Background: Clinical prediction models are needed to accurately predict the prognosis of patients with gastric cancer who have received neoadjuvant therapy and to determine the best treatment strategies. The aim of this study is to determine the role of two prognostic factors, the neoadjuvant rectal (NAR) score and the downstaging depth score (DDS), in predicting survival in patients with gastric cancer who received neoadjuvant therapy and underwent curative gastrectomy. Methods: We reviewed the medical records of 129 patients who had been diagnosed with primary gastric cancer and underwent radical gastrectomy after receiving neoadjuvant therapy. We calculated the NAR score and DDS values for each patient and conducted a survival analysis to assess the accuracy of these prognostic factors in predicting overall survival. Results: The median overall survival time of the patients was found to be 29 months. Patients with low NAR scores and high DDS had significantly longer overall survival. Univariate analyses based on clinical and laboratory characteristics showed that gender, surgery type, resection type, neural invasion, grade, adjuvant radiotherapy, lymphocyte level, carcinoembryonic antigen (CEA) level, NAR score, and DDS were associated with survival. Moreover, multivariate analyses showed that lymphocyte level, DDS, and NAR score were independent prognostic factors. Conclusions: In summary, our research indicates that NAR score and DDS may serve as useful prognostic markers for predicting overall survival in patients with locally advanced gastric cancer who receive neoadjuvant chemotherapy followed by curative surgery. Patients with high DDS and low NAR scores were found to have better prognoses.

Introduction: Spleen volume (SV) may increase during systemic chemotherapy, potentially reflecting treatment-related hepatic, hematological, and immune alterations. However, the clinical significance of SV changes during neoadjuvant chemotherapy (NAC) for gastric cancer remains unclear. This study evaluated SV changes during NAC and their associations with radiological response and overall survival (OS). Methods: This retrospective cohort study included 111 patients with gastric adenocarcinoma who received NAC followed by curative-intent gastrectomy. SV was measured on computed tomography before and after NAC using semiautomated volumetric segmentation. Relative SV change (ΔSV%) was calculated. Radiological response was assessed according to RECIST 1.1. Associations of ΔSV% with objective response and OS were evaluated using logistic and Cox regression analyses, respectively. Results: Mean SV increased significantly from 250.59 ± 98.11 to 335.40 ± 126.81 cm³ (p < 0.001), with a mean ΔSV% of 34.53 ± 15.72%. SV increased in 108 patients (97.3%). Objective response was observed in 56 patients (50.5%). ΔSV% did not differ between responders and nonresponders (34.05 ± 15.66% vs. 35.03 ± 15.90%; p = 0.730) and was not associated with objective response after multivariable adjustment (OR per 10% increase, 0.932; 95% CI, 0.715–1.207; p = 0.578). ΔSV% was also not associated with OS (adjusted HR, 1.031; 95% CI, 0.859–1.236; p = 0.745). Conclusions: SV increased markedly in nearly all patients during NAC for gastric cancer. However, the magnitude of this increase was not associated with radiological response or OS, suggesting that splenic enlargement during NAC may represent a treatment-associated phenomenon rather than a marker of antitumor efficacy or prognosis.

Isolated hyperthermic limb perfusion (ILP) is a limb-salvage technique used in the treatment of malignant melanoma and soft tissue sarcomas with in-transit or locally advanced disease. ILP allows regional administration of high-dose chemotherapy with minimal systemic toxicity. This study aims to evaluate postoperative complications and identify predictive factors influencing outcomes in patients undergoing ILP. We retrospectively analyzed 49 patients with malignant melanoma or extremity soft tissue sarcoma who underwent ILP at a single tertiary center between 2014 and 2024. Complications were classified using the Clavien-Dindo system; toxicity was graded via the Wieberdink scale. Logistic regression and univariate analyses were used to evaluate clinical, surgical, and laboratory parameters predictive of severe complications, toxicity, and mortality. Of the patients, 32 (65.3%) experienced complications, primarily within the first 3 postoperative days. Severe complications (Clavien-Dindo grade ≥ 3) occurred in 11 patients (22.4%). Severe regional toxicity (Wieberdink grade ≥ 4) was observed in 6.1%. Early mortality occurred in 3 cases. Preoperative and postoperative albumin levels, along with C-reactive protein levels on postoperative days 3 and 5, were significantly associated with severe complications. No significant relationship was found between modified Systemic Inflammation Scores and postoperative outcomes. ILP remains a valuable regional treatment option for carefully selected patients with advanced melanoma and extremity soft tissue sarcoma. Preoperative nutritional status and early postoperative inflammatory markers, particularly albumin and C-reactive protein, may serve as valuable predictors for adverse outcomes. Optimization of these parameters could improve postoperative recovery and treatment planning.