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.

Background/Objectives: Sentinel lymph-node biopsy (SLNB) may be omitted in selected patients with clinically node-negative, early-stage breast cancer; however, the extent to which nodal information still influences contemporary adjuvant-treatment planning remains uncertain. This study aimed to determine whether disclosure of SLNB pathology changed multidisciplinary systemic-treatment and/or radiotherapy recommendations among patients fulfilling study-defined criteria derived from the 2025 American Society of Clinical Oncology omission pathway. Methods: In this single-center, retrospective, record-based paired decision-impact study, routine clinical records of consecutive postmenopausal women aged ≥ 50 years who underwent breast-conserving surgery and SLNB between 1 January 2015 and 30 June 2026 were reviewed after closure of the prespecified clinical-record window. Each anonymized case was assessed by a six-member virtual tumor board in two stages: first with SLNB pathology concealed and subsequently, after a six-week washout period, with nodal findings disclosed. The primary outcome was a definitive change in chemotherapy, CDK4/6-inhibitor, and/or radiotherapy recommendation. Paired transitions, interobserver agreement, decision confidence, and pre-SLNB factors associated with management-changing information were evaluated. Results: Among 412 eligible patients, occult sentinel-node deposits were identified in 46 (11.2%; 95% confidence interval [CI], 8.5–14.6%), including isolated tumor cells in seven, micrometastases in 13, and macrometastases in 26. Nodal disclosure produced at least one definitive management change in 28 patients (6.8%; 95% CI, 4.7–9.6%), corresponding to 14.7 SLNB procedures per management-changing recommendation. Twenty-six changes represented treatment escalation. Radiotherapy recommendations changed in 22 patients, CDK4/6-inhibitor recommendations in 13, and chemotherapy recommendations in seven, with overlap between domains. The expanded decision-impact endpoint was reached in 43 patients (10.4%; 95% CI, 7.8–13.8%). Management changed in 0.5% of patients with pN0 disease, none with isolated tumor cells, 46.2% with micrometastases, and 76.9% with macrometastases (p < 0.001). Increasing clinical tumor size was associated with management-changing information (adjusted odds ratio per 5 mm increase, 1.58; 95% CI, 1.07–2.37; p = 0.023). Conclusions: SLNB pathology left definitive adjuvant-treatment recommendations unchanged in more than 90% of selected patients but altered management in approximately one in 15, predominantly through radiotherapy-field selection and CDK4/6-inhibitor consideration. These findings support selective, multidisciplinary implementation of SLNB omission while emphasizing that decision changes do not necessarily represent proven oncological benefit.