Clinical value of the novel inflammatory-nutritional marker PALR in predicting early postoperative recurrence of colorectal cancer

The purpose of this study is to evaluate the clinical application value of (platelet × albumin)/lymphocyte ratio (PALR) as a novel prognostic indicator in predicting early postoperative recurrence in colorectal cancer (CRC) patients who have undergone radical surgery. By investigating the association between this inflammatory marker and disease progression, it aims to provide a theoretical basis for early clinical intervention. Clinical data of 739 patients diagnosed with primary colorectal cancer (CRC) in our hospital between February 2022 and May 2023 were retrospectively included. The non-linear association between PALR and the risk of early postoperative recurrence was explored using restricted cubic spline (RCS) analysis, and a receiver operating characteristic (ROC) curve was constructed to evaluate the predictive efficacy of PALR. Patients were stratified into high- and low-PALR groups based on the optimal cutoff value derived from Youden’s index. Univariate and multivariate logistic regression models were used to identify independent predictors of early postoperative recurrence, and sensitivity analysis with PALR quartiles was performed to validate the stability of primary findings. A total of 340 eligible primary colorectal cancer (CRC) patients were retrospectively enrolled in this study. The area under the receiver operating characteristic (ROC) curve of PALR for predicting early postoperative recurrence or metastasis in CRC patients was 0.659. Restricted cubic spline (RCS) analysis revealed a linear ascending trend between PALR and early postoperative recurrence risk (P value for non-linearity = 0.276). Multivariate logistic regression identified PALR as an independent predictor of early postoperative recurrence (odds ratio [OR] = 2.65, 95% confidence interval [CI]: 1.12–6.39, P = 0.026). A nomogram model incorporating PALR and other independent predictors was constructed, with an internally validated concordance index (C-index) of 0.835. Calibration plots and decision curve analysis (DCA) supported the favorable predictive performance and clinical utility of the model, while sensitivity analysis further confirmed the robustness of our findings. The PALR serves as an independent predictor for early postoperative recurrence in colorectal cancer (CRC) patients, demonstrating substantial clinical utility in risk assessment and guiding personalized intervention strategies.