The prognostic nutritional index (PNI) is a prognostic nutritional-immune marker, but its association with long-term mortality and phenotypic aging among adults with a history of digestive system cancer is uncertain. We analyzed 338 adults with self-reported digestive system cancer in NHANES 1999-2010 and 2015-2018. PNI was modeled continuously and using sample-derived categories (≤48, >48-52, and >52). In the fully adjusted Cox model, each 1-unit higher PNI was associated with lower all-cause mortality (hazard ratio [HR], 0.91; 95% confidence interval [CI], 0.88-0.95), while HRs were 0.47 (0.31-0.70) and 0.42 (0.28-0.62) for the middle and highest categories versus the lowest. Restricted cubic splines indicated nonlinearity, with the main separation occurring between the lowest category and the two higher categories. PNI correlated inversely with PhenoAgeAccel (Spearman ρ = -0.241). Exploratory pathway analysis suggested an indirect-effect component through PhenoAgeAccel; after removing albumin- and lymphocyte-related terms from the aging construct, the estimated indirect-effect proportion decreased from 26.3% to 16.1%. Higher PNI was associated with lower mortality, but the sample-derived thresholds and aging-pathway findings require cautious, noncausal interpretation.

Alcohol consumption is a known risk factor for various cancers, but the dose-response relationship between alcohol intake and pancreatic cancer risk remains unclear. This meta-analysis aimed to evaluate the dose-response relationship between them. A search was conducted in PubMed, Web of Science, and Embase for prospective cohort studies up to February 10, 2026. Ten high-quality studies were identified, involving 22,365,829 participants and 21,255 cases. Comparing the highest with the lowest alcohol consumption categories, the pooled relative risk (RR) was 1.19 (95% CI: 1.10-1.28). No nonlinear association was observed in the dose-response analysis (p = .195). For every 10-gram increase in daily alcohol intake, the risk of pancreatic cancer increased by 5% (RR = 1.04, 95% CI: 1.03-1.05). This linear association was also suggested in the never-smoker subgroup and appeared consistent across genders and regions. Alcohol consumption appears to increase the risk of pancreatic cancer in a linear dose-response manner, although the risk elevation at light drinking levels (e.g., below approximately 15 g/day) was not statistically significant.

Nutrition is a critical component of cancer care, influencing treatment tolerance, nutritional status, quality of life, and overall clinical outcomes. Patients with cancer often face complex and sometimes conflicting dietary information, making food and nutrition literacy-the ability to access, understand, evaluate, and apply nutrition information-particularly important. Despite growing interest, evidence on nutrition literacy in oncology remains fragmented and conceptually heterogeneous. This systematic review synthesizes quantitative evidence on food and nutrition literacy and related constructs among adults with cancer and examines associations with clinical, nutritional, behavioral, and healthcare-related outcomes. Following Joanna Briggs Institute and PRISMA guidelines, five databases were searched for peer-reviewed studies published in English. Nineteen studies (2013-2025) met the inclusion criteria. Overall, higher levels of nutrition literacy were consistently associated with healthier dietary behaviors, improved diet quality, better nutritional status, higher quality of life, and greater self-management capacity. Intervention studies suggested that literacy-focused nutritional education may reduce treatment-related symptoms and improve psychosocial outcomes, with limited evidence indicating possible reductions in healthcare utilization. Despite variability in terminology and measurement tools, findings highlight nutrition literacy as a meaningful and modifiable determinant in cancer care, underscoring the need for clearer conceptual frameworks and validated oncology-specific instruments.

Carrots are a rich dietary source of carotenoids and polyacetylenes, bioactive compounds with demonstrated anti-inflammatory and anticancer properties in experimental models. Epidemiological evidence suggests that carrot consumption is associated with a reduced risk of colorectal cancer; however, clinical data linking carrot intake to molecular changes in premalignant colorectal tissue remain limited. In this pilot intervention study, 20 patients with advanced colorectal adenomas were enrolled. Fifteen participants consumed carrot juice daily for 21 days, while five served as untreated controls. Paired adenoma biopsies were collected before and after the intervention and were analyzed using gene expression microarrays to assess transcriptional responses. Carrot juice intake was well tolerated, with adherence exceeding 95% and no reported adverse events. Transcriptomic analysis revealed modulation of key pathways implicated in colorectal carcinogenesis, including downregulation of the WNT, PI3K-AKT, and MAPK signaling pathways, as well as cyclooxygenase-2-related inflammatory pathways and cytokine signaling. These changes were consistent with reduced oncogenic signaling and attenuation of inflammatory activity within adenoma tissue. In summary, short-term carrot juice consumption was associated with coordinated suppression of molecular pathways involved in colorectal adenoma progression. These findings provide preliminary clinical evidence that a whole-food dietary intervention may influence early carcinogenic processes and support the need for larger controlled studies evaluating clinical outcomes.

