High CALLY index predicts improved survival outcomes in colorectal cancer patients compared to low scores

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Clinics and research in hepatology and gastroenterology Published May 3, 2026 Medically reviewed May 8, 2026 Study authors: Li Xiuxi, Chu Tongtong, Chen Wenwen, Zhang Lijuan PubMed ↗ DOI ↗ By Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease

Key Takeaway

High CALLY index significantly predicts better overall and disease-free survival in colorectal cancer patients compared to low scores.

This comprehensive meta-analysis evaluated the prognostic value of the CALLY index in individuals diagnosed with colorectal cancer. The study pooled data from multiple sources to assess how high versus low CALLY scores influenced key survival metrics. With a total sample size of 7,467 participants, the research aimed to determine if this biomarker could reliably forecast patient outcomes across diverse settings.

results indicated that a high CALLY index was a substantial predictor of favorable prognoses. Specifically, patients with high scores demonstrated significantly better overall survival compared to those with low scores. The hazard ratio for overall survival was 0.58, with a 95% confidence interval ranging from 0.52 to 0.63. This association was statistically significant with a p-value less than 0.001, confirming the robustness of the finding.

Further analysis showed that high CALLY scores also correlated with improved disease-free and progression-free survival. The hazard ratio for disease-free survival was 0.39, while recurrence-free survival showed a hazard ratio of 0.70. Both metrics maintained statistical significance with p-values under 0.001. These results highlight the potential utility of the CALLY index in guiding treatment decisions and monitoring disease progression.

A notable limitation identified was regional heterogeneity in the prediction of overall survival. This suggests that geographic or demographic factors might influence the index's performance. Despite this, the overall evidence supports the CALLY index as a strong predictor of good prognoses in colorectal cancer management.

Study Details

Study typeMeta analysis

EvidenceLevel 1

PublishedMay 2026

PMID41895658

View Original Abstract ↓

OBJECTIVE: The prognostic performance of the C-reactive protein-albumin-lymphocyte (CALLY) index in individuals with colorectal cancer (CRC) remains inconsistent. Therefore, this research intended to ascertain the utility of CALLY for prognostic prediction in individuals with CRC. METHODS: PubMed, Cochrane Library (Cochrane), Web of Science (WOS), and Embase were retrieved to collect articles published up to October 20, 2025, ascertaining the prognostic utility of CALLY in CRC. The overall hazard ratio (HR) and its 95% confidence interval (CI) were estimated to appraise the relations between CALLY and overall survival (OS), disease-free survival (DFS) or progression-free survival (PFS), and recurrence-free survival (RFS). All analyses were implemented utilizing STATA 15.1. RESULTS: Totally 10 studies involving 7,467 individuals with CRC were included. Analysis indicated that, with low CALLY as a reference, high CALLY was a substantial predictor of good prognoses for OS (HR=0.58, 95% CI: 0.52-0.63, p<0.001), DFS/PFS (HR=0.39, 95% CI: 0.23-0.66, p<0.001), and RFS (HR=0.70, 95% CI: 0.63-0.79, p<0.001). Subgroup analysis demonstrated that high CALLY was robust as a predictor of good prognosis. Regional heterogeneity was observed in its prediction of OS, while consistent results were found across subgroups with different analysis methods and sample sizes. CONCLUSION: In the current research, with low CALLY as a reference, high CALLY was substantially linked to better OS, DFS/PFS, and RFS in individuals with CRC. CALLY may act as a bioindicator for the prognosis of individuals with CRC.