Background and Objectives: The systemic immune-inflammation index (SII), derived from peripheral blood parameters, has emerged as a novel marker reflecting the balance between host immunity and tumor-related inflammatory burden. This study aimed to investigate the prognostic impact of baseline SII on survival outcomes in patients with gastric or gastroesophageal junction (GEJ) cancer undergoing perioperative FLOT (5-fluorouracil, leucovorin, oxaliplatin, and docetaxel) chemotherapy. Materials and Methods: In this retrospective study, 168 patients with histologically confirmed gastric or GEJ cancer who received perioperative FLOT therapy were included. SII was calculated using the formula: SII = (Platelets × Neutrophils)/Lymphocytes. ROC curve analysis determined the optimal SII cutoff for predicting mortality. Patients were categorized into low (SII ≤685) and high (SII >685) groups. Overall survival (OS) and disease-free survival (DFS) were evaluated using Kaplan–Meier analysis and compared via the log-rank test. Cox proportional hazards regression models were used for univariate and multivariate analysis. Results: The optimal cutoff value for SII was determined to be 685 (AUC: 0.652, 95% CI: 0.558–0.747, p = 0.003). High SII was significantly shorter OS (17.4 vs. 28.2 months, p = 0.001) Multivariate analysis identified high SII (HR = 1.88, 95% CI: 1.36–2.89, p = 0.039), advanced T stage (HR = 3.693, p < 0.001), poor treatment response (HR = 0.36, p < 0.001), and ECOG-PS ≥1 (HR = 3.297, p < 0.001) as independent predictors of mortality. Conclusions: Elevated baseline SII is an independent predictor of worse OS and DFS in gastric and GEJ cancer patients receiving perioperative FLOT chemotherapy. SII may serve as a practical and inexpensive biomarker to support risk stratification and personalized treatment decisions.

The aim of our study was to evaluate the incidence of KRAS/NRAS and BRAF mutations, analyze molecular patterns, and investigate associations with clinical parameters of these mutations in CRC KRAS/NRAS and BRAF mutations analyzed by next-generation sequencing. The detection rates of these mutations and patients’ demographics were recorded and the relationship between them was evaluated using the chi-square test. KRAS mutation was detected in 332 of 694 patients, while the mutation rates in KRAS exons 2/3 and 4 were 39.6%/3.2% and 5%, respectively. The most common mutation pattern was KRAS G12D. Five atypical variants were detected: V14I in KRAS exon 2, A18D, Q22K and T50I in exon 3, and T148P in exon 4. NRAS mutation was detected in 29 (4.5%) patients. One atypical variant L80W was detected in NRAS exon 3. BRAF mutation was seen in 37 (5.3%) patients, with BRAF^V600E (83.8%) being the most common mutation pattern. NRAS mutation was significantly more frequent in patients > 64 years of age, BRAF mutation in women, and NRAS/BRAF mutations in right colon tumors. Grouping BRAF mutations into BRAF^V600E and BRAF^non-V600E and their analysis according to specific tumor localizations showed that all four BRAF^non-V600E mutations originated in the rectum. In our study, KRAS exon 2 and other RAS mutation rates were higher than in the literature, while the BRAF v.600E mutation rate was similar. NRAS and BRAF mutations were significantly more frequent in the right colon. BRAF mutation was more common in women and in the right colon.

Objective: The aim of our study was to assess the impact of the combination of HALP score with TTCR score on OS and PFS in PC patients who developed castration resistance.Patients and methods: The study enrolled 152 patients with metastatic disease who had received either ARTAs or docetaxel as first-line treatment. The median cut-off was 30.83 months for the HALP score and 16.1 months for TTCR determined by ROC analysis. Based on these cut-off values, patients were categorized into low-high HALP score and TTCR <16.1 months-TTCR ≥16.1 months groups. The combination of HALP score and TTCR was then stratified by risk into three new groups: Factor 0, Factor 1, and Factor 2.Results: PFS was significantly shorter in the TTCR <16.1 months group compared to the TTCR ≥16.1 months group, as well as in the low-HALP score group compared to the high-HALP score group. Furthermore, as the number of factors increased, a significant increase in OS and PFS was observed in the groups formed by the combination of HALP score and TTCR.Conclusion: We have validated the predictive capability of combining low HALP score (<30.38) and short TTCR (<16.1 months) parameters in estimating the OS and PFS durations of mCRPC patients, both recognized as unfavorable prognostic indicators.

