{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T04:27:49Z","timestamp":1787632069847,"version":"build-2736575974"},"reference-count":33,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T00:00:00Z","timestamp":1787356800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"KAU Endowment (WAQF) at King Abdulaziz University"},{"id":[{"id":"https:\/\/ror.org\/02ma4wv74","id-type":"ROR","asserted-by":"publisher"}]},{"name":"Deanship of Scientific Research"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Curr. Oncol.","Current Oncology"],"abstract":"<jats:p>Preoperative immunonutritional indices are widely reported to predict survival after colorectal cancer (CRC) resection, yet their independence varies across cohorts and no data exist from the Arab Gulf. In this retrospective cohort study we analyzed 316 patients undergoing curative resection for stage I\u2013III colorectal adenocarcinoma at a Saudi tertiary center between 2013 and 2022, of whom 48 (15.2%) presented as emergencies. The prognostic nutritional index (PNI) and a composite albumin\u2013neutrophil-to-lymphocyte ratio (albumin\u2013NLR) score were assessed against overall survival (OS) and disease-free survival (DFS) using Cox models adjusted for age, sex, emergency presentation, tumor site, neoadjuvant therapy, adjuvant chemotherapy and lymphovascular invasion and stratified by stage and American Society of Anesthesiologists class. Over a median follow-up of 58.1 months there were 88 deaths and 124 DFS events. The PNI independently predicted OS (adjusted hazard ratio 0.958, 95% CI 0.929\u20130.987) and DFS (0.964, 0.940\u20130.988); the albumin\u2013NLR score did not. Albumin alone carried the signal (OS 0.938), with lymphocytes, neutrophils and the NLR all null. The PNI effect was confined to the first 36 months (0.944 versus 1.003 thereafter), and published cut-offs classified 70.8% of the cohort as high-risk. Immunonutritional prognostication in CRC is albumin-driven, time-limited and sensitive to cut-off provenance.<\/jats:p>","DOI":"10.3390\/curroncol33090496","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T10:07:53Z","timestamp":1787566073000},"page":"496","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Preoperative Immunonutritional Indices in Colorectal Cancer: The Contribution of Albumin, Time-Dependence of Effect, and Threshold Transportability in a Saudi Cohort"],"prefix":"10.3390","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6893-537X","authenticated-orcid":false,"given":"Moaz W.","family":"Abulfaraj","sequence":"first","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali H. M.","family":"Farsi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,22]]},"reference":[{"key":"ref_1","first-page":"229","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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