Background and Aims: Lymphomas of the gastrointestinal tract represent a rare pathology, frequently associated with a poor outcome. This study aimed to determine the prognostic factors of digestive tract lymphomas and to evaluate the role of endoscopy in the diagnosis and outcome. Methods: Our prospective study evaluated a number of 63 patients diagnosed with digestive tract lymphomas. Results: The mean age of the patients was 62 years ± 13.1 years. Most of the patients had B-cell lymphoma (88.8%). Localization was represented by the stomach (44.4%), followed by the small bowel (25.4%) and the oropharynx (14.2%). Diffuse large B-cell lymphoma was the most common subtype (52.3%), followed by Mantle cell lymphoma (15.8%) and MALT (14.2%). T-cell lymphoma was present in a small number of patients. Anaplastic large cell lymphoma was the most common subtype of T-cell lymphoma (6.35%) and was localized in the small bowel. One-quarter of the patients had complications such as bleeding, obstruction, or perforation. Chemotherapy alone (38.1%) was the most common treatment option, followed by surgery (28.5%). Endoscopic examination and sampling biopsy were performed on 74.6% of the patients included in the study, with a positive diagnosis for lymphoma in 58.7% of the cases. Age (p=0.208), higher ECOG values (p=0.0487), and level of albumin (p=0.0355) were independent prognostic factors for overall survival. Endoscopic monitoring impacted overall survival (p<0.0001), due to the early detection of relapse. Conclusions: Age, high ECOG value, and low albumin levels are independent prognostic factors for overall survival. Early diagnosis of recurrent gastrointestinal tract lymphomas by endoscopy increases overall survival.
Background/Objectives: Sarcopenia and frailty are both multidimensional and interrelated problems for patients with cirrhosis and require prompt assessment and appropriate management because of their impact on disease outcomes. Our purpose is to identify the prevalence of sarcopenia and frailty in patients with advanced liver disease. Furtherksdnvk more, our purpose is to explore the association between sarcopenia, frailty, and various complications and the impact of these conditions on short- and long-term hospital survival rates. Methods: A prospective, observational, unicentric study was conducted in an emergency university hospital in Romania between January 2021 and December 2023 that included patients with advanced liver diseases. The patients with sarcopenia and frailty were selected using measurements of handgrip strength (HGS), Short Physical Performance Battery (SPPB), liver frailty index (LFI), and skeletal muscle index (SMI). Patients were divided into four groups based on the presence of sarcopenia and/or frailty. Results: This study included 128 patients. Younger patients associated with both sarcopenia and frailty (55.76 ± 10.46 years). Most males were without sarcopenia and frailty (63.93%) compared to those with both sarcopenia and frailty (36.07%). The Child–Pugh score C was identified in the majority of those with both sarcopenia and frailty (69.70%). Higher values for MELD-Na scores were obtained in the group with sarcopenia and frailty (25.45 ± 6.924). Biomarkers like albumin, sodium, C-reactive protein, bilirubin, and platelets were statistically significant as mortality predictors in all four groups. Patients with both sarcopenia and frailty presented more often with encephalopathy and spontaneous bacterial peritonitis. Survival rates in the short and long term were lower for the patients who associated both sarcopenia and frailty compared to those without sarcopenia and frailty. Conclusions: The presence of sarcopenia and frailty significantly impacts outcomes in patients with decompensated advanced liver disease. When both conditions coexist in the same patient, they markedly increase in-hospital mortality, as well as short- and long-term survival rates.