{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T05:04:53Z","timestamp":1783919093711,"version":"3.55.0"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"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. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Postoperative complications of colorectal cancer significantly impact prognosis and healthcare burdens. While the dynamic change from preoperative to the lowest albumin level on postoperative day 2 (\u0394Alb) has been linked to complications, their predictive value remains controversial. This study aims to explore the relationship between \u0394Alb and postoperative complications, and evaluates a multifactorial predictive model for severe complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study analyzed 932 patients undergoing colorectal cancer resection (August 2020\u2013April 2022). Data included preoperative\/postoperative albumin levels, demographics, surgical\/anesthetic details, and 30-day complications. \u0394Alb\u2019s association with severe complications was assessed via logistic regression, and a nomogram was developed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Severe complications (Clavien\u2013Dindo III\u2013V) occurred in 14.2% of patients. \u0394Alb showed no significant association with severe complications in univariate (P\u00a0=\u00a00.185) or multivariate analysis and discriminated poorly on ROC analysis (AUC 0.536, 95% CI 0.479\u20130.593). In the final multivariable model using clinically dichotomised predictors, preoperative albumin &amp;lt;35 g\/L (OR 2.05, 95% CI 1.29\u20133.25, P\u00a0=\u00a00.003) and POD2 nadir albumin &amp;lt;28.5 g\/L (OR 1.55, 95% CI 1.01\u20132.38, P\u00a0=\u00a00.044) were independent risk factors. Other independent predictors were age &amp;gt;65 years (OR 2.14, P\u00a0=\u00a00.003), ASA \u22653 (OR 2.14, P\u00a0=\u00a00.001), preoperative NRS2002 \u22652 (OR 1.97, P\u00a0=\u00a00.028) and rocuronium dose \u2265117.5 mg (OR 4.44, P&amp;lt;0.001). A nomogram integrating these factors showed good discrimination (apparent C-index 0.794; optimism-corrected 0.784 by 1000-sample bootstrapping), good calibration (Hosmer\u2013Lemeshow P\u00a0=\u00a00.72) and net clinical benefit on decision-curve analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\u0394Alb alone has limited predictive value, whereas absolute preoperative albumin &amp;lt;35 g\/L and POD2 nadir albumin &amp;lt;28.5 g\/L are independent predictors of severe complications. A multifactorial model integrating these absolute albumin thresholds with age, ASA score, preoperative NRS2002 and rocuronium dose improves prediction (optimism-corrected C-index 0.78) compared with individual factors (AUC &amp;lt;0.7). Because rocuronium dose may also reflect surgical complexity and perioperative management, these associations require prospective, multicentre validation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1864078","type":"journal-article","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T04:23:43Z","timestamp":1783916623000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Preoperative and early postoperative albumin thresholds, rather than \u0394Alb, predict severe complications after colorectal cancer surgery: a multifactorial model and nomogram"],"prefix":"10.3389","volume":"16","author":[{"given":"Lu","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, General Hospital of Ningxia Medical University, First Clinical Medical College, Ningxia Medical University","place":["Ningxia, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui-Rui","family":"Lyu","sequence":"additional","affiliation":[{"name":"Department of Radiology, General Hospital of Ningxia Medical University","place":["Ningxia, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, General Hospital of Ningxia Medical University, First Clinical Medical College, Ningxia Medical University","place":["Ningxia, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ze-Qing","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, General Hospital of Ningxia Medical University, First Clinical Medical College, Ningxia Medical University","place":["Ningxia, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Qin","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, General Hospital of Ningxia Medical University, First Clinical Medical College, Ningxia Medical University","place":["Ningxia, China"]},{"name":"Department of Anesthesiology and Perioperative Medicine, General Hospital of Ningxia Medical University","place":["Ningxia, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,13]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA Cancer J 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