1. Department of Otorhinolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan.
2. College of Medicine, Chang Gung University, Taoyuan, Taiwan.
3. Department of Radiation Oncology, Chang Gung Memorial Hospital, Chiayi, Taiwan.
4. Department of Otorhinolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan.
5. Department of Otorhinolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Background: The prognostic value of the CRP-albumin-lymphocyte index (CALLY index) was analyzed in patients with oral cavity squamous cell carcinoma (OSCC) undergoing curative surgery.
Methods: We retrospectively included 279 patients who were diagnosed as having primary OSCC and being treated with surgery. The optimal cutoff for the preoperative CALLY index was identified by considering the area under the receiver operating characteristic curve; subsequently, the discriminatory ability of the cutoff was determined. We employed Kaplan-Meier analysis and the log-rank test to elucidate associations between the CALLY index and survival outcomes. We identified prognostic variables by using the Cox proportional hazards model. Finally, we devised a nomogram based on the CALLY index for predicting individualized survival.
Results: The cutoff value of the CALLY index was determined to be 0.65. A CALLY index < 0.65 exhibited a significant association with pathological aggressiveness as well as shorter overall and disease-free survival (OS and DFS, both P < 0.001). A low CALLY index was an independent risk factor for short OS and DFS [hazard ratio = 3.816; 95% confidence interval (CI) 2.393-6.086; P < 0.001; and hazard ratio = 2.103; 95% CI 1.451-3.049; P < 0.001, respectively] in multivariate Cox analysis. The prognostic nomogram based on the CALLY index yielded accurate predictions of OS, as revealed by a concordance index of 0.797.
Conclusions: The preoperative CALLY index is easy and inexpensive to calculate and, in patients with OSCC, can be a valuable prognostic biomarker. The CALLY-index-based nomogram established in this study provides accurate survival predictions.
Keywords: CRP-albumin-lymphocyte index, oral cavity cancer, overall survival, disease-free survival, nomogram