Background: The Naples prognostic score (NPS) is a scoring system that reflects a patient’s systemic inflammatory and nutritional status. This study aimed to evaluate whether postoperative NPS is effective in assessing the prognosis of stage II–III colorectal cancer (CRC) patients compared with preoperative NPS. Methods: Between 2005 and 2012, a total of 164 patients diagnosed with stage II–III CRC, who underwent curative resection followed by adjuvant chemotherapy, were divided into two groups: Group 0–1 (NPS = 0–2) and Group 2 (NPS = 3 or 4). Preoperative NPS was calculated based on the results before surgeries, and postoperative NPS was assessed using the results obtained before adjuvant chemotherapy. Results: The overall survival of Group 0–1 was higher than that of Group 2 in both pre- and postoperative NPS assessments. According to the ROC curve analysis, the Area Under the Curve (AUC) ratio for postoperative NPS was 0.64, compared with 0.57 for preoperative NPS, 0.52 for the preoperative neutrophil–lymphocyte ratio (p = 0.032), and 0.51 for the preoperative platelet–lymphocyte ratio (p = 0.027). Conclusions: Postoperative NPS is effective in predicting the prognosis of stage II–III CRC patients who underwent curative resection followed by adjuvant chemotherapy. The use of NPS could be beneficial in evaluating the prognosis of CRC patients after surgeries.

Background: We retrospectively evaluated the usefulness of an elevated glucose-to-lymphocyte ratio (GLR) as a sensitive prognostic biomarker of disease-specific survival in 338 patients who underwent surgical resection of pancreatic ductal adenocarcinoma (PDAC). Methods: The optimal GLR cutoff value was determined using the method of Contal and O’Quigley. Patient demographics, clinical information, and imaging data were analyzed to identify preoperative predictors of long-term survival outcomes. Results: Elevated GLR correlated significantly with aggressive tumor biologic behaviors, such as a high carbohydrate antigen (CA) 19-9 level (p = 0.003) and large tumor size (p = 0.011). Multivariate analysis identified (1) GLR > 92.72 [hazard ratio (HR) = 2.475, p < 0.001], (2) CA 19-9 level > 145.35 (HR = 1.577, p = 0.068), and (3) symptoms (p = 0.064) as independent predictors of long-term, cancer-specific survival. These three risk factors were used to group patients into groups 1 (0 factors), 2 (1–2 factors), and 3 (3 factors), which corresponded to significantly different 5-year overall survival rates (50.2%, 34.6%, and 11.7%, respectively; p < 0.001). Conclusions: An elevated preoperative GLR is associated with aggressive tumor characteristics and is an independent predictor of poor postoperative prognosis in patients with PDAC. Further prospective studies are required to verify these findings.

The prognostic impact of the combination of the modified Glasgow prognostic score (mGPS) and C-reactive protein/albumin ratio (CAR) in colorectal cancer (CRC) is unclear. We aimed to investigate the clinical usefulness of this combination as a predictor of survival in CRC patients. We retrospectively evaluated 769 CRC patients who had undergone surgery between January 2006 and March 2014. The CAR and mGPS within 1 month postoperation were examined. The integrated area under the curve (iAUC) was compared among mGPS, CAR, and the combined classification (CC). The optimal CAR cut-off for discriminating overall survival was 0.14. Based on this cut-off, the mGPS 0 group was divided into the mGPS 0 with low CAR and the mGPS 0 with high CAR groups, whereas all mGPS 1 and 2 patients were classified into the high CAR group. CC was an independent prognostic factor, and its iAUC value (0.587, 95% CI 0.553–0.624) was superior to those of the mGPS (0.544, 95% CI 0.516–0.576) (bootstrap iAUC mean difference = 0.043; 95% CI = 0.015–0.072) and CAR (0.578, 95% CI 0.545–0.613) (bootstrap iAUC mean difference = 0.009; 95% CI = 0.002–0.017), respectively. In conclusion, the combination of mGPS and CAR has a synergistic effect and has a higher prognostic accuracy than mGPS or CAR alone in patients with CRC.

Robot-assisted pancreaticoduodenectomy (R-PD) helps further improve the safety and efficacy of minimally invasive pancreaticoduodenectomy. However, it faces challenges such as high costs and limitations in availability at different centers, making it difficult for patients to access. In this study, we evaluate the initial experience of Artisential®-assisted PD (A-PD) and compare its perioperative outcomes with R-PD, discussing the clinical applicability of A-PD. This study reviewed cases of R-PD and A-PD conducted between 2022 and 2023. A total of 34 patients underwent R-PD, while 26 patients underwent A-PD. Statistical analysis was conducted based on factors related to the patient's surgical procedure and postoperative prognostic indicators. There were no significant differences observed between the two groups in terms of surgical factors. There were also no differences in the occurrence of postoperative complications. However, there was a significant difference in the length of hospital stay, with the Artisential® group having an average of 11.50 ± 5.54 days and the Robot group having 15.06 ± 5.34 days (p = 0.001). R-PD and A-PD showed no differences in procedures or outcomes. Using a multi-articulated device is beneficial where robot use is challenging.

Su Hyeong Park, Zhanay Zhassanov, Chang Moo Kang. Ann Hepatobiliary Pancreat Surg -0001;0:. https://doi.org/10.14701/ahbps.23-092

Hye Jin Kim, Hyun Soo Shin, Su Hyeong Park, Hye Yeon Yang, Chang Moo Kang. Ann Hepatobiliary Pancreat Surg -0001;0:. https://doi.org/10.14701/ahbps.22-137