Preoperative low C-reactive protein–albumin–lymphocyte (CALLY) index is a poor prognostic indicator for overall survival in patients undergoing surgery for pancreatic ductal adenocarcinoma

Abstract Purpose This study aimed to investigate the prognostic impact of preoperative indicators that reflect systemic inflammatory, nutritional, and immune status, focusing on the C-reactive protein–albumin–lymphocyte (CALLY) index in patients undergoing surgery for pancreatic ductal adenocarcinoma. Methods This retrospective study included 120 patients (stage I = 19, II = 94, III = 7) who underwent surgical resection for pancreatic ductal adenocarcinoma between 2007 and 2019. Preoperative laboratory data and the CALLY index were collected to evaluate their impact on overall survival (OS). A receiver operating characteristic (ROC) curve analysis was used to identify the optimal cutoff values. Results The optimal cutoff value for the preoperative CALLY index was 4.0. Patients with a low CALLY index (< 4.0) demonstrated a significantly worse OS than those with a high CALLY index (≥ 4.0) ( P = 0.001). A multivariate analysis of composite indices identified low CALLY index ( P = 0.001) as an independent prognostic factor, along with positive lymph node metastasis ( P = 0.035) and the absence of adjuvant chemotherapy ( P = 0.005). Conclusion The CALLY index reflects the preoperative systemic inflammatory, nutritional, and immune status. It is a convenient and practical prognostic predictor of OS in patients undergoing surgery for pancreatic ductal adenocarcinoma.