Prognostic Value of the CALLY Index in Hypopharyngeal Cancer Treated with Definitive Chemoradiotherapy: A Retrospective Cohort Study
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Design and Patient Selection
2.2. Treatment
2.3. Data Collection
2.4. Calculation of the CALLY Index
2.5. Statistical Analysis
3. Results
3.1. Patient Characteristics
3.2. ROC Curve Analyses
3.3. Survival Analyses
4. Discussion
4.1. Clinical Implications
4.2. Biological Basis of the CALLY Index
4.3. The Challenge of Cut-Off Value Heterogeneity
4.4. Limitations of the Study
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
CRP | C-reactive protein |
Alb | Albumin |
LRFS | Local Recurrence-Free Survival |
PFS | Progression-Free Survival |
OS | Overall Survival |
ECOG-PS | Eastern Cooperative Oncology Group-Performance Status |
CCI | Charlson Comorbidity Index |
BMI | Body Mass Index |
AJCC | American Joint Committee on Cancer |
ROC | Receiver Operating Characteristic |
AUC | Area Under the Curve |
HR | Hazard Ratio |
CI | Confidence Interval |
IMRT | Intensity-Modulated Radiotherapy |
VMAT | Volumetric Modulated Arc Therapy |
CONUT | Controlling Nutritional Status |
PNI | Prognostic Nutritional Index |
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Characteristic | All Patients (n = 71) | CALLY Index < 1.47 (n = 40) | CALLY Index ≥ 1.47 (n = 31) | p-Value |
---|---|---|---|---|
Age | ||||
<63 years | 36 (51%) | 18 (45%) | 18 (58%) | 0.27 |
≥63 years | 35 (49%) | 22 (55%) | 13 (42%) | |
Gender | ||||
Female | 24 (33.8%) | 12 (30%) | 12 (38.7%) | 0.44 |
Male | 47 (66.2%) | 28 (70%) | 19 (61.3%) | |
ECOG-PS | ||||
0–1 | 65 (91.5%) | 35 (87.5%) | 30 (96.7%) | 0.22 |
2 | 6 (8.5%) | 5 (12.5%) | 1 (3.3%) | |
Charlson Comorbidity Index | ||||
<5 | 50 (70.4%) | 28 (70%) | 22 (71%) | 0.92 |
≥5 | 21 (29.6) | 12 (30%) | 9 (29%) | |
BMI | ||||
<23.7 | 35 (49.2%) | 22 (55%) | 13 (42%) | 0.27 |
≥23.7 | 36 (50.8%) | 18 (45%) | 18 (58%) | |
Feeding Tube | ||||
Yes | 16 (22.5%) | 11 (27.5%) | 5 (16.1%) | 0.25 |
No | 55 (77.5%) | 29 (72.5%) | 26 (83.9%) | |
T Stage | ||||
T2 | 13 (18.3%) | 6 (15%) | 7 (22.5%) | 0.09 |
T3 | 16 (22.6%) | 6 (15%) | 10 (32.3%) | |
T4 | 42 (59.1%) | 28 (70%) | 14 (45.2%) | |
N Stage | ||||
N0–1 | 28 (39.4%) | 13 (32.5%) | 15 (48.3%) | 0.17 |
N2–3 | 43 (60.6%) | 27 (67.5%) | 16 (51.7%) | |
TNM Stage | ||||
Stage II | 4 (5.7%) | 1 (2.5%) | 3 (9.7%) | 0.02 |
Stage III | 9 (12.7%) | 2 (5%) | 7 (22.5%) | |
Stage IV | 58 (81.6%) | 37 (92.5%) | 21(67.8%) |
Univariate Analysis | Multivariate Analysis | ||||
---|---|---|---|---|---|
Variables | Cut-Off | HR (%95 CI) | p | HR (%95 CI) | p |
Age (years) | <63 vs. ≥63 | 0.76 (0.44–1.30) | 0.32 | ||
Gender | Female vs. Male | 0.90 (0.51–1.59) | 0.72 | ||
ECOG-PS | 0–1 vs. 2 | 2.21 (0.85–5.72) | 0.10 | ||
CCI | <5 vs. ≥5 | 0.94 (0.52–1.68) | 0.84 | ||
