Pre-Treatment CRP-Albumin-Lymphocyte Index (CALLY Index) as a Prognostic Biomarker of Survival in Patients with Epithelial Ovarian Cancer

Wei Wang,1,&ast; Jinyu Gu,1,&ast; Yanxia Liu,2 Xiaoxu Liu,1 Lei Jiang,1 Changfen Wu,1 Jing Liu3 1Department of Obstetrics and Gynecology, Shijiazhuang Maternal and Child Health Care Hospital, Shijiazhuang, Hebei, 050000, People’s Republic of China; 2Department of Pediatrics, Shijiazhuang Maternity and Child Health Care Hospital, Shijiazhuang, Hebei, 050000, People’s Republic of China; 3Department of Reproductive Medicine, Shijiazhuang Maternity and Child Health Care Hospital, Shijiazhuang, Hebei, 050000, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Jing Liu, Department of Reproductive Medicine, Shijiazhuang Maternity and Child Health Care Hospital, No. 396 South Friendship Street, Shijiazhuang, Hebei, 050000, People’s Republic of China, Email jingll127@tom.comBackground: The novel CRP–albumin–lymphocyte (CALLY) index is an improved immunonutritive scoring system, based on serum C-reactive protein (CRP), serum albumin, and the lymphocyte count. It has been determined as a prognostic index for patients with hepatocellular carcinoma. This study was conducted to explore the prognostic value of the CALLY index in patients with epithelial ovarian cancer (EOC) undergoing surgery.Methods: Patients with EOC treated with surgery as an initial therapy were enrolled to form the training and validation cohorts. The effect of the CALLY index on overall survival (OS) and disease-free survival (DFS) was analyzed using Kaplan–Meier method and Cox proportional hazards model. The CALLY index was calculated as: (Albumin × Lymphocyte)/ (CRP × 104).Results: There were 190 patients in the training cohort and 120 in the validation cohort, respectively. With a cut-off value of 3, patients were classified into the CALLY < 3 and CALLY ≥ 3 groups. The CALLY index ≥ 3 was associated with better survival outcomes both in the training and validation cohorts. The univariate and multivariate COX analysis revealed that FIGO stage, lymphatic metastasis, and CALLY index were the prognostic factors for both OS and DFS.Conclusion: The CALLY index is a novel prognostic biomarker for patients with EOC after surgery. The novel CALLY index could select appropriate patients with poor prognosis for postoperative adjuvant therapy.Keywords: epithelial ovarian cancer, CALLY index, biomarker, survival