Background and Objectives: Venous thromboembolism (VTE) is a serious complication frequently encountered in cancer patients and is associated with high morbidity. In patients undergoing cancer treatment—particularly those receiving chemotherapy—VTE increases treatment-related complications and has a direct impact on mortality. The development of VTE in oncology patients varies depending on cancer type, treatment protocols, and individual patient characteristics. The Khorana Risk Score (KRS) is a validated risk assessment tool used to estimate the risk of VTE development in patients receiving chemotherapy. KRS provides risk estimations based on the patient’s clinical features, cancer type, and treatment process. This study aims to investigate the prognostic value of the Khorana Risk Score in predicting VTE development and overall survival in patients with metastatic gastric cancer. Materials and Methods: This retrospective study used data from 337 metastatic gastric cancer patients who presented to Kartal Dr. Lütfi Kırdar City Hospital between January 2012 and June 2024. Patients were categorized into intermediate- and high-risk groups according to the Khorana Risk Score. The study’s primary endpoints were the development of VTE and overall survival. Results: There was no statistically significant difference in VTE incidence (p = 0.27) or overall survival (11.9 months vs. 11.5 months, p = 0.23) between patients in the intermediate- and high-risk groups. Conclusions: These results indicate that the Khorana Risk Score is insufficient in predicting VTE development in patients with metastatic gastric cancer and has a weak association with overall survival outcomes. In conclusion, this study demonstrates the KRS’s inadequacy in predicting VTE and survival outcomes in patients with metastatic gastric cancer, highlighting the need for more tailored approaches.

Objectives: Aging is associated with immunosenescence, which may alter the physiological response to trauma and influence long-term outcomes. This study aimed to compare clinical and laboratory parameters associated with in-hospital (iHM) and one-year mortality (OYM) between adult and geriatric patients with multisystem trauma and to explore laboratory findings consistent with immunosenescence in geriatric patients. Methods: In this retrospective study, 345 patients with multisystem trauma were categorized into adult (n = 255) and geriatric (n = 90) groups according to age. Clinical characteristics and laboratory parameters obtained at emergency department admission were analyzed in relation to iHM and OYM. Results: Although iHM did not differ significantly between groups (p = 0.764), OYM was significantly higher in the geriatric group (p < 0.001). In adults, iHM was associated with a higher Injury Severity Score (ISS), prolonged intensive care unit (ICU) stay, elevated white blood cell and monocyte counts, and hypoalbuminemia. OYM in adults was further associated with a higher ISS, longer hospital stays, and lower hemoglobin and hematocrit levels. In geriatric patients, iHM was associated with a higher ISS, male sex, high-energy trauma, elevated lymphocyte and creatinine levels, and lower hematological ratios. OYM in the geriatric group was additionally associated with advanced age, major surgical intervention, thrombocytopenia, elevated urea–creatinine levels, hypoalbuminemia, and lower hematological ratios. Conclusions: Despite comparable in-hospital mortality, geriatric patients with multisystem trauma demonstrated significantly higher one-year mortality. The reduced post-traumatic inflammatory response observed in geriatric patients may be indicative of underlying immunosenescence and diminished immune reserve, thus emphasizing the necessity for age-specific prognostic models in trauma care.

Background/Objectives: While bariatric surgery is known to improve plantar pressure distribution and reduce foot-related symptoms, its impact on radiographic forefoot alignment parameters, such as the intermetatarsal angle (IMA) and hallux valgus angle (HVA), remains unclear, highlighting the need for further investigation. The aim of this study was to quantitatively evaluate changes of HVA and IMA in patients undergoing bariatric surgery and to determine whether weight loss-induced reductions in mechanical load are associated with differential changes of the forefoot. Methods: Weight-bearing anteroposterior foot radiographs of 102 patients who underwent laparoscopic sleeve gastrectomy were obtained preoperatively and at 6 months postoperatively. HVA and IMA were measured using standardized digital techniques. Changes in angular parameters were analyzed in relation to body mass index reduction. Results: Intra-observer reliability was excellent for all angular measurements (ICC: 0.987–0.999, p < 0.001). Radiographic evaluation demonstrated no significant change in HVA (p = 0.147), whereas IMA showed a significant decrease postoperatively (p < 0.001). No significant change was observed in HVA distribution (p = 0.341), and although the proportion of patients within the normal IMA range increased, this did not reach statistical significance (p = 0.091). Correlation analysis revealed significant associations of postoperative angles with age and body weight parameters (p < 0.05), while no significant relationship was found between changes in body weight or BMI and angular measurements (p > 0.05). Conclusions: Sleeve gastrectomy significantly improves biomechanically driven aspects of forefoot alignment (decrease in IMA), while structural deformities (HVA) remain unchanged in the short-term. These findings highlight that obesity-related forefoot pathology is predominantly linked to altered load distribution rather than fixed structural deformity, suggesting that radiographic parameters reflecting biomechanical loading are more sensitive to weight loss.

Background/Objectives: Tumor size is not included in the TNM staging system for colon cancer, and its prognostic significance remains controversial. We aimed to evaluate the impact of tumor size on recurrence-free survival (RFS) and overall survival (OS) in patients with stage T3N1 colon cancer. Methods: We retrospectively analyzed 336 patients with pathologically confirmed pT3N1 colon cancer who underwent curative resection between January 2015 and January 2025 at our tertiary institution. Clinicopathological features, adjuvant chemotherapy details, and survival outcomes were collected. Tumor size was measured pathologically, and a cutoff was determined by receiver operating characteristic (ROC) analysis. Kaplan–Meier and Cox regression analyses were performed to identify prognostic factors. Results: The optimal cutoff for tumor size predicting recurrence was 4 cm. Patients with tumors ≥ 4 cm had significantly lower 5-year RFS compared to those with smaller tumors (65.1% vs. 80.3%, p = 0.007). In multivariate analysis, tumor size ≥ 4 cm (HR: 2.014, 95% CI: 1.093–3.714, p = 0.025), ECOG performance status ≥ 2 (p = 0.005), positive resection margin (p = 0.011), and failure to complete adjuvant chemotherapy (p = 0.007) were identified as independent adverse prognostic factors for RFS. Tumor size was not independently associated with OS (p = 0.46). Adjuvant chemotherapy significantly improved both RFS (p < 0.001) and OS (p < 0.001). Conclusions: In patients with stage T3N1 colon cancer, tumor size ≥ 4 cm is an independent adverse prognostic factor for RFS. Incorporating tumor size into risk stratification, alongside TNM staging and treatment completion status, may improve prognostic assessment and guide clinical decision-making.