Evidence map›Paper›PMID 40217204›Full record

SynthesisBMC cancer2025

Integrating inflammation, nutrition, and immunity: the CALLY index as a prognostic tool in digestive system cancers - a systematic review and meta-analysis.

Bo Wu, Jingting Liu, Chaodan Shao, Dongli Yu, Jianhua Liao

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
39citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

39 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
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  5. Prognostic value of the lactate-based modified cally score in postoperative gastric cancer patients admitted to the ICU.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026
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  6. Predicting intestinal ischemia in mechanical intestinal obstruction: the role of the C-reactive protein-albumin-lymphocyte index.Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Bo Wu *Department of Surgery, Zhejiang Hospital, 12 Lingyin Road, Zhejiang, 310013, China.
Jingting Liu *Department of Health Management, Sir Run Run Shaw International Medical Centre, 9 Jingtan Road, Hangzhou, Zhejiang, 310000, China.
Chaodan ShaoDepartment of Surgery, Zhejiang Hospital, 12 Lingyin Road, Zhejiang, 310013, China.
Dongli YuDepartment of Surgery, Zhejiang Hospital, 12 Lingyin Road, Zhejiang, 310013, China.
Jianhua LiaoDepartment of Surgery, Zhejiang Hospital, 12 Lingyin Road, Zhejiang, 310013, China. ljhsywzh@163.com.

Funding

Zhejiang Traditional Chinese Medicine Administration 2023ZL221
6 · The paper itself

Abstract

backgroundDigestive system cancers remain a leading cause of cancer-related mortality globally, underscoring the need for reliable prognostic tools. The C-reactive protein-Albumin-Lymphocyte (CALLY) index, which reflects inflammation, nutrition, and immunity, has shown potential in predicting survival. However, comprehensive evaluations of its role in digestive system cancers are still limited.

methodsA meta-analysis of English-language studies from online databases was performed to assess the prognostic value of the CALLY index. Pooled hazard ratios (HRs) were calculated for overall survival (OS), disease-free survival (DFS), recurrence-free survival (RFS), and cancer-specific survival (CSS).

resultsA total of eighteen articles (19 studies, encompassing 7,951 patients) were included. A lower CALLY index was significantly associated with poorer outcomes across all survival endpoints. The pooled HR for OS was 1.973 (95% CI: 1.734-2.244), with HRs for DFS, RFS, and CSS being 2.093 (95% CI: 1.682-2.604), 1.462 (95% CI: 1.292-1.654), and 2.456 (95% CI: 1.887-3.221), respectively (all P < 0.001). Subgroup analyses for OS demonstrated consistent prognostic significance across various treatment strategies, cancer types, cutoff values, sample sizes, and regions. Notably, the CALLY index was a strong predictor of OS in surgical patients (HR = 2.014, 95% CI: 1.794-2.260, P < 0.001). Sensitivity analyses validated the robustness of these findings, with minimal publication bias (Egger's test P = 0.053).

conclusionsThe CALLY index serves as a cost-effective and reliable biomarker for predicting prognosis in digestive system cancers. Its utility as a pre-treatment risk stratification tool, which integrates key factors of inflammation, nutrition, and immunity, renders it valuable for guiding clinical decision-making.

Indexed as

C-Reactive ProteinDigestive System NeoplasmsInflammationLymphocytesNutritional StatusSerum AlbuminBiomarkers, TumorHumansPrognosisBiomarkers, TumorC-Reactive ProteinSerum AlbuminCALLY indexDigestive system cancersMeta-analysisPrognostic biomarker

Identifiers

PMID40217204
PMCPMC11992890

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.