2025 Volume 9 Issue 4 Pages 398-405
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.
