Introduction: Surgery is the primary treatment modality for oral squamous cell carcinoma (OSCC). Therefore, accurate preoperative prognostic assessment is essential for optimizing treatment strategies and improving clinical outcomes. The C-reactive protein-albumin-lymphocyte (CALLY) index is a novel prognostic biomarker that integrates serum albumin, absolute lymphocyte count, and C-reactive protein (CRP) levels, providing a comprehensive assessment of nutritional, inflammatory, and immune status. However, its prognostic value in patients with surgically treated OSCC remains unclear, particularly in cohorts with long-term follow-up. This study aimed to investigate the association between the CALLY index and overall survival (OS) in patients undergoing surgery for OSCC.
Methods: We retrospectively analyzed 821 patients who underwent surgical treatment for OSCC at Tokyo Medical and Dental University (currently the Institute of Science Tokyo) between 2000 and 2020.
Results: The 1-, 3-, and 5-year OS rates were 96.3%, 90.6%, and 87.0%, respectively. In a Cox proportional hazards model, the CALLY index was independently associated with OS when analyzed as a continuous variable (hazard ratio [HR], 0.978; 95% confidence interval [CI], 0.967-0.990; P < 0.001). Receiver operating characteristic (ROC) curve analysis identified an optimal CALLY index cutoff value of 5.26 (AUC = 0.664). Kaplan-Meier survival analysis demonstrated significantly better OS in patients with a high CALLY index than in those with a low CALLY index (P < 0.0001).
Conclusion: These findings indicate that the CALLY index is an independent prognostic factor for overall survival in patients undergoing surgery for OSCC.
**CALLY index = serum albumin (g/L) x absolute lymphocyte count (cells/L)/[CRP x 10 (mg/L)]**