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Background <p>Although the prognostic value of the C-reactive–protein–Albumin–Lymphocyte (CALLY) index has been reported across several cancers, its role in colorectal cancer (CRC) remains uncertain. We conducted a systematic review and meta-analysis to evaluate the prognostic utility of the pretreatment CALLY index in CRC patients.</p> Methods <p>Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched PubMed, Web of Science, Scopus, Embase, and Google Scholar from inception to 15 February 2026 for studies including adults with histologically confirmed CRC that reported pretreatment CALLY and time-to-event outcomes (overall survival (OS), disease-free survival (DFS), recurrence-free survival (RFS), and/or progression-free survival (PFS)). Hazard ratios (HRs) were pooled using random-effects models. Heterogeneity was assessed with I² and τ²; small-study effects were explored with Egger’s test.</p> Results <p>Fifteen studies (16 independent groups; <i>n</i> = 9179) met the inclusion criteria. A higher CALLY index was associated with improved OS (pooled HR 0.556, 95% confidence intervals (CIs) 0.464–0.666; I² = 72.0%; 12 cohorts) and pooled DFS/RFS (HR 0.712, 95% CI 0.634-0.800; I² = 14.6%; 9 cohorts), with limited evidence for PFS (HR 0.324, 95% CI 0.178–0.589; I² = 76.0%; 3 cohorts).</p> Conclusions <p>A higher pretreatment CALLY is associated with longer OS and DFS/RFS in patients with CRC. Limited evidence also suggests an association with improved PFS. These findings suggest that pretreatment CALLY may be useful for risk stratification, but prospective validation and standardized cutoffs are needed before routine clinical adoption.</p>

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Prognostic Value of Pretreatment C-Reactive–Protein–Albumin–Lymphocyte Index in Colorectal Cancer: Systematic Review and Meta-Analysis

  • 期刊论文

  • 发表日期：

    2026年3月20日

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  • Mohammadsadra Shamohammadi,
  • Danial Yarahmadi,
  • Marina Yiasemidou,
  • Mohammad Hossein Teymoori,
  • Arian Karimi Rouzbahani,
  • Mansour Bahrdoust,
  • Armaghan Abbasi Garavand

摘要

Background

Although the prognostic value of the C-reactive–protein–Albumin–Lymphocyte (CALLY) index has been reported across several cancers, its role in colorectal cancer (CRC) remains uncertain. We conducted a systematic review and meta-analysis to evaluate the prognostic utility of the pretreatment CALLY index in CRC patients.

Methods

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched PubMed, Web of Science, Scopus, Embase, and Google Scholar from inception to 15 February 2026 for studies including adults with histologically confirmed CRC that reported pretreatment CALLY and time-to-event outcomes (overall survival (OS), disease-free survival (DFS), recurrence-free survival (RFS), and/or progression-free survival (PFS)). Hazard ratios (HRs) were pooled using random-effects models. Heterogeneity was assessed with I² and τ²; small-study effects were explored with Egger’s test.

Results

Fifteen studies (16 independent groups; n = 9179) met the inclusion criteria. A higher CALLY index was associated with improved OS (pooled HR 0.556, 95% confidence intervals (CIs) 0.464–0.666; I² = 72.0%; 12 cohorts) and pooled DFS/RFS (HR 0.712, 95% CI 0.634-0.800; I² = 14.6%; 9 cohorts), with limited evidence for PFS (HR 0.324, 95% CI 0.178–0.589; I² = 76.0%; 3 cohorts).

Conclusions

A higher pretreatment CALLY is associated with longer OS and DFS/RFS in patients with CRC. Limited evidence also suggests an association with improved PFS. These findings suggest that pretreatment CALLY may be useful for risk stratification, but prospective validation and standardized cutoffs are needed before routine clinical adoption.