Pretreatment CRP–Albumin–Lymphocyte (CALLY) Index as a Prognostic Biomarker of Survival and Recurrence‐Free Survival in Patients With Early‐Stage Cervical Cancer After Radical Hysterectomy: A Multicenter Retrospective Cohort Study

Introduction/Background: The C-reactive protein (CRP)-albumin-lymphocyte (CALLY) index is a new prognostic biomarker combining CRP, serum albumin, and lymphocyte count that can be associated with the survival of cancer patients by assessing immune, nutritional, and inflammatory status as an important immune indicator. The association of CALLY index as a marker predicting survival of cancer patients with cervical cancer (CC) remains unclear. This study aimed to evaluate the prognostic value of the CALLY index with overall survival (OS) and recurrence-free survival (RFS) in patients with early-stage CC after radical hysterectomy. Methodology: In this multicenter retrospective cohort study, we examined the medical profile of 806 women with early-stage CC who underwent Type II/III radical hysterectomy and bilateral pelvic lymphadenectomy at three centers affiliated to our center between 2012 and 2022. The CALLY index was calculated before treatment. OS and RFS were the primary endpoints. Kaplan-Meier and Cox models assessed the association between CALLY index and outcomes, adjusting for age, histology, tumor size, FIGO stage, grade, extent of lymphadenectomy, and adjuvant therapy. A CALLY index cutoff of 3 maximized discrimination (AUC 0.822; 95% CI, 0.75-0.90). Results: = 0.001). In addition, age ≥ 45 years, nonsquamous histology, tumor size ≥ 3 cm, FIGO stage > IB, grade > G2, and LNR > 40% were significantly associated with poorer OS and RFS, whereas receiving adjuvant therapy was associated with a better prognosis. Conclusions: Pretreatment CALLY index is an independent, readily obtainable prognostic biomarker for OS and RFS after radical hysterectomy in early-stage CC. This index can be useful as a predictor of the prognosis for patients with CC.