Objective:

To evaluate the diagnostic value of preoperative HALP, SII, and LMR in distinguishing malignant from benign colonic disease and to develop a nomogram for predicting disease-free survival (DFS) in stage III colon cancer patients, focusing on their prognostic implications.

Key Findings:

• HALP, SII, and LMR showed moderate discrimination for malignancy with AUC values of 0.773, 0.758, and 0.739, respectively.
• Independent predictors of DFS identified were HALP (HR = 0.384, 95% CI: 0.225–0.655), LMR (HR = 0.483, 95% CI: 0.286–0.815), tumor stage (HR = 2.435, 95% CI: 1.432–4.140), and chemotherapy cycles (HR = 0.380, 95% CI: 0.223–0.647).
• The nomogram demonstrated good discrimination with C-index values of 0.759 and 0.743 in training and validation sets.

Interpretation:

Preoperative HALP and LMR are significant independent predictors of DFS in stage III colon cancer, suggesting their utility in risk stratification.

Limitations:

• Retrospective design may introduce selection bias.
• Single-center study limits generalizability of findings.
• Sample size may not be sufficient to capture all potential confounding factors.

Conclusion:

Integrating preoperative HALP and LMR into a nomogram allows for individualized recurrence risk estimation, potentially guiding postoperative management in stage III colon cancer patients, thereby enhancing clinical decision-making.