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Article

Prognostic value of the postoperative CALLY index in T1/T2 clear cell renal cell carcinoma

  • Authors:
    • Hiroshi Hirata
    • Nakanori Fujii
    • Takanori Tokunaga
    • Kosuke Shimizu
    • Keita Kobayashi
    • Koji Shiraishi
  • View Affiliations / Copyright

    Affiliations: Department of Urology, Graduate School of Medicine, Yamaguchi University, Ube, Yamaguchi 755‑8505, Japan
  • Article Number: 584
    |
    Published online on: October 10, 2025
       https://doi.org/10.3892/ol.2025.15330
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Abstract

Identifying patients with renal cell carcinoma (RCC) at risk of postoperative recurrence remains challenging, particularly in those with early‑stage disease. The objective of the present study was to evaluate the prognostic utility of the C‑reactive protein (CRP)‑albumin‑lymphocyte (CALLY) index and other haematological biomarkers in patients with pathologic T1/T2 clear‑cell RCC (ccRCC). In total, data from 253 patients with pT1/T2 ccRCC who underwent nephrectomies were retrospectively analysed. Preoperative and postoperative levels of CRP, neutrophil‑to‑lymphocyte ratio (NLR) and CALLY index were assessed, and cut‑off values were determined using receiver operating characteristic curves. Prognostic significance was evaluated using Kaplan‑Meier and Cox regression analyses. A postoperative CALLY index of ≤2.163 was significantly associated with shorter progression‑free survival [hazard ratio (HR)=3.64] and overall survival (HR=4.98). A preoperative NLR of ≥3.015 also predicted recurrence (HR=2.74). Furthermore, the postoperative CALLY index demonstrated the highest predictive accuracy for overall survival (area under the curve=0.8141). In conclusion, the postoperative CALLY index is a robust and accessible biomarker for recurrence and survival in patients with T1/T2 ccRCC, and may guide postoperative surveillance strategies.
View Figures

Figure 1

ROC curve analysis for
progression-free survival using pre- and postoperative biomarkers:
(A) Preoperative CRP, (B) preoperative NLR, (C) preoperative CALLY
index, (D) postoperative CRP, (E) postoperative NLR, (F)
postoperative CALLY index. ROC, receiver operating characteristic;
CRP, C-reactive protein; NLR, neutrophil-to-lymphocyte ratio;
CALLY, CRP-albumin-lymphocyte.

Figure 2

ROC curve analysis for OS using pre-
and postoperative biomarkers: (A) Preoperative CRP, (B)
preoperative NLR, (C) preoperative CALLY index, (D) postoperative
CRP, (E) postoperative NLR, (F) postoperative CALLY index. ROC,
receiver operating characteristic; CRP, C-reactive protein; NLR,
neutrophil-to-lymphocyte ratio; CALLY, CRP-albumin-lymphocyte; OS,
overall survival.

Figure 3

Kaplan-Meier survival analysis for PFS
stratified by biomarker cut-offs: (A) Preoperative CRP, (B)
preoperative NLR, (C) preoperative CALLY index, (D) postoperative
CRP, (E) postoperative NLR, (F) postoperative CALLY index. Patients
were divided into H and L groups according to the cut-off value
determined by receiver operating characteristic curve analysis.
CRP, C-reactive protein; NLR, neutrophil-to-lymphocyte ratio;
CALLY, CRP-albumin-lymphocyte; PFS, progression-free survival; H,
high; L, low.

Figure 4

Kaplan-Meier survival analysis for OS
stratified by biomarker cut-offs: (A) Preoperative CRP, (B)
preoperative NLR, (C) preoperative CALLY index, (D) postoperative
CRP, (E) postoperative NLR, (F) postoperative CALLY index. Patients
were divided into H and L groups according to the cut-off value
determined by receiver operating characteristic curve analysis.
CRP, C-reactive protein; NLR, neutrophil-to-lymphocyte ratio;
CALLY, CRP-albumin-lymphocyte; OS, overall survival; H, high; L,
low.
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Copy and paste a formatted citation
Spandidos Publications style
Hirata H, Fujii N, Tokunaga T, Shimizu K, Kobayashi K and Shiraishi K: Prognostic value of the postoperative CALLY index in T1/T2 clear cell renal cell carcinoma. Oncol Lett 30: 584, 2025.
APA
Hirata, H., Fujii, N., Tokunaga, T., Shimizu, K., Kobayashi, K., & Shiraishi, K. (2025). Prognostic value of the postoperative CALLY index in T1/T2 clear cell renal cell carcinoma. Oncology Letters, 30, 584. https://doi.org/10.3892/ol.2025.15330
MLA
Hirata, H., Fujii, N., Tokunaga, T., Shimizu, K., Kobayashi, K., Shiraishi, K."Prognostic value of the postoperative CALLY index in T1/T2 clear cell renal cell carcinoma". Oncology Letters 30.6 (2025): 584.
Chicago
Hirata, H., Fujii, N., Tokunaga, T., Shimizu, K., Kobayashi, K., Shiraishi, K."Prognostic value of the postoperative CALLY index in T1/T2 clear cell renal cell carcinoma". Oncology Letters 30, no. 6 (2025): 584. https://doi.org/10.3892/ol.2025.15330
Copy and paste a formatted citation
x
Spandidos Publications style
Hirata H, Fujii N, Tokunaga T, Shimizu K, Kobayashi K and Shiraishi K: Prognostic value of the postoperative CALLY index in T1/T2 clear cell renal cell carcinoma. Oncol Lett 30: 584, 2025.
APA
Hirata, H., Fujii, N., Tokunaga, T., Shimizu, K., Kobayashi, K., & Shiraishi, K. (2025). Prognostic value of the postoperative CALLY index in T1/T2 clear cell renal cell carcinoma. Oncology Letters, 30, 584. https://doi.org/10.3892/ol.2025.15330
MLA
Hirata, H., Fujii, N., Tokunaga, T., Shimizu, K., Kobayashi, K., Shiraishi, K."Prognostic value of the postoperative CALLY index in T1/T2 clear cell renal cell carcinoma". Oncology Letters 30.6 (2025): 584.
Chicago
Hirata, H., Fujii, N., Tokunaga, T., Shimizu, K., Kobayashi, K., Shiraishi, K."Prognostic value of the postoperative CALLY index in T1/T2 clear cell renal cell carcinoma". Oncology Letters 30, no. 6 (2025): 584. https://doi.org/10.3892/ol.2025.15330
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