This study aimed to assess the impact of a dietary intervention on changes in adiposity and oxidative stress markers and the associations between these changes in overweight and obese breast cancer survivors. This quasi-experimental pre-test-post-test study included 25 overweight or obese (BMI: 25-40 kg/m[2]) female breast cancer survivors. Participants followed an energy-restricted Mediterranean diet for 8 wk. Anthropometric measurements, body composition, and biochemical markers were assessed pre- and post-intervention. Correlation analyses examined associations between changes in adiposity indices and oxidative stress markers. After the 8-week intervention, significant reductions were observed in BMI, body fat percentage, fat mass, BFMI, body weight, waist circumference, and visceral adiposity index (all p < 0.001). CRP, TNF-α, and MDA levels also decreased significantly. Moderate positive associations were identified between ΔMDA and changes in body weight, ΔBFMI, and body fat percentage, whereas the association with fat mass was not statistically significant (p = 0.050). These associations were attenuated after adjustment for age and disease stage. An energy-restricted Mediterranean diet may contribute to reductions in adiposity and improvements in inflammatory and oxidative stress markers in overweight and obese breast cancer survivors. These preliminary findings require confirmation in adequately powered controlled trials.

With advances in surgical treatment for gastric cancer and improvements in long-term prognosis, increasing attention has been directed toward late nutritional complications. This retrospective study focused on body composition as an indicator of nutritional status, aiming to elucidate mid- to long-term changes following minimally invasive gastrectomy (MIG). A total of 102 3-year cancer survivors who underwent curative laparoscopic or robotic gastrectomy were included. Body composition indices, including subcutaneous fat, visceral fat, and skeletal muscle, were calculated using multidetector computed tomography images. All indices decreased relative to preoperative levels and remained lower during long-term postoperative follow-up. The reduction was more pronounced during the mid-term period. Although the body fat indices demonstrated a slight trend toward recovery, skeletal muscle showed persistently reduced levels in the long term. Multiple regression analysis revealed that only total gastrectomy (MITG) was identified as an independent predictor of reductions in all indices (all P < 0.01). When stratified by the extent of gastrectomy, the postoperative values of all indices were lower in the MITG group than in the distal gastrectomy group. To address late nutritional complications following MIG, particular attention should be paid to the mid-postoperative period, when nutritional status reaches its lowest point, as well as to patients undergoing MITG.

Fasting-mimicking diet (FMD) exerts antitumor effects in multiple cancer types, but the role of neural regulation remains unclear. Here, we investigated the involvement of peripheral and central nervous systems in FMD-mediated suppression of colorectal cancer using a murine MC38 tumor model. Cyclic FMD treatment significantly inhibited tumor growth. Three-dimensional imaging revealed abundant neural fibers within colorectal tumor tissues. To assess the contribution of distinct neural pathways, enteric denervation, vagotomy, sympathetic denervation, and sensory nerve ablation were performed. Enteric denervation markedly attenuated the antitumor effect of FMD, whereas vagal, sympathetic, and sensory denervation had limited impact. In addition, c-Fos immunofluorescence demonstrated region-specific central neural responses to FMD, including increased neuronal activation in the arcuate nucleus and insular cortex and altered activity in the rostral ventrolateral medulla. These findings suggest that neural signaling contributes to the antitumor effects of FMD and implicate enteric nerves in this response. Our study highlights the potential involvement of both peripheral and central neural pathways in the regulation of colorectal cancer progression during dietary intervention.

Purpose: Acute Myeloid Leukemia (AML) is a highly aggressive hematological malignancy driven by mutations in early hematopoietic cells, leading to uncontrolled myeloid cell proliferation. The development of efficacious and less toxic therapies remains a critical challenge.Methods: Herein, we evaluated the anti-leukemic potential of a 70% tocotrienol-enriched fraction (TEF), a vitamin E isoform, using different AML models.Results: TEF demonstrated selective cytotoxicity against AML cells, evidenced by low IC50 values and significant induction of apoptosis in AML cell lines and primary AML patient samples, with minimal impact on nonmalignant cells. Mechanistic studies revealed that the TEF treatment disrupted mitochondrial function, leading to reduced mitochondrial membrane potential and ROS generation in AML cells. This triggered the intrinsic apoptotic pathway, as indicated by decreased BCL2 and increased active caspase-3 levels. In a 3D bone marrow niche co-culture system, the treatment with TEF effectively diminished AML cell populations (OCI-AML3 and primary AML cells) while preserving mesenchymal stromal cells and endothelial cells. Importantly, administration of TEF reduced AML burden in leukemic mice.Conclusions: These comprehensive results suggest that the 70% tocotrienol-enriched fraction holds significant promise as a selective anti-neoplastic agent for AML, capable of targeting leukemic cells even within the protective bone marrow microenvironment.

