Aim This research links systemic inflammation and nutritional status with gastric cancer prognosis and postoperative outcomes. Methods Patients undergoing total gastrectomy for gastric adenocarcinoma (2015-2018) were categorized into two: Low Lymphocyte–Albumin(LA) score (Group 1) and High Lymphocyte-Albumin score (Group 2). Demographics, clinical data, operative outcomes, and survival rates were compared. The LA score's predictive ability for lymph node positivity was assessed. Results Using a cut-off value of 6069.7, Group 1 had 59 patients (low value) and Group 2 had 45 (high value). Hospital readmissions due to wound infections were higher in Group 1 (16.9% vs. 2.2%, p=0.041). Both groups had similar tumor localization and total lymph nodes removed, but Group 1 had more positive lymph nodes (4 vs. 2, p=0.026). Survival rates were comparable (32.59 vs. 31.32 months, p=0.390). Conclusion Low LA scores correlate with a higher number of positive lymph nodes, serving as a postoperative quality assessment indicator.

Diverticula, sac-like protrusions in hollow organ walls appear throughout the gastrointestinal system, most commonly in the duodenum near the ampulla. They are classified as true (congenital, with all intestinal wall layers) and false diverticula (acquired, with a muscular layer defect). Duodenal diverticula are usually asymptomatic, found incidentally during endoscopies. Symptoms, when present, manifest as dyspeptic complaints. Radiographs show these diverticula as atypical gas balloons, while CT scans reveal them as mass-like structures. Complications are rare but can include obstruction, bleeding, perforation, and blind loop syndrome. Less than 5% require surgical intervention due to complications. Treatment typically involves endoscopic or surgical excision. The management of biliary and pancreatic complications remains debatable.

Aim: This study investigates the link between proliferation markers (PCNA, p16, Ki-67) and histopathological factors, exploring their prognostic value in breast cancer patients. Materials and methods: We analyzed female breast cancer patients who underwent surgery. Data collected included demographics, clinical parameters (hemogram, Ca 15.3, menopause status, etc.), family cancer history, pathology, treatments (neoadjuvant, surgical, oncological), tumor staging, lymph node status, receptor status (ER, PR, cerb-b2), and survival. Paraffin blocks were retrospectively analyzed for PCNA, p16, and Ki-67 expression via immunohistochemical staining. Results: PCNA scores showed no association with demographic or clinical features, though a statistically significant inter-marker correlation with p16 was found (both markers increased together). P16 scores were not linked to other parameters aside from Ki-67 (also demonstrating positive correlation). Higher Ki-67 index was associated with decreased ER and PR expression and, importantly, decreased survival. Although a significant correlation was observed between PCNA and p16 expression levels, neither marker demonstrated independent prognostic significance with respect to overall survival. Conclusions: Although PCNA and p16 expression levels were inter-correlated, neither marker showed an independent association with clinicopathological variables or overall survival in our cohort. In contrast, the Ki-67 index was significantly associated with hormone receptor status, pathological stage, and shorter overall survival, and remains the most informative proliferation marker for prognostic stratification in breast cancer. Further prospective studies with standardized scoring and multivariate analysis are warranted to clarify the prognostic value of PCNA and p16.

Introduction: Carcinoembryonic antigen(CEA) serves as a biomarker for gastrointestinal cancers, with high levels often indicating a poor prognosis. Specifically, CEA levels above 10 µg/L are associated with unfavorable outcomes, and those exceeding 20 µg/L are linked to metastatic disease. This investigation aims to explore the relationship between elevated preoperative CEA levels and the survival and prognosis of colon cancer patients at our institution. Materials and Methods: This study was designed as a single-center, retrospective analysis involving colon cancer patients who underwent surgery at *** from 2012 to 2022. Patients were stratified based on preoperative CEA levels into three groups: 3-10 µg/L (low-high), 10-20 µg/L (moderately high), and over 20 µg/L (very high). The study compared demographic data, pathological features, and survival outcomes across these groups. Results: The study included 226 patients, 124 males and 102 females, with an average age of 61 years. Analysis revealed no significant difference in TNM and pathological stages among the groups. Notably, higher CEA levels were significantly correlated with increased instances of venous, perineural and lymphatic invasion. The occurrence of local, para-aortic, and peritoneal recurrences did not significantly differ across the groups, although liver metastasis was more prevalent in the first group. Discussion: The findings highlight a significant link between high preoperative CEA levels and an increased risk of lymphovascular and perineural invasion in colon cancer patients. This association underscores the potential for tailoring more intensive treatment regimens for patients with elevated CEA levels,including the possibility of enhanced chemotherapy or radiotherapy.

Background/Aims: This study aimed to compare the patient groups who received and did not receive immunonutrition in terms of mor tality and morbidity in patients who underwent radical pancr eatic oduod enect omy. Materials and Methods: Two groups were formed from 40 patients who underwent radical pancr eatic oduod enect omy in our clinic in 2021. The patients in study group were given enteral immunonutrition support for 5 days preoperatively. For this purpose, a standard enteral immunonutrition product containing arginine, omega-3 fatty acids, and RNA (dietary nucleotides) was used. Patients’ data of demographical, laboratory, postoperative complications, and current clinical status were analyzed. Result: Mortality developed in 5 (25 %) patients in the treatment group and 4 (20 %) patients in the control group in the following months (P > .05). The estimated survival rate in the treatment group was 21.8 ± 2.8 months in the treatment group 19.1 ± 1.7 months in the control group (P > .05). The length of hospital stay was 12.89 ± 3.3 days in the treatment group, while it was 16.47 ± 6.83 days in the control group (P < .05). In the postoperative follow-ups, delayed gastric emptying symptoms developed in 3 patients in the treat ment group, while the same complication was observed in 9 patients in the control group (P < .05). Surgical site infections occurred in 4 patients in the treatment group and 9 patients in the control group (P < .05). Conclusion: It was observed that preoperative oral immunonutrition before pancr eatic oduod enect omy was effective in reducing the risk of delayed gastric emptying after surgery and the length of hospital stay. Cite this article as: Aba M, Sarıtaş AG, Yavuz B, Dalcı K, Ülkü A, Akçam AT. Preoperative immunonutrition and postoperative outcomes in radical pancr eatic oduod enect omy patients. Turk J Gastroenterol. 2024;35(1):32-40.