CRP–Albumin–Lymphocyte (CALLY) Index Is an Independent Prognostic Factor for Recurrent Esophageal Cancer After Curative Treatment

Background/Aim: The C-reactive protein–albumin–lymphocyte (CALLY) index is a promising biomarker. We investigated the prognostic significance of the CALLY index in patients with recurrent esophageal cancer (EC). Patients and Methods: Consecutive patients who developed recurrent EC after curative esophagectomy and received treatment for recurrence at Yokohama City University from 2005 to 2022 were selected based on medical records. The CALLY index was calculated as follows: serum albumin level (g/dl) × peripheral lymphocyte count (/μl)/[C-reactive protein level (mg/dl) × 104]. The primary endpoint was overall survival after recurrence. The secondary endpoint was the association between the CALLY index and the clinical course after recurrence, including the administration of first-, second-, and third- line treatments. Results: One hundred patients were included in this retrospective study. The cut-off value for the CALLY index was set at 5. The 5-year overall survival rates were 11.2% and 46.9% for the low and high CALLY index groups, respectively (p<0.001). Multivariate analysis demonstrated that a low CALLY index was an independent prognostic factor for poor overall survival (hazard ratio=4.271, 95% confidence interval=2.370–7.696, p<0.001). Patients with a high CALLY index were significantly more likely to receive first-, second-, and third-line treatments than those with a low CALLY index. Conclusion: The CALLY index may serve as a useful prognostic biomarker and may also be associated with the ability to receive subsequent lines of treatment in patients with recurrent esophageal cancer.