Neutrophil Lymphocyte Ratio(NLR) & Albumin - derived Neutrophil Lymphocyte Ratio Score(ANS) in perioperative period of Cancer surgery and its relevance on surgical outcomes

The study is a prospective observational study evaluating Neutrophil Lymphocyte Ratio and Albumin-derived NLR Score as prognostic markers for surgical outcomes in adult cancer surgery patients. It aims to correlate perioperative changes in NLR/ANS with postoperative complications and to assess their impact on long term survival and recurrence

All cancer patients over 18 years meeting the inclusion criteria and undergoing surgery in surgical oncology department will be enrolled. Perioperative albumin and NLR/derived-NLR values will be measured within 4 weeks before surgery, and post operative CBCs will be taken on POD 1, 3 and 5 to calculate serial NLR, ensuring at least 4 samples per patient. Post operative complications will be graded using Clavien - Doindo classification, with patients grouped into Major, Grade III or higher, and non major, no complications group, and clinicopathological variables of inflammatory markers will be compared between groups. A total of 1000 patients will be enrolled over a duration of 2 years. Participants will be followed for at least 6months postoperatively to relate biomarker trends to complications, recurrence and survival with the expectation that results will improve perioperative risk stratification and postoperative management