{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T02:07:10Z","timestamp":1779070030862,"version":"3.51.4"},"reference-count":79,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T00:00:00Z","timestamp":1775779200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000},"content-version":"vor","delay-in-days":38,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Gastroenterol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Gastrointestinal (GI) malignancies are a major cause of cancer-related morbidity and mortality. While prognostic tools such as TNM staging and serum biomarkers are widely used, they have limitations. The C-reactive protein-albumin-lymphocyte (CALLY) index, an integrated marker of inflammation, nutrition, and immunity, has emerged as a potential prognostic tool. However, its prognostic value across GI malignancies remains unclear. This systematic review aims to assess the prognostic significance of the CALLY index in GI malignancies, with a primary focus on survival outcomes and a secondary assessment of its association with postoperative complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methodology<\/jats:title>\n                    <jats:p>Relevant literature was screened through December 2024 to identify studies assessing the prognostic significance of the CALLY index in GI malignancies. Outcomes included overall survival (OS), cancer-specific survival (CSS), disease-free survival (DFS), recurrence-free survival (RFS), recurrence rates, and postoperative complications. Eligible studies underwent qualitative synthesis, while meta-analysis was conducted for gastric cancer only. Relative risks (RRs) were pooled using a fixed- or random-effects model based on heterogeneity (I\u00b2 &gt; 50%). Subgroup analyses were performed based on CALLY cutoff values and TNM stage. Publication bias was assessed using funnel plots and Egger\u2019s test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 21 studies (8,600 patients) met inclusion criteria. Across all GI malignancies, higher CALLY values, regardless of cutoff variations (range: 0.369\u20136.96), were consistently associated with improved OS, CSS, DFS, and RFS, while lower values correlated with increased recurrence rates and higher postoperative complication rates. In gastric cancer, a higher CALLY index was associated with improved 5-year OS (RR\u2009=\u20090.81,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.00001) and lower major postoperative complications (RR\u2009=\u20091.48,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02). Subgroup analysis suggested that a CALLY cutoff\u2009&lt;\u20093 and TNM stage IV inclusion contributed to heterogeneity. No significant publication bias was detected.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The CALLY index appears to be a promising independent prognostic biomarker in GI malignancies, with higher values associated with improved survival and fewer postoperative complications. In gastric cancer specifically, meta-analysis confirms its predictive value for 5-year overall survival and major postoperative outcomes. Larger prospective studies are warranted to establish standardized cutoff points and to optimize its clinical utility across diverse patient populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12876-026-04793-7","type":"journal-article","created":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T03:18:50Z","timestamp":1775791130000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prognostic role of C-reactive protein-albumin-lymphocyte (CALLY) index in gastrointestinal malignancies: a systematic review and meta-analysis"],"prefix":"10.1186","volume":"26","author":[{"given":"Yaser","family":"Rayyan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nada","family":"Odeh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laith","family":"Theeb","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yazeed Y.","family":"Alajlouni","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad","family":"Alzoubi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noor F.","family":"Al-Assaf","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Layan A.","family":"Jaber","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hashim M.","family":"AlHammouri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdullah H.","family":"Alzghoul","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdallah M.","family":"Khamaiseh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayham S.","family":"Hamdan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmad M.","family":"Alhaj","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,4,10]]},"reference":[{"issue":"3","key":"4793_CR1","doi-asserted-by":"publisher","first-page":"229","DOI":"10.3322\/caac.21834","volume":"74","author":"F Bray","year":"2024","unstructured":"Bray F, Laversanne M, Sung H, et al. 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