Background and Objectives: Sarcopenia is frequently observed in cancer patients and is associated with short survival. In this study, the aim was to research the sarcopenia risk factors, the correlation of sarcopenia with inflammatory biomarkers, and the prognostic significance of sarcopenia and inflammation markers in patients with metastatic gastric cancer. Material and Method: The study included 177 patients diagnosed with metastatic gastric cancer attending Dokuz Eylül University Faculty of Medicine (DEUFM) Medical Oncology clinic from 2016 to 2022. The skeletal muscle area at L3 vertebral level was identified on abdominal computed tomography (CT) images, and the skeletal muscle index (SMI, cm²/m²) was calculated. Additionally, PLR, MLR, NLR, dNLR, SIRI, SII, PIV, PNI, CAR, and LAR were assessed among systemic inflammatory biomarkers. Cut-off values were determined with ROC curve analysis. Survival analyses were performed with the Kaplan–Meier method, and risk factors were investigated with Cox regression analysis. For all statistical analyses, p < 0.05 was accepted as significant. Results: Among patients, 71.8% were identified to have sarcopenia. Significant levels of difference were identified for median SIRI, NLR, MLR, PLR, SII, PNI, and dNLR values between patients with and without sarcopenia (p < 0.05). The sarcopenia risk was assessed between groups created according to the cut-off values for inflammation markers. Univariate regression analysis found that SIRI, PIV, NLR, MLR, PLR, SII, PNI, and dNLR were statistically significant (p < 0.05). Multivariate analysis identified SIRI and PNI as independent risk factors. For all patients, median overall survival was identified to be 12.4 ± 0.8 months (CI 95%, 10.8–13.9). For patients with sarcopenia, overall survival duration was 11.5 ± 0.8 months, while survival duration for patients without sarcopenia was 17.5 ± 4.6 months (p = 0.010). Elevation in the inflammatory biomarkers of SIRI, NLR, SII, LAR, and CAR and low PNI values appear to be associated with short survival (p < 0.05). Conclusions: In this study, sarcopenia was frequently observed in patients with metastatic gastric cancer and sarcopenia was associated with shorter survival. A significant correlation was observed between sarcopenia and inflammatory biomarkers, with SIRI and PNI identified to be independent risk factors for sarcopenia. Our study emphasizes the prognostic importance of sarcopenia and inflammatory markers for the management of patients with metastatic gastric cancer.

Background/Aims: The prevalence of sarcopenia and osteopenia/osteoporosis is increased in chronic pancreatitis (CP). This study aims to evaluate the prevalence and related factors of osteosarcopenia in CP patients. Materials and Methods: Eighty-three CP patients were included in this cross-sectional observational study. Sarcopenia was assessed by measuring the surface area of the paravertebral muscles at the third lumbar region. Pancreatic fecal elastase (PFE) tests evaluated exocrine pancreatic insufficiency (EPI), while dual-energy x-ray absorptiometry scans assessed osteopenia/osteoporosis. EORTC PAN26 and a symptom questionnaire were administered, alongside nutritional marker assessments concurrent with PFE. Results: The prevalence of sarcopenia and osteopenia/osteoporosis was found to be 22.9% (n = 19) and 68.7% (n = 44), respectively. Factors associated with sarcopenia included male gender (OR: 4.9, P = .044), severe EPI (OR: 4.2, P = .043), smoking (OR: 4.6, P = .040), and zinc deficiency (OR: 2.2, P = .029). Severe EPI was significantly associated with osteopenia/osteoporosis (P = .010), diabetes mellitus (P = .001), sarcopenia (P = .016), and zinc deficiency (P = .012). Individuals with osteoporosis had higher PAN26 scores (P = .029). Factors independently associated with osteopenia/osteoporosis included female gender (OR: 7.8, P = .004), severe EPI (OR: 8.1, P = .003), and sarcopenia (OR: 5, P = .037). The prevalence of osteosarcopenia was 19.2%. Conclusion: Osteosarcopenia is common in CP patients. Smoking, zinc deficiency, EPI, and male gender are strongly associated with sarcopenia. Screening for osteosarcopenia is essential in CP patients to facilitate appropriate interventions. Cite this article as: Döngelli H, Bengi G, Yarol RC, et al. Clinical features and prevalence of osteosarcopenia in chronic pancreatitis. Turk J Gastroenterol. 2025;36(10):669-679.