Although anamorelin improves appetite and body composition in cancer cachexia, early discontinuation is common. We aimed to evaluate predictors of 12-week treatment completion and longitudinal changes among patients who completed treatment. This single-center, retrospective study included patients with advanced gastrointestinal cancer who received anamorelin for cachexia (July 2021-March 2025). Baseline factors were compared between continuation and discontinuation groups, and predictors were assessed using multivariable logistic regression. Of 89 eligible patients, 36 (40.4%) completed 12 wk of treatment. In multivariable analyses, Eastern Cooperative Oncology Group (ECOG) performance status (PS) ≥1 (OR, 0.39; 95% CI, 0.15-0.98; p = 0.048) and neutrophil-to-lymphocyte ratio (NLR) ≥3.0 (OR, 0.35; 95% CI, 0.12-0.95; p = 0.047) were associated with lower treatment completion. In another model, NLR ≥3.0 remained significantly associated with lower treatment completion, while concurrent systemic anticancer therapy at anamorelin initiation showed a nonsignificant association with treatment completion (OR, 4.42; 95% CI, 0.92-43.07; p = 0.064). In the continuation group, nutritional status, body composition, handgrip strength, and anorexia-related symptoms improved, whereas NLR increased. Impaired ECOG PS and elevated NLR were associated with failure to complete 12-week anamorelin treatment. Earlier initiation of anamorelin before performance status declines and systemic inflammation progresses may support treatment completion.

Weight loss is a common symptom in patients with esophageal cancer and can negatively impact survival outcomes. This meta-analysis aimed to systematically evaluate the relationship between weight loss and survival outcomes in individuals diagnosed with esophageal cancer. We conducted a comprehensive search of PubMed, Embase, and Web of Science for studies reporting the association between weight loss and overall survival or progression-free survival in patients with esophageal cancer. Pooled adjusted hazard ratios (HR) and 95% confidence intervals (CI) were calculated using a random-effects model. Eleven studies involving 3,566 esophageal cancer patients were included. The pooled results indicated that weight loss was significantly associated with poorer overall survival (HR 1.68; 95% CI 1.49-1.90) and progression-free survival (HR 1.61; 95% CI 1.39-1.86). Subgroup analyses revealed a numerically higher HR for overall survival in patients aged 60 years or younger, those assessed for weight loss during treatment, patients with a follow-up duration exceeding 36 months, and individuals diagnosed with squamous cell carcinoma. Weight loss was significantly associated with poorer overall survival in patients with esophageal cancer. Regarding progression-free survival, a preliminary pooled analysis based on only two studies suggested a potential association; however, this finding requires confirmation in future research.

In gastric cancer (GC) patients, malnutrition is associated with a worse prognosis. Decreases in body mass index (BMI) can reflect malnutrition. Here, we determined whether preoperative time-dependent changes (Δ/day) in BMI provide better prognostic insights than single point-in-time measurements of BMI. A single-center retrospective analysis of 140 GC patients was performed. BMI was measured at both the initial surgical visit and then again at the time of hospitalization for surgery. ΔBMI/day was determined. Associations with time to surgery, intraoperative blood loss, tumor stage, and survival were determined. ΔBMI/day was strongly associated with time to surgery (P = 0.001), magnitude of intraoperative blood loss, tumor stage, progression-free survival (PFS), and overall survival (OS) (all Ps <0.001). In multivariable Cox analyses adjusted for age, sex, Eastern Cooperative Oncology Group Performance Status, pathological stage, surgical approach, blood loss, time-to-surgery, and static BMI measurements, large ΔBMI/day was associated with worse PFS (hazard ratio 2.81, 95% confidence interval 1.07-7.42, P = 0.037) whereas static measurements of BMI at the time of the initial visit or surgery were not independently associated with PFS. ΔBMI/day was not independently associated with OS. In conclusion, preoperative changes in BMI/day provide better prognostic insights, particularly for PFS, compared to measurements of BMI at a single point in time.