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Volume 15
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10.3390/jcm15010312
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

Real-World Evaluation of the HELPP Score and CALLY Index for Preoperative Prognostic Stratification in Resectable Pancreatic Ductal Adenocarcinoma

by
İlkay Çıtakkul
*,
Umut Kefeli
,
Khatira Shukurova
,
Zehra Aytin
,
Yasemin Bakkal Temi
,
Ece Baydar
,
Kazım Uygun
and
Devrim Çabuk
Department of Internal Medicine and Medical Oncology, Kocaeli University, 41380 Kocaeli, Turkey
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2026, 15(1), 312; https://doi.org/10.3390/jcm15010312
Submission received: 4 December 2025 / Revised: 26 December 2025 / Accepted: 29 December 2025 / Published: 31 December 2025
(This article belongs to the Special Issue Pancreatic Cancer: Novel Strategies of Diagnosis and Treatment)
Versions Notes

Abstract

Background/Objectives: Preoperative prognostic assessment is essential for optimizing treatment strategies in pancreatic ductal adenocarcinoma (PDAC). This study aimed to evaluate and compare the prognostic value of the Heidelberg Pancreatic Prognostic (HELPP) score and the C-reactive protein–albumin–lymphocyte (CALLY) index in patients with resectable PDAC. Methods: We retrospectively analyzed clinical and laboratory data of 109 patients with resectable PDAC who underwent curative-intent surgery and adjuvant therapy. Patients were stratified based on preoperative HELPP and CALLY scores. Overall survival (OS) and disease-free survival (DFS) were assessed using Kaplan–Meier analysis, while independent prognostic factors were determined through multivariate Cox regression. Results: Kaplan–Meier survival analyses demonstrated that a HELPP score > 3 and a low CALLY index (≤1.029) were significantly associated with worse OS and DFS (log-rank p < 0.05). In multivariate analysis, the HELPP score was identified as an independent predictor of survival, whereas the CALLY index, although associated with survival in univariate analysis, did not reach statistical significance. In ROC analysis, both models exhibited acceptable discrimination, with the HELPP score achieving superior AUC values in predicting 1-year OS compared to the CALLY index. Conclusions: The HELPP score demonstrated independent prognostic value in multivariate analysis and may serve as a robust preoperative tool in resectable PDAC. The CALLY index, although not independently significant in multivariate analysis, showed strong prognostic separation in Kaplan–Meier survival analyses and may still aid in preoperative risk stratification, particularly where access to comprehensive scoring systems is limited.
Keywords: pancreatic ductal adenocarcinoma; HELPP score; CALLY index; prognosis; survival pancreatic ductal adenocarcinoma; HELPP score; CALLY index; prognosis; survival

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MDPI and ACS Style

Çıtakkul, İ.; Kefeli, U.; Shukurova, K.; Aytin, Z.; Temi, Y.B.; Baydar, E.; Uygun, K.; Çabuk, D. Real-World Evaluation of the HELPP Score and CALLY Index for Preoperative Prognostic Stratification in Resectable Pancreatic Ductal Adenocarcinoma. J. Clin. Med. 2026, 15, 312. https://doi.org/10.3390/jcm15010312

AMA Style

Çıtakkul İ, Kefeli U, Shukurova K, Aytin Z, Temi YB, Baydar E, Uygun K, Çabuk D. Real-World Evaluation of the HELPP Score and CALLY Index for Preoperative Prognostic Stratification in Resectable Pancreatic Ductal Adenocarcinoma. Journal of Clinical Medicine. 2026; 15(1):312. https://doi.org/10.3390/jcm15010312

Chicago/Turabian Style

Çıtakkul, İlkay, Umut Kefeli, Khatira Shukurova, Zehra Aytin, Yasemin Bakkal Temi, Ece Baydar, Kazım Uygun, and Devrim Çabuk. 2026. "Real-World Evaluation of the HELPP Score and CALLY Index for Preoperative Prognostic Stratification in Resectable Pancreatic Ductal Adenocarcinoma" Journal of Clinical Medicine 15, no. 1: 312. https://doi.org/10.3390/jcm15010312

APA Style

Çıtakkul, İ., Kefeli, U., Shukurova, K., Aytin, Z., Temi, Y. B., Baydar, E., Uygun, K., & Çabuk, D. (2026). Real-World Evaluation of the HELPP Score and CALLY Index for Preoperative Prognostic Stratification in Resectable Pancreatic Ductal Adenocarcinoma. Journal of Clinical Medicine, 15(1), 312. https://doi.org/10.3390/jcm15010312

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