of OS and RFS in BC patients. The preoperative CALLY index may serve as an accessible and independent prognostic biomarker in patients with BC.