Acute pancreatitis (AP) presents a significant clinical challenge due to its wide range of severity, from mild cases to life-threatening complications such as severe acute pancreatitis (SAP), necrosis, and multi-organ failure. Traditional scoring systems, such as Ranson and BISAP, offer foundational tools for risk stratification but often lack early precision. This review aims to explore the transformative role of artificial intelligence (AI) and machine learning (ML) in AP management, focusing on their applications in diagnosis, severity prediction, complication management, and treatment optimization. A comprehensive analysis of recent studies was conducted, highlighting ML models such as XGBoost, neural networks, and multimodal approaches. These models integrate clinical, laboratory, and imaging data, including radiomics features, and are useful in diagnostic and prognostic accuracy in AP. Special attention was given to models addressing SAP, complications like acute kidney injury and acute respiratory distress syndrome, mortality, and recurrence. AI-based models achieved higher AUC values than traditional models in predicting acute pancreatitis outcomes. XGBoost reached an AUC of 0.93 for early SAP prediction, higher than BISAP (AUC 0.74) and APACHE II (AUC 0.81). PrismSAP, integrating multimodal data, achieved the highest AUC of 0.916. AI models also demonstrated superior accuracy in mortality prediction (AUC 0.975) and ARDS detection (AUC 0.891) AI and ML represent a transformative advance in AP management, facilitating personalized treatment, early risk stratification, and allowing resource utilization to be optimized. By addressing challenges such as model generalizability, ethical considerations, and clinical adoption, AI has the potential to significantly improve patient outcomes and redefine AP care standards globally.

Ductal carcinoma in situ (DCIS)-associated invasive ductal carcinoma (IDC) is present in a large number of patients with breast cancer. However, the association between these two entities has not been studied in detail. The aim of this study is to compare the clinical and histopathological factors associated to recurrence of IDC with those of DCIS-associated IDC (IDC + DCIS). A prospective observational longitudinal study of 464 patients was performed between 2010 and 2015. Patients with IDC and DCIS + IDC were included and analyzed. IDC + DCIS was present in 243 patients (52.4%). No difference on histopathological characteristics were found, only Grade I and II of invasive component were more frequent in patients with IDC + DCIS than those with IDC (p = 0.038). No differences on recurrence were found between the main groups (p = 0.256). For patients who received neoadjuvant chemotherapy, those with IDC + DCIS had lower response than those with IDC alone (p = 0.014). No differences between the main groups were found on recurrence (p = 0.256). For patients who received neoadjuvant chemotherapy, recurrence was present in 19 patients (30.6%) in the IDC group in contrast to 5 (12.2%) in the IDC + DCIS group (p = 0.030). Mortality was present in 15 patients (24.2%) in the IDC group in contrast to 3 (7.3%) in the IDC + DCIS group (p = 0.027). At 7 years, 80.8% patients were alive: 71.9% from the IDC group and 92.7% from the IDC + DCIS group. The presence of DCIS seems to be indicative of a benign behavior in patients who receive neoadjuvant chemotherapy. Longer DFS and higher overall survival were found in the IDC + DCIS group despite presenting with a lower response to chemotherapy. These findings help us identify patients with better prognosis in breast cancer.

Pancreatic ductal adenocarcinoma contributes significantly to global cancer-related deaths, featuring only a 10% survival rate over five years. The quest for novel tumor markers is critical to facilitate early diagnosis and tailor treatment strategies for this disease, which is key to improving patient outcomes. In pancreatic ductal adenocarcinoma, these markers have been demonstrated to play a crucial role in early identification, continuous monitoring, and prediction of its prognosis and have led to better patient outcomes. Nowadays, biopsy specimens serve to ascertain diagnosis and determine tumor type. However, liquid biopsies present distinct advantages over conventional biopsy techniques. They offer a noninvasive, easily administered procedure, delivering insights into the tumor’s status and facilitating real-time monitoring. Liquid biopsies encompass a variety of elements, such as circulating tumor cells, circulating tumor DNA, extracellular vesicles, microRNAs, circulating RNA, tumor platelets, and tumor endothelial cells. This review aims to provide an overview of the clinical applications of liquid biopsy as a technique in the management of pancreatic cancer.

Axillary lymph node dissection (ALND), although increasingly less necessary, is still required in specific breast cancer surgery scenarios, such as cases with a high axillary tumor burden. However, traditional practices are being reassessed due to the associated morbidity and impacts on recovery. This review explores five critical and controversial innovations in ALND: (1) same-day discharge, (2) omission of surgical drains, (3) application of fibrin sealants, (4) minimally invasive techniques, and (5) their collective influence on quality of life (QoL). Same-day discharge has proven to be safe and cost-effective, increasing patient satisfaction without raising complication rates. The omission of drains, while slightly increasing seroma volumes, is linked to shorter hospital stays and fewer complications. The use of fibrin sealants shows promising results in reducing the seroma volume and duration, expediting recovery, although their routine use remains under debate. Minimally invasive and endoscopic techniques reduce morbidity and improve cosmetic outcomes while maintaining oncological safety. Quality of life (QoL) is essential in the evaluation of breast cancer treatment and is evaluated using tools such as EORTC QLQ-C30, QLQ-BR23, and FACT-B, SF-36, which assess physical, emotional, and psychosocial recovery. Innovations in ALND seem to improve QoL by minimizing pain, increasing arm function, and reducing psychological stress, underscoring the importance of patient-centered strategies. Although axillary lymphadenectomy increases arm morbidity compared to sentinel node biopsy, its overall impact on quality of life appears limited, likely due to the overlapping effects of systemic therapies and breast surgery.

Background: Seroma after breast cancer surgery is a frequent entity; therefore, different products have been described in literature with the aim to reduce it. The most studied ones have been the sealants products, being tested with aspirative drains. Symptomatic seroma represents the 19% after axillary lymphadenectomy without drains. The aim of this study is to analyze the effect of a sealant in the seroma control after axillary lymphadenectomy without drains and identify the risk factors related to symptomatic seroma. Methods: This is a prospective, multicenter, international, and randomized clinical trial. Patients undergoing conservative surgery and axillary lymphadenectomy for breast cancer will be randomized to control group (lymphadenectomy without sealant) or interventional group (lymphadenectomy with sealant Glubran 2®). In any of the study groups, drains are placed. Patients who received neoadjuvant treatment are included. Measurements of the study outcomes will take place at baseline; at 7, 14, and 30 days post-surgery; and at 6–12 months. The primary outcome is symptomatic seroma. Secondary outcomes are seroma volume, morbidity, quality of life, and lymphedema. Discussion: Several studies compare the use of sealant products in axillary lymphadenectomy but generally with drains. We would like to demonstrate that patients who underwent axillary lymphadenectomy could benefit from an axillary sealant without drains and reduce axillary discomfort while maintaining a good quality of life. Assessing the relationship between axillary volume, symptoms, and related risk factors can be of great help in the control of seroma in patients who received breast cancer surgery. Trial registration: ClinicalTrials.gov, NCT05280353. Registration date 02 August 2022.