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The following is a summary of “Integrating inflammation, nutrition, and immunity: the CALLY index as a prognostic tool in digestive system cancers – a systematic review and meta-analysis,” published in the April 2025 issue of BMC Cancer by Wu et al. 

Digestive system malignancies continue to account for a substantial proportion of global cancer-related deaths, emphasizing the critical need for accessible and reliable prognostic indicators. The C-reactive protein–Albumin–Lymphocyte (CALLY) index, a composite marker encompassing inflammatory response, nutritional status, and immune function, has gained attention as a potential predictor of survival outcomes in various cancer populations. However, its prognostic utility in digestive system cancers remains incompletely characterized. This meta-analysis aimed to systematically evaluate the association between the CALLY index and survival outcomes in patients with digestive system malignancies.

A comprehensive literature search of English-language studies was conducted across major electronic databases. Eligible studies that examined the prognostic value of the CALLY index in digestive system cancers were included. Pooled HRs with 95% CIs were calculated to assess the association between CALLY index levels and survival outcomes, including OS, disease-free survival, recurrence-free survival, and cancer-specific survival. Subgroup and sensitivity analyses were also performed to explore the robustness and consistency of the findings.

The final analysis comprised 18 articles, which collectively included 19 individual studies involving a total of 7,951 patients. A low CALLY index was consistently associated with adverse prognoses across all evaluated survival metrics. Specifically, the pooled HRs were 1.973 (95% CI: 1.734–2.244) for OS, 2.093 (95% CI: 1.682–2.604) for DFS, 1.462 (95% CI: 1.292–1.654) for RFS, and 2.456 (95% CI: 1.887–3.221) for CSS—all statistically significant (P < 0.001). Subgroup analyses revealed the prognostic value of the CALLY index remained robust across diverse variables, including cancer subtype, treatment modality, regional cohort, sample size, and CALLY cutoff thresholds. In particular, the index was strongly predictive of OS in patients undergoing surgical treatment (HR = 2.014, 95% CI: 1.794–2.260, P < 0.001). Sensitivity analyses confirmed the reliability of the results, and Egger’s test indicated minimal risk of publication bias (P = 0.053).

In conclusion, the CALLY index represents a practical, inexpensive, and effective prognostic biomarker for digestive system cancers. By capturing essential aspects of systemic inflammation, nutritional reserve, and immune competence, it offers clinicians a valuable pre-treatment tool for risk stratification and personalized therapeutic planning.

Source: bmccancer.biomedcentral.com/articles/10.1186/s12885-025-14074-3