The alpha angle is a radiological measurement that has been proposed for the detection of cam morphology in patients suspected of femoroacetabular impingement syndrome (FAIS). After analysing published articles on FAIS, it is apparent that different types of circles are used in the measurement of alpha angles. To determine the interobserver and intraobserver reliability of alpha angle values measured using different types of circles on a 45° Dunn lateral radiograph in patients with symptomatic FAIS. The 45° Dunn lateral radiographs of the operated hips of patients who underwent hip preservation surgery in Dokuz Eylül University Hospital between 2014 and 2017 were evaluated retrospectively. Alpha angles were measured manually with transparent goniometers using three different circle types: thin full circle, thin-dashed circle, and thick full circle, and eye estimation without circle insertion. Measurements were made separately by an orthopaedist and a radiologist. A second measurement was made by the radiologist 1 month later for intraobserver reliability. Interobserver reliability for the thin full circle, thin-dashed circle, thick circle, and eye estimation (ICC = 0.645, 0.525, 0.494, and 0.588, respectively). Intraobserver reliability for the thin, thin-dashed, thick line, and eye estimation (ICC= 0.626, 0.681, 0.681, and 0.462 respectively). Interobserver difference of mean values of alpha angles for thin full, thin-dashed, thick full, and eye estimation were 2.7°, 0.9°, 1.1°, and 2.3°, respectively. Intraobserver differences between measurements were 1.5°, 0.9°, 0°, and 1.6°, respectively. Our study demonstrated that interobserver reliability is highest when measurements are made using a thin full circle.

Neoadjuvant chemoradiotherapy (CRT) is known to increase sphincter preservation rates and decrease the risk of postoperative recurrence in patients with locally advanced rectal tumors. However, the response to CRT in patients with locally advanced rectal cancer (LARC) varies significantly. The objective of this study was to compare the performance of models based on radiomics features of the tumor alone, the mesorectum alone, and a combination of both in predicting tumor response to neoadjuvant CRT in LARC. This retrospective study included 101 patients with LARC. Patients were categorized as responders (modified Ryan score 0-1) and non-responders (modified Ryan score 2-3). Pre-CRT magnetic resonance imaging evaluations included tumor-T2 weighted imaging (T2WI), tumor-diffusion weighted imaging (DWI), tumor-apparent diffusion coefficient (ADC) maps, and mesorectum-T2WI. The first radiologist segmented the tumor and mesorectum from T2-weighted images, and the second radiologist performed tumor segmentation using DWI and ADC maps. Feature reproducibility was assessed by calculating the intraclass correlation coefficient (ICC) using a two-way mixed-effects model with absolute agreement for single measurements [ICC(3,1)]. Radiomic features with ICC values <0.60 were excluded from further analysis. Subsequently, the least absolute shrinkage and selection operator method was applied to select the most relevant radiomic features. The top five features with the highest coefficients were selected for model training. To address class imbalance between groups, the synthetic minority over-sampling technique was applied exclusively to the training folds during cross-validation. Thereafter, classification learner models were developed using 10-fold cross-validation to achieve the highest performance. The performance metrics of the final models, including accuracy, precision, recall, F1-score, and area under the receiver operating characteristic curve (AUC), were calculated to evaluate the classification performance. Among the 101 patients, 36 were classified as responders and 65 as non-responders. A total of 25 radiomic features from the tumor and 20 from the mesorectum were found to be statistically significant (P < 0.05). The AUC values for predicting treatment response were 0.781 for the tumor-only model (random forest), 0.726 for the mesorectum-only model (logistic regression), and 0.837 for the combined model (logistic regression). Radiomic features derived from both the tumor and mesorectum demonstrated complementary prognostic value in predicting treatment response. The inclusion of mesorectal features substantially improved model performance, with the combined model achieving the highest AUC value. These findings highlight the added predictive contribution of the mesorectum as a key peritumoral structure in radiomics-based assessment. Currently, the response of locally advanced rectal tumors to neoadjuvant therapy cannot be reliably predicted using conventional methods. Recently, the significance of the mesorectum in predicting treatment response has gained attention, although the number of studies focusing on this area remains limited. In our study, we performed radiomics analyses of both the tumor tissue and the mesorectum to predict neoadjuvant treatment response.

Objective: To evaluate the technical feasibility and procedural safety of carbon dioxide (CO₂) angiography during renal artery stenting compared with iodinated contrast angiography, and to identify baseline factors associated with postprocedural improvement in renal function. Materials and Methods: This single-center, retrospective study involved 99 patients who underwent renal artery stenting, with 37 in the CO₂ angiography group and 62 in the iodinated contrast medium control group. Kidney disease progression was described as a decline in the estimated glomerular filtration rate (eGFR) of ≥20% and/or evolution to end-stage disease. Improvement in function was stated as a ≥25% increment in eGFR within one month after the procedure. Demographic, periprocedural, and postprocedural variables were compared between the two groups (CO₂ versus control group). Receiver operating characteristic curve analyses were done to specify cut-off values for renal function improvement in the CO₂ group. Results: There were no significant differences in procedure time, complication rates, and technical challenges between the two groups. Improvement in kidney function after stenting was experienced more frequently in the CO₂ group. Exploratory ROC (Receiever operating characteristic) analyses identified baseline serum creatinine and eGFR cut-off values of 35 mL/min/1.73 m², respectively, for discriminating patients with renal function improvement. Conclusions: CO₂ can be safely and effectively used as an alternative contrast agent during renal artery stenting in patients with CKD (chronic kidney disease).