AccScience Publishing / EJMO / Online First / DOI: 10.36922/EJMO025140082
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ORIGINAL RESEARCH ARTICLE

Albumin and neutrophil-to-lymphocyte ratio-based predictive nomogram for post-operative complications following colon cancer resection

Jiayao Wu1† ,  Jun Zou2,3† ,  Kan Wang2,3† ,  Shuting Yang2,3 ,  Haoquan Huang2,3* ,  Chengli Wang2,3*
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1 Department of Anesthesiology, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
2 Department of Anesthesiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
3 Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
†These authors contributed equally to this work.
EJMO, 025140082 https://doi.org/10.36922/EJMO025140082
Received: 2 April 2025 | Revised: 3 July 2025 | Accepted: 17 July 2025 | Published online: 13 August 2025
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
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Abstract

Introduction: The albumin combined with the neutrophil-to-lymphocyte ratio (NLR) score may be a useful marker of inflammation, but its associations with post-operative complications in colon cancer patients are unknown.

Objective: This study aims to construct and validate a predictive model incorporating albumin and NLR to predict post-operative complications in patients who underwent colon cancer resection.

Methods: A retrospective analysis was conducted on patients who underwent colon cancer resections between 2019 and 2021 at Sun Yat-sen Memorial Hospital. Clinical characteristics and systemic inflammatory markers, including lymphocytes and neutrophils, were collected. Post-operative complications served as the primary outcome. Logistic regression analyses were performed to identify the potential risk factors for post-operative complications after colon cancer resection. Nomograms with or without albumin and NLR score for post-operative complications were further constructed according to the results of the multivariable logistic regression analysis using the Akaike information criterion.

Results: Pre-operative albumin combined with NLR score (p=0.01; odds ratio [OR]: 2.69; 95% confidence interval [CI]: 1.90–8.06), age (p=0.007; OR: 1.05; 95% CI: 1.01–1.09), intraoperative blood transfusion (p=0.002; OR:5.32; 95% CI: 1.87–15.15), and duration of surgery (p=0.001; OR:1.70; 95% CI: 1.24–2.34) were identified as independent risk factors for post-operative complications. The nomogram, which included pre-operative albumin and NLR scores, demonstrated superior predictive performance, with a concordance index of 0.821 (95% CI: 0.758–0.883) and improved calibration.

Conclusion: Pre-operative albumin and NLR score are independent risk factors for post-operative complications following colon cancer resection. The developed nomogram incorporating these markers exhibited enhanced predictive capability for post-operative complications.

Keywords
Albumin
Neutrophil-to-lymphocyte ratio
Colon cancer
Nomogram
Post-operative complications
Systemic inflammatory marker
Funding
None.
Conflict of interest
The authors declare no competing interests in this article.
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Eurasian Journal of Medicine and Oncology, Electronic ISSN: 2587-196X Print ISSN: 2587-2400, Published by AccScience Publishing
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