Purpose Preoperative nutrition is beneficial for malnourished cancer patients. Yet, there is little evidence whether or not it should be given to nonmalnourished patients. The aim of this study was to assess the need to introduce preoperative nutritional support in patients without malnutrition at qualification for surgery. Methods This was a prospective, two-arm, randomized, controlled, open-label study. Patients in interventional group received nutritional supplementation for 14 days before surgery, while control group kept on to their everyday diet. Each patient’s nutritional status was assessed twice—at qualification (weight loss in 6 months, laboratory parameters: albumin, total protein, transferrin, and total lymphocyte count) and 1 day before surgery (change in body weight and laboratory parameters). After surgery, all patients were followed up for 30 days for postoperative complications. Results Fifty-four patients in interventional and 48 in control group were analyzed. In postoperative period, patients in control group suffered from significantly higher (p < 0.001) number of serious complications compared with patients receiving nutritional supplementation. Moreover, levels of all laboratory parameters declined significantly (p < 0.001) in these patients, while in interventional arm were stable (albumin and total protein) or raised (transferrin and total lymphocyte count). Conclusions Preoperative nutritional support should be introduced for nonmalnourished patients as it helps to maintain proper nutritional status and reduce number and severity of postoperative complications compared with patients without such support.

Background: Short-chain fatty acids (SCFAs), the main microbial fermentation products in the colon, have immunometabolic and anti-neoplastic properties. Alterations in fecal SCFA profiles have been proposed as potential non-invasive biomarkers for colorectal cancer (CRC), but previous findings remain inconsistent. This systematic review and meta-analysis aimed to determine whether fecal acetate, propionate, and butyrate concentrations differ between patients with CRC and healthy individuals. Methods: A comprehensive search of PubMed, Web of Science and Cochrane Library was conducted on 18 September 2025. Eligible studies were observational, included adults with histologically confirmed CRC and healthy controls, and reported fecal concentrations of at least one SCFA quantified using validated analytical methods. Two independent reviewers performed study screening, data extraction, and risk-of-bias assessment. Random-effects models were applied to calculate pooled standardized mean differences (SMDs) with 95% confidence intervals (CIs). Results: Thirteen studies met inclusion criteria for qualitative synthesis, and four (141 CRC cases, 98 controls) were eligible for meta-analysis. Compared with healthy controls, patients with CRC had significantly lower fecal acetate (pooled SMD −0.37; 95% CI −0.63 to −0.10; p = 0.006; I² = 0%) and butyrate (pooled SMD −0.59; 95% CI −1.10 to −0.07; p = 0.026; I² = 64.4%), whereas propionate did not differ significantly (pooled SMD −0.02; 95% CI −0.85 to 0.82; p = 0.971; I² = 89%). Conclusions: CRC is associated with reduced fecal butyrate and, to a lesser extent, acetate, suggesting impaired microbial fermentation. Propionate shows no consistent difference. SCFA profiling currently lacks sufficient standardization and validation for clinical application. Future harmonized, longitudinal studies integrating diet, microbiome, and metabolomic data are warranted to confirm SCFAs as reproducible biomarkers of CRC.

Background: Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) can cure selected patients with colorectal peritoneal metastases (CPM). Real-world prognostic data, especially for the Peritoneal Cancer Index (PCI) and completeness of cytoreduction (CCR), are limited. Methods: We retrospectively analysed 75 consecutive patients treated with CRS + HIPEC at a tertiary centre (2014–2022), giving ≥36 months potential follow-up. Overall survival (OS) was assessed by Kaplan–Meier and Cox models. PCI was grouped 0–10, 11–20, >20; CCR was dichotomised (CCR-0 vs. CCR 1/2). Multivariable analysis included PCI, CCR, and resection extent; HIPEC drug was examined univariately. Results: The median follow-up was 41 months. Crude 3-year OS was 50.7% (38/75). Survival decreased with higher PCI: 69% for 0–10 (n = 42), 38% for 11–20 (n = 21), and 0% for > 20 (n = 4). Versus PCI 0–10, the adjusted hazard ratios (HR) were 3.02 (95% CI 1.52–6.03) for PCI 11–20 and 7.29 (1.72–30.81) for > 20. CCR-0 improved OS univariately (HR 0.43) but was non-significant after adjustment (HR 0.89). Resection limited to the peritoneum (HR 0.99) and choice of intraperitoneal drug showed no independent effect. Conclusions: In this real-world cohort, PCI was the only independent predictor of 3-year survival after CRS + HIPEC for CPM; neither CCR status, surgical extent, nor HIPEC agent altered prognosis once PCI was considered. PCI should therefore remain the principal selection criterion while molecular and biological markers are integrated into future risk models.