Obesity is a worldwide epidemic, and bariatric surgery is considered the primary treatment for long-term weight loss and managing obesity-related health issues. Sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) are the most performed procedures. Nutritional deficiencies are a significant concern following bariatric surgery and can have serious consequences. This study aims to compare the incidence of nutritional deficiencies in patients undergoing RYGB and SG. A retrospective analysis was conducted on the nutritional status of 505 consecutive patients who underwent either RYGB or SG between January and December 2019. Data were collected regarding vitamin B12, folic acid, vitamin D, calcium, PTH, magnesium, hemoglobin, iron, ferritin, and transferrin at preoperative, 6-month, and 12-month intervals post-surgery. The RYGB group showed significantly higher excess weight loss. Vitamin B12, hemoglobin, and ferritin levels were consistently higher in the SG group throughout the study. Vitamin D deficiency was prevalent, with no significant difference between the groups. Vitamin B12 deficiency was significantly more common in the RYGB group (6 months: 17.46% vs. 4.69%, p < 0.001; 12 months: 16.74% vs. 0.93%, p < 0.001). Despite differences in their mechanisms, bariatric surgeries were associated with nutritional deficiencies. It is crucial to efficiently assess, prevent, and manage these deficiencies tailored to each surgical procedure.

Introduction: In locally advanced rectal cancers (LARC), tumour node metastasis (TNM) staging is far from optimal. The authors aimed to investigate the value of previously described circulating biomarkers as predictors of prognosis. Methods: Retrospective analysis of 245 LARC patients diagnosed between January 2010 and December 2022, who underwent neoadjuvant chemoradiotherapy and surgery at two centres. A Cox regression and Kaplan–Meier analysis were performed. Results: Post-treatment platelet-to-lymphocyte ratio (PLR) predicted pathological complete response. The neutrophil-to-lymphocyte ratio (NLR) in two timepoints of the treatment significantly predicted overall survival, whereas the platelet-neutrophil (PN) index significantly predicted disease-free survival. In pathological stage II, the PN index predicted patients with a higher risk of disease-free survival. Conclusion: Blood parameters might allow the definition of subgroups of risk beyond TNM for the application of different therapeutic strategies.

“Watch and wait” is becoming a common treatment option for patients with locally advanced rectal cancer (LARC) submitted to neoadjuvant treatment. However, currently, no clinical modality has an acceptable accuracy for predicting pathological complete response (pCR). The aim of this study was to assess the clinical utility of circulating tumor DNA (ctDNA) in predicting the response and prognosis in these patients. We prospectively enrolled a cohort of three Iberian centers between January 2020 and December 2021 and performed an analysis on the association of ctDNA with the main response outcomes and disease-free survival (DFS). The rate of pCR in the total sample was 15.3%. A total of 24 plasma samples from 18 patients were analyzed by next-generation sequencing. At baseline, mutations were detected in 38.9%, with the most common being TP53 and KRAS. Combination of either positive magnetic resonance imaging (MRI) extramural venous invasion (mrEMVI) and ctDNA increased the risk of poor response (p = 0.021). Also, patients with two mutations vs. those with fewer than two mutations had a worse DFS (p = 0.005). Although these results should be read carefully due to sample size, this study suggests that baseline ctDNA combined with mrEMVI could potentially help to predict the response and baseline ctDNA number of mutations might allow the discrimination of groups with different DFS. Further studies are needed to clarify the role of ctDNA as an independent tool in the selection and management of LARC patients.

Aims: To investigate the value of previously described pretreatment hematological and biochemical biomarkers as predictors of pathological response. Methods: The authors performed a retrospective a...

Purpose: Non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) is a premalignant tumor formerly known as non-invasive encapsulated follicular variant of papillary thyroid carcinoma. The aim of this study was to investigate the clinicopathological traits of NIFTP to discern them from well-differentiated cancers and potentially avoid overtreatment. Methods: We conducted a retrospective cohort study of NIFTP cases from July 2017 to November 2022 at our center. A review of demographic, clinical, sonographic, cytologic and surgical data was performed. Results: During the study period 70 NIFTP cases were included. Among the cohort 74.3% (52/70) were women and the mean age was 55 years (range, 25–84). The majority of patients presented euthyroid (92.9%). Median NIFTP size was 2.5 cm (range, 1.0-10.8). Most nodules displayed low or intermediate risk on ultrasound being labeled EU-TIRADS 3 (46/70, 65.7%) and EU-TIRADS 4 (23/70, 32.9%). In cytology they were typically diagnosed as Bethesda III (15/70, 21.4%) or Bethesda IV (41/70, 58.6%). Regarding surgical procedures, 36 patients (51.4%) underwent lobo-isthmectomy and 34 patients (48.6%) received total thyroidectomy. Thirteen patients (18.6%) had coexisting microcarcinomas. No patients received radioiodine ablation. After a median follow-up of 27.5 months, no structural or biochemical recurrences were observed. Conclusion: Non-suspect thyroid nodules on preoperative ultrasound when combined with an indeterminate cytology and altered molecular profile should raise awareness towards the possibility of NIFTP. Even though neither FNAB nor CNB are definitive for NIFTP, CNB may be considered when additional architectural assessment is needed. Management with lobectomy seems to suffice unless total thyroidectomy is justified.