Objective: The Prognostic Nutritional Index (PNI), reflects the nutritional and immunological status of the patient and has been associated with outcomes in various cancers. In this study, the prognostic significance of PNI in metastatic hormone‐sensitive prostate cancer (mHSPC) and its potential role in guiding treatment decisions between abiraterone acetate and enzalutamide is investigated.Methods: Retrospective analysis was performed on 167 mHSPC patients treated between 2019 and 2024. PNI was calculated using the formula: 10 × serum albumin (g/dL) + 0.005 × total lymphocyte count (/mm³). Patients were stratified into high and low PNI groups according to a cutoff value of 49.98, determined via receiver operating characteristic (ROC) analysis. Survival outcomes, including overall survival (OS), radiographic progression‐free survival (rPFS), and PSA progression‐free survival (PSA‐PFS), were assessed. Treatment responses to abiraterone acetate and enzalutamide were compared within PNI strata.Results: Patients with PNI > 49.98 had significantly longer median OS than those with PNI ≤ 49.98 (36.6 months vs. 30.0 months, p < 0.01). Multivariate analysis identified high PNI, ECOG performance status 0–1, and absence of visceral metastasis as independent predictors of improved OS. Among patients with low PNI, those treated with enzalutamide had superior OS compared to those receiving abiraterone acetate (p = 0.004), while no significant OS difference was noted between treatments in the high PNI group (p = 0.55).Conclusion: PNI serves as a significant prognostic biomarker in mHSPC, correlating with overall survival and potentially influencing treatment efficacy between abiraterone acetate and enzalutamide. Integrating PNI into clinical practice may aid in tailoring individualized treatment options.

Background: The clinical impact of HER2‐low status on the efficacy of cyclin‐dependent kinase 4/6 inhibitor (CDK4/6i). Therapy in patients with hormone receptor‐positive (HR+), HER2‐negative metastatic breast cancer (MBC) remains unclear. Methods: We conducted a multicenter, retrospective analysis including 212 female patients with HR+/HER2−MBC treated with CDK4/6is between 2018 and 2022. Patients were classified as HER2‐zero or HER2‐low based on immunohistochemistry results. Progression‐free survival (PFS), objective response rate (ORR), and disease control rate (DCR) were compared between the two groups. Results: Median PFS was 16.0 months in the HER2‐low group and 13.9 months in the HER2‐zero group ( p = 0.40). In first‐line therapy, PFS was numerically longer in the HER2‐low group (18.6 vs. 14.9 months; p = 0.26) although this was not statistically significant. ORR was 71.4% in HER2‐low and 62% in HER2‐zero patients, and DCR was 86.6% and 82%, respectively (both p > 0.05). Subgroup analyses showed that within the HER2‐low group, patients with ≥ 2 metastatic sites had significantly shorter PFS compared with those with a single site (14.1 vs. 20.2 months; p = 0.02), and the presence of visceral metastases was associated with poorer PFS ( p = 0.003). Overall survival (OS) data were immature, with only 24.6% of the patients deceased at the time of analysis. Conclusion: HER2 status did not significantly impact treatment outcomes with CDK4/6i in HR+/HER2‐negative MBC patients. However, subgroup analyses indicated that metastatic burden, particularly the number of metastatic sites and the presence of visceral disease, may adversely influence PFS. These findings highlight the need for further validation in larger prospective studies.

Comprehensive Mapping of Psychosocial Burden in Breast Cancer: A Multicenter Cross-Sectional Study in Türkiye - Namık Kemal Medical Journal