{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T16:17:18Z","timestamp":1792513038353,"version":"4.5.0"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T00:00:00Z","timestamp":1747094400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>This study aims to explore the prognostic value of \u0394Alb in combination with malnutrition for postoperative outcomes in rectal cancer patients with normal preoperative albumin levels.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective study of patients undergoing proctectomy for rectal cancer at our department between January 2013 and April 2019. Malnutrition was defined according to the Global Leadership Initiative on Malnutrition (GLIM) criteria. A receiver operating characteristic curve analysis was used to determine the cut-off values for \u0394Alb. Univariate and multivariate analyses evaluating the risk factors for postoperative complications and \u0394Alb were performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 526 patients were enrolled in this study. \u2206Alb was significantly associated with postoperative complications in patients with normal preoperative albumin levels (AUC\u202f=\u202f0.651, <jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.001), but was not in patients with hypoalbuminemia (<jats:italic>p<\/jats:italic>\u202f=\u202f0.808). The optimal cut-off value was established at 16%. \u2206ALB \u2265 16% and malnutrition were both independent risk factors for postoperative complications with an odds ratio (OR) of 2.179 and 1.730, respectively. When combined then together, the OR would reach to 3.779. On the other hand, low muscle mass (OR\u202f=\u202f2.058, <jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.001), tumor location in the lower third (OR\u202f=\u202f2.909, <jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.001), and surgical duration \u2265 180\u202fmin (OR\u202f=\u202f1.659, <jats:italic>p<\/jats:italic>\u202f=\u202f0.01) were identified as independent risk factors associated with \u2206ALB.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>\u0394Alb in combination with GLIM-defined malnutrition would enhance the predictive value for postoperative outcomes in rectal cancer patients with normal preoperative albumin levels, and it is necessary to conduct a nutritional assessment for then.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fnut.2025.1542581","type":"journal-article","created":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T04:10:10Z","timestamp":1747109410000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Prognostic value of postoperative decrease of albumin (\u0394Alb) in combination with GLIM-defined malnutrition for the prediction of postoperative outcomes in rectal cancer patients with normal preoperative albumin levels"],"prefix":"10.3389","volume":"12","author":[{"given":"Chong-Jun","family":"Zhou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ke-Yu","family":"Ling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Fang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng-Fan","family":"Ye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng-Li","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia-Can","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen-Guo","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shao-Tang","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,5,13]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e111","DOI":"10.1097\/sla.0000000000000741","article-title":"Anastomotic leak increases distant recurrence and long-term mortality after curative resection for colonic Cancer","volume":"262","author":"Nachiappan","year":"2015","journal-title":"Ann Surg"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"576","DOI":"10.1186\/s12885-023-11083-y","article-title":"Malnutrition and visceral obesity predicted adverse short-term and long-term outcomes in patients undergoing proctectomy for rectal cancer","volume":"23","author":"Zhou","year":"2023","journal-title":"BMC Cancer"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"324","DOI":"10.1007\/s10147-016-1054-1","article-title":"Risk scores as useful predictors of perioperative complications in patients with rectal cancer who received radical surgery","volume":"22","author":"Miyakita","year":"2017","journal-title":"Int J Clin Oncol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1186\/s13741-022-00238-3","article-title":"Postoperative decrease of albumin (DeltaAlb) as early predictor of complications after gastrointestinal surgery: a systematic review","volume":"11","author":"Joliat","year":"2022","journal-title":"Perioper Med (Lond)"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"402","DOI":"10.1097\/SLA.0000000000006030","article-title":"Goal-directed perioperative albumin substitution versus standard of care to reduce postoperative complications: a randomized clinical trial (SuperAdd trial)","volume":"279","author":"Schaller","year":"2024","journal-title":"Ann Surg"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"7028216","DOI":"10.1155\/2020\/7028216","article-title":"Role of albumin as a nutritional and prognostic marker in elective intestinal surgery","volume":"2020","author":"Galata","year":"2020","journal-title":"Can J Gastroenterol Hepatol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.clnu.2018.08.002","article-title":"GLIM criteria for the diagnosis of malnutrition - 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