Background: The neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) may be useful for drawing conclusions about the survival of head and neck squamous cell carcinoma (HNSCC) patients. Methods: Clinical data of 156 patients managed for HNSCC at two head and neck surgery centres were analyzed retrospectively. We studied the relationships between survival and PLR as well as NLR. Results: With regards to 5-year survival, the difference between the two groups with PLR values lower or higher than the threshold was statistically significant (p = 0.004), and we found the same for disease-free survival (p = 0.05), and tumour-specific mortality (p = 0.009). Concerning NLR, the difference in tumour-specific survival was statistically significant (p = 0.006). According to the multivariate analysis, NLR values higher than the threshold indicated an enhanced risk for overall as well as for tumour-specific mortality. Conclusion: In HNSCC patients, a high NLR may be considered as an independent risk factor for 5-year overall survival.

Both esophageal squamous cell carcinoma (ESQCC) and adenocarcinoma (EAC) are known to have poor prognosis. We aimed to investigate the invasion front areas of 57 ESQCC and 43 EAC cases to find histological signs of metastatic progression. Tumor cell clusters with different cell counts, including tumor buds (TBs) and poorly differentiated clusters (PDCs), were assessed. The presence of the recently described Stroma AReactive Invasion Front Area (SARIFA) phenomenon, which defines a direct contact between tumor cells and adipocytes, was more frequently observed in EAC than in ESQCC (p = 0.004). In adenocarcinomas, a higher prevalence of SARIFA was observed in tumors with a higher number of small clusters (TBs and small PDCs; p < 0.001); furthermore, both the high number of TBs (p = 0.016) and the presence of SARIFA (p = 0.001) correlated with a higher pT stage. SARIFA positivity in EAC (p = 0.011) and high TB in ESQCC (p = 0.0006) were found to be independent prognostic factors for lymph node metastases. Moreover, in ESQCC, the higher absolute number of both TBs and PDCs was associated with shorter overall survival (p = 0.0269 and p = 0.0377, respectively). Our results suggest that the histological subtypes of esophageal cancer behave differently, namely, that different features of the invasion front are of prognostic significance.

Diverticulitis of the vermiform appendix is a rare disease with clinical features often similar to conventional acute appendicitis. The importance of appendiceal diverticulosis is the fact that it can lead to an early and a higher incidence of perforation and therefore a higher mortality rate, in contrast to acute appendicitis alone. In this study we present the clinicopathology, diagnosis and therapy of the disease with a review of the literature. A 65-year-old woman presented to the emergency department with a 48-hour history of intermittent pain in the right iliac fossa. Abdominal ultrasound raised the possibility of acute appendicitis but because of the relative asymptomatic state of the patient, the lack of fever and rebound tenderness we started observation. After 2 days with episodic abdominal pain, the patient was taken to the operating theatre for laparoscopic exploration. Intraoperatively, multiple diverticula were noted on the appendix and appendectomy was performed. Histopathological examination revealed diverticulosis and inflammation of the appendiceal wall. Due to the possible complications, the difficult preoperative diagnosis and its frequent association with appendiceal neoplasm, appendiceal diverticulosis requires special attention. For asymptomatic cases, incidentally diagnosed intraoperatively or discovered by radiology prophylactic appendectomy is recommended.

Tumors of the upper gastrointestinal tract have a high mortality. Due to technical advances in recent decades, the survival of patients has improved significantly, but the average 5-year survival rate for neither stomach nor esophageal tumors does not exceed 35%. In countries that have introduced the screening program, patients are often detected at an early stage, when endoscopic care is also possible. With the development of oncology, the multimodal approach in tumor therapy became the standard, thereby opening a way to treat more and more advanced patients for curative purposes. The introduction of minimally invasive techniques, along with adequate oncological radicality, reduced the surgical load and improved postoperative recovery. In recent years, an increasing emphasis has been placed on the complex preparation of patients, so the morbidity indicators associated with surgery have improved further. Here we summarize the changes in the care of tumors of the upper digestive tract. Orv Hetil. 2024; 165(6): 203–210.

