Correlation between the C reactive protein-albumin-lymphocyte (CALLY) index and malnutrition due to dysphagia as well as prognosis in patients with laryngeal carcinoma undergoing postoperative radiotherapy

Dai Honglei; Ma Wenxue; Qi Jingjing; Liu Tao; Gong Bing; Xie Yuanchun

doi:10.16689/j.cnki.cn11-9349/r.2026.03.016

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Electronic Journal of Metabolism and Nutrition of Cancer ›› 2026, Vol. 13 ›› Issue (3) : 434-443. DOI: 10.16689/j.cnki.cn11-9349/r.2026.03.016

Original Articles

Correlation between the C reactive protein-albumin-lymphocyte (CALLY) index and malnutrition due to dysphagia as well as prognosis in patients with laryngeal carcinoma undergoing postoperative radiotherapy

Dai Honglei, Ma Wenxue, Qi Jingjing, Liu Tao, Gong Bing, Xie Yuanchun

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Abstract

Objective To investigate the predictive value of the pretreatment C reactive protein-albumin-lymphocyte (CALLY) index for malnutrition due to dysphagia and survival prognosis in patients with laryngeal carcinoma undergoing postoperative radiotherapy. Method Retrospective collection of 102 laryngeal cancer patients who received postoperative radiotherapy at Jingmen People's Hospital from January 2019 to December 2021. The CALLY index was calculated from pretreatment laboratory parameters. The optimal cut-off value for predicting malnutrition was determined by receiver operating characteristic (ROC) curve analysis, and patients were accordingly stratified into low-CALLY group (n=52) and high-CALLY group (n=50). Baseline characteristics were compared. Logistic regression was used to analyze factors associated with malnutrition. The median follow-up time was 33.05 (9.65,60.01) months. In the low CALLY group, there were 36 deaths and 32 relapses; in the high CALLY group, there were 28 deaths and 22 relapses. The Kaplan-Meier method and Cox proportional hazards models were employed to assess the correlation between the CALLY index and overall survival (OS) as well as progression-free survival (PFS). Result The area under the ROC curve (AUC) of the CALLY index for predicting malnutrition was 0.942, with an optimal cut-off value of 1.382. The incidence of malnutrition was significantly higher in the low-CALLY group (64.5% vs 26.0%, P<0.001). Multivariate logistic regression identified that after adjusting for factors such as age, body mass index, ECOG-PS score, smoking history, alcohol consumption history, and resection margin status, a low CALLY index was an influencing factor for malnutrition (OR=0.507, 95%CI=0.295-0.870, P=0.014). Survival analysis revealed that the low-CALLY group had significantly shorter OS and PFS (P<0.001). Multivariate Cox analysis confirmed that after adjusting for factors such as age, tumor differentiation degree, margin status, TNM stage, and smoking history, a low CALLY index was an independent protective factor for both OS (HR=0.644,95%CI=0.509-0.816, P<0.001) and PFS (HR=0.669,95%CI=0.508-0.880, P=0.004). Conclusion The CALLY index may serve as a potential biomarker for identifying dysphagia-related malnutrition and unfavorable survival outcomes in patients with laryngeal carcinoma undergoing postoperative radiotherapy, and may provide a reference for clinical risk stratification and individualized management.

Key words

C reactive protein-albumin-lymphocyte index / Laryngeal neoplasms / Postoperative radiotherapy / Dysphagia / Malnutrition / Prognosis / Overall survival / Progression-free survival

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Dai Honglei, Ma Wenxue, Qi Jingjing, Liu Tao, Gong Bing, Xie Yuanchun. Correlation between the C reactive protein-albumin-lymphocyte (CALLY) index and malnutrition due to dysphagia as well as prognosis in patients with laryngeal carcinoma undergoing postoperative radiotherapy[J]. Electronic Journal of Metabolism and Nutrition of Cancer. 2026, 13(3): 434-443 https://doi.org/10.16689/j.cnki.cn11-9349/r.2026.03.016

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