Adam Mylonakis

Background: Patients with pancreatic cancer are at increased risk of malnutrition and functional decline. This study aimed to identify preoperative nutritional and functional risk factors associated with postoperative complications. Methods: Adult patients with pancreatic cancer admitted to two university surgical departments in Athens, Greece, were included. Preoperative laboratory values, nutritional status, and functional status were assessed. Results: Among 96 patients included in this study, postoperative complications occurred in 69 (71.9%). Complication rates were significantly higher in patients with severe malnutrition (87.9% vs. 62.7%, p = 0.015), low Geriatric Nutritional Risk Index (GNRI) (90.5% vs. 66.2%, p = 0.023), low handgrip strength (91.7% vs. 61.5%, p = 0.037), and low gait speed (90.5% vs. 63.6%, p = 0.027). Major complications were linked to lower hemoglobin (Hb) (11.5 ± 1.9 vs. 12.8 ± 1.7 g/dL, p = 0.001), lower hematocrit (HCT) (34.7 ± 5.4% vs. 38.4 ± 4.7%, p = 0.001), and severe malnutrition (42.4% vs. 23.7%, p = 0.05). Lower Hb, lower HCT, malnutrition, and greater waist circumference were associated with postoperative mortality. Longer hospital stays were correlated with weaker handgrip strength and slower gait speed. Conclusion: Preoperative malnutrition and impaired functional status are significant predictors of adverse postoperative outcomes in pancreatic cancer surgery.

Background/Objectives: Chemerin, which is a multifunctional cytokine and adipokine, has been implicated in inflammatory and metabolic processes and might play a role in upper gastrointestinal (GI) malignancies, particularly gastric and esophageal cancer. The aim of this review is to explore the role of chemerin in the pathophysiology of upper GI cancers, as well as its potential as a biomarker for early detection and as a therapeutic target. Methods: A comprehensive review of recent studies about chemerin’s biochemical properties and interaction with its receptors, as well as its effects on inflammatory responses, immune regulation, and metabolic processes, was conducted. The clinical implications of chemerin for gastric and esophageal cancer were analyzed, whereas the potential therapeutic strategies targeting chemerin were discussed. Results: Elevated chemerin levels are associated with poor prognosis in gastric cancer and promote invasiveness and metastasis in esophageal cancer. Chemerin receptor antagonists show promising results in inhibiting cancer cell migration, invasion, and progression. Conclusions: Chemerin could represent a valuable prognostic biomarker and therapeutic target for upper GI cancers. Future observational studies should validate its clinical applications and investigate the efficacy of chemerin inhibitors as potential therapeutic targets.