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

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.