Background and Objectives: We investigated how pretreatment body-composition parameters relate to pathologic complete response (pCR), disease-free survival (DFS), and overall survival (OS) in women with non-metastatic breast cancer who received neoadjuvant chemotherapy (NAC). Materials and Methods: We retrospectively analyzed 278 women treated with NAC at a single institution between January 2010 and December 2022. On computed tomography (CT) or PET-CT, visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), skeletal muscle mass (SMM), and skeletal muscle density (SMD) were measured at the third lumbar vertebra (L3) with a semi-automated technique. Receiver operating characteristic (ROC) analysis was used to define optimal SMM cut-offs, and survival was examined by Kaplan–Meier estimation and Cox proportional-hazards regression. Results: The median follow-up was about 62 months. BMI was correlated with VAT (r = 0.449) and SAT (r = 0.482) but not with SMM (r = 0.075; p = 0.211). SMM was higher in women who attained pCR (107.4 ± 14.4 vs. 101.1 ± 16.1; p = 0.003). Derived by ROC analysis against distant metastasis—the event defining DFS—the SMM cut-off was 105 cm² (AUC = 0.725); values below it predicted poorer DFS on both univariable (HR = 4.80; p < 0.001) and multivariable testing (adjusted HR = 3.83; 95% CI 1.78–8.26; p = 0.001). The recurrence/metastasis rate was far higher among sarcopenic obese women (n = 34) than non-sarcopenic obese women (n = 56) (41.2% vs. 10.7%; log-rank p = 0.0004). With adjustment for molecular subtype, greater SMM remained an independent correlate of pCR (adjusted OR 1.26 per 10-cm² increment; 95% CI 1.04–1.53; p = 0.020). SMM was not significantly related to OS (univariable HR 1.75; p = 0.081). Sensitivity and specificity of the 105-cm² cut-off were 92.3% and 48.2%, respectively. Conclusions: In this retrospective cohort, greater pretreatment skeletal muscle area was independently linked to pathologic complete response and lower area to worse disease-free survival, while no significant link emerged with overall survival. Since BMI captures muscle mass poorly, body composition obtained from CT/PET-CT may add complementary prognostic information; nevertheless, because the design was observational and the cut-offs internally derived, these hypothesis-generating results need prospective external validation before clinical adoption.

Background and Objectives: This study aimed to evaluate and compare the early postoperative outcomes of patients who underwent pancreaticoduodenectomy (PD) with total mesopancreatic excision (TMpE) versus conventional pancreaticoduodenectomy (Co-PD) for pancreatic head ductal adenocarcinoma (PDAC). Materials and Methods: Patients who underwent PD for pancreatic head cancer between January 2021 and December 2024 in our clinic and had a pathological diagnosis of PDAC were included. Patients were stratified into two groups according to the surgical technique performed (TMpE-PD vs. Co-PD). Demographic characteristics and early postoperative clinicopathological data were compared between the groups. Results: A total of 41 patients were included: 17 (41.5%) underwent TMpE-PD and 24 (58.5%) underwent Co-PD. Demographic and clinicopathological parameters were comparable between the groups. Although not statistically significant, the TMpE-PD group demonstrated higher R0 resection rates (58.8% vs. 45.8%; p = 0.412) and greater lymph node yield (33.9 vs. 29.1; p = 0.757) compared to the Co-PD group. Overall postoperative complications were more frequent in the TMpE-PD group (82.4% vs. 63.4%; p = 0.034). A smaller pancreatic duct diameter was associated with an increased risk of postoperative complications in both groups, approaching statistical significance (p = 0.053). Multivariable logistic regression analysis revealed that the surgical technique was not an independent risk factor for postoperative complications (OR: 0.64; 95% CI: 0.14–2.83; p = 0.56). No direct correlation was found between resection margin status (R0 vs. R1) and the development of postoperative complications. Conclusions: TMpE demonstrated non-significant trends toward higher R0 resection rates and greater lymph node yield compared with conventional PD. These findings suggest possible oncological benefits without significantly increasing perioperative morbidity.