Bevezetés: A nyelőcsőtumor az alig több mint 20%-os 5 éves túlélésével rendkívül rosszindulatú betegség. A Magyarországon mért 7%-os túlélés világszinten is kiemelkedően kismértékű, ennek hátterében leginkább a tumor késői felfedezése és az emiatt túl későn megkezdett onkológiai kezelés állhat. Célkitűzés: Célkitűzésünk volt, hogy klinikánk beteganyagának áttekintésével pontosabb képet kapjunk a magyar betegeknek a diagnózis felállításakor tapasztalt általános és tápláltsági állapotáról, táplálkozási képességéről, valamint ezek túlélésre gyakorolt hatásáról. Módszer: A Semmelweis Egyetem Sebészeti, Transzplantációs és Gasztroenterológiai Klinikáján a 2006 és 2021 közötti időszakban kezelt 183 beteg retrospektív adatelemzését végeztük. Eredmények: Vizsgálatunk során megállapítható volt, hogy a dysphagia foka (p = 0,001) és a panaszos hetek száma (p = 0,001) szoros összefüggést mutatott a fogyás mértékével, valamint a fogyás mértéke és a dysphagiaprogresszió sebessége jelentős hatással volt a teljes túlélésre. A 10 kg-ot meghaladó fogyás mellett a betegek teljes túlélése kevesebb mint 50% volt a 10 kg-ot el nem érő fogyással szemben (1347 vs. 560 nap, p = 0,01). Gyors progresszió mellett a betegek átlagosan 413 napot, míg a lassan romló nyelési nehezítettséget mutató páciensek átlagosan 1138 napot éltek (p = 0,006). A mirigyhám-eredetű daganatos betegek között nagyobb volt a fogyás mértéke (p = 0,05), de ez túlélési különbségben nem mutatkozott meg. Megbeszélés: Eredményeink a nemzetközi adatokkal összehasonlítva a magyar betegekről lényegesen súlyosabb képet mutatnak, aminek oka többszintű problémát feltételez. Következtetés: A betegség túlélésének javításához a népegészségügytől az alapellátáson át a végső ellátóhelyig számos probléma megoldására van szükség. Alapvető jelentőségű a betegek tájékozottságának növelése, a nyelési panaszokkal jelentkezők korai kiemelése, kivizsgálása, a táplálkozási rizikó korai észlelése és azonnali adekvát kezelése. Orv Hetil. 2026; 167(2): 58–64.

Background: The Stroma AReactive Invasion Front Areas (SARIFA) is a novel histological phenomenon characterized by direct tumour cell‐adipocyte interaction without intervening stroma or inflammatory cells and easily identifiable in routine haematoxylin–eosin‐stained sections. Methods: This study evaluated the prognostic significance of SARIFA in a cohort consisting of 333 gastric cancer patients, including 171 intestinal and 162 non‐intestinal adenocarcinoma cases. Associations between SARIFA and various well‐known histopathological tumour parameters, including lymphovascular invasion, perineural invasion, tumour budding and poorly differentiated clusters (PDCs), were investigated and the prognostic value of these features for survival was determined. Results: SARIFA was more frequently observed in non‐intestinal carcinomas but was significantly associated with lymphovascular and perineural invasion in both gastric cancer subtypes. Number of SARIFA foci showed a weak positive correlation with the number of tumour buds and PDCs. SARIFA was identified as an independent negative prognostic factor for overall survival in non‐intestinal gastric cancers. According to time‐dependent ROC curve analysis, quantification of SARIFA foci did not increase the prognostic accuracy beyond detecting their absence or presence in both gastric cancer subtypes. In addition, the lymph node ratio in both subcohorts and perineural invasion in intestinal adenocarcinomas were also found to be independent prognostic factors for overall survival. Conclusion: SARIFA is a robust, easily assessable histological marker with independent prognostic value in non‐intestinal gastric adenocarcinomas. Reliable histopathological markers for this group of tumours, characterized by their distinctive morphology and infiltration pattern, remain limited. Integration of SARIFA into routine diagnostics may enhance risk stratification.