Prognostic Value of Pretreatment C-Reactive-Protein-Albumin-Lymphocyte Index in Colorectal Cancer: Systematic Review and Meta-Analysis
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Authors
Shamohammadi, Mohammadsadra
Yarahmadi, Danial
Yiasemidou, Marina
Teymoori, Mohammad Hossein
Rouzbahani, Arian Karimi
Bahrdoust, Mansour
Garavand, Armaghan Abbasi
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Issue Date
2026
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Article
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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 t²; 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.
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Journal of gastrointestinal cancer
Volume
57
Issue
1