The C-reactive protein-albumin-lymphocyte (CALLY) index has been widely used in previous studies to investigate its relationship with postoperative prognosis in various cancers. However, malnutrition, a common issue among cancer patients, often manifests as sarcopenia, which is closely associated with inflammation, nutrition, and immunity. This study aimed to evaluate the relationship between the CALLY index and overall survival in cancer patients with sarcopenia.Data were collected from 1389 cancer patients in the Investigation on Nutrition Status and Clinical Outcome of Patients With Common Cancers in China database. The cutoff value for the CALLY index was determined using R software, categorizing patients into high and low groups. Cox regression analysis was employed to assess the association between the CALLY index and overall survival. A nomogram incorporating the CALLY index, sex, and hypertension as well as TNM stage was developed to predict survival outcomes. Receiver operating characteristic curves were used to compare the prognostic value of the nomogram with traditional TNM stage.Based on the cutoff value, patients were categorized into high and low CALLY index groups, with the high CALLY index group showing significantly better survival outcomes (P < 0.001). Both univariate and multivariate analyses identified significant prognostic factors. The nomogram, which included the CALLY index, sex, hypertension, and TNM stage, demonstrated superior prognostic ability compared with models that considered TNM stage alone.The CALLY index provides a more comprehensive assessment of overall survival in cancer patients with sarcopenia compared with traditional TNM stage, offering valuable insights for more integrated clinical prognostication.Copyright © 2025 Elsevier Inc. All rights reserved.