BMI | <23.7 vs. ≥23.7 | 0.75 (0.44–1.28) | 0.29 | ||
T stage | T2–3 vs. T4 | 2.57 (1.45–4.57) | 0.001 | 2.11 (1.15–3.90) | 0.01 |
N stage | N0–1 vs. N2–3 | 1.85 (1.05–3.26) | 0.03 | 1.24 (0.68–2.28) | 0.47 |
CALLY Index | <1.47 vs. ≥1.47 | 0.41 (0.23–0.73) | 0.003 | 0.49 (0.27–0.89) | 0.01 |
Univariate Analysis | Multivariate Analysis | ||||
---|---|---|---|---|---|
Variables | Cut-Off | HR (%95 CI) | p | HR (%95 CI) | p |
Age (years) | <63 vs. ≥63 | 0.77 (0.45–1.32) | 0.35 | ||
Gender | Female vs. Male | 0.89 (0.50–1.58) | 0.70 | ||
ECOG-PS | 0–1 vs. 2 | 2.45 (0.94–6.39) | 0.06 | ||
CCI | <5 vs. ≥5 | 0.93 (0.51–1.66) | 0.80 | ||
BMI | <23.7 vs. ≥23.7 | 0.77 (0.45–1.32) | 0.34 | ||
T stage | T2–3 vs. T4 | 2.55 (1.43–4.53) | 0.001 | 2.12 (1.15–3.91) | 0.01 |
N stage | N0–1 vs. N2–3 | 1.77 (1.01–3.12) | 0.04 | 1.20 (0.65–2.20) | 0.55 |
CALLY Index | <1.47 vs. ≥1.47 | 0.41 (0.23–0.73) | 0.002 | 0.48 (0.27–0.87) | 0.01 |
Univariate Analysis | Multivariate Analysis | ||||
---|---|---|---|---|---|
Variables | Cut-Off | HR (%95 CI) | p | HR (%95 CI) | p |
Age (years) | <63 vs. ≥63 | 0.88 (0.50–1.55) | 0.67 | ||
Gender | Female vs. Male | 0.89 (0.49–1.62) | 0.72 | ||
ECOG-PS | 0–1 vs. 2 | 3.46 (1.30–9.20) | 0.01 | 1.88 (0.69–5.10) | 0.21 |
CCI | <5 vs. ≥5 | 0.98 (0.53–1.81) | 0.97 | ||
BMI | <23.7 vs. ≥23.7 | 0.87 (0.49–1.52) | 0.63 | ||
T stage | T2–3 vs. T4 | 2.79 (1.52–5.09) | <0.001 | 2.32 (1.24–4.37) | 0.008 |
N stage | N0–1 vs. N2–3 | 1.80 (0.99–3.27) | 0.051 | 1.19 (0.64–2.23) | 0.57 |
CALLY Index | <1.47 vs. ≥1.47 | 0.35 (0.19–0.64) | 0.002 | 0.41 (0.22–0.77) | 0.006 |
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Cetinayak, H.O.; Aydin, B.; Semiz, V.; Atac Kutlu, E.; Basan, U.; Aksoy, R.A. Prognostic Value of the CALLY Index in Hypopharyngeal Cancer Treated with Definitive Chemoradiotherapy: A Retrospective Cohort Study. Diagnostics 2025, 15, 2237. https://doi.org/10.3390/diagnostics15172237
Cetinayak HO, Aydin B, Semiz V, Atac Kutlu E, Basan U, Aksoy RA. Prognostic Value of the CALLY Index in Hypopharyngeal Cancer Treated with Definitive Chemoradiotherapy: A Retrospective Cohort Study. Diagnostics. 2025; 15(17):2237. https://doi.org/10.3390/diagnostics15172237
Chicago/Turabian StyleCetinayak, Hasan Oguz, Barbaros Aydin, Volkan Semiz, Ece Atac Kutlu, Umut Basan, and Rahmi Atıl Aksoy. 2025. "Prognostic Value of the CALLY Index in Hypopharyngeal Cancer Treated with Definitive Chemoradiotherapy: A Retrospective Cohort Study" Diagnostics 15, no. 17: 2237. https://doi.org/10.3390/diagnostics15172237
APA StyleCetinayak, H. O., Aydin, B., Semiz, V., Atac Kutlu, E., Basan, U., & Aksoy, R. A. (2025). Prognostic Value of the CALLY Index in Hypopharyngeal Cancer Treated with Definitive Chemoradiotherapy: A Retrospective Cohort Study. Diagnostics, 15(17), 2237. https://doi.org/10.3390/diagnostics15172237