Background/ aim: Post - traumatic growth (PTG) is defined as positive psychological changes following a challenging or traumatic life event. The purpose of this study is to define the predictors of PTG and death anxiety (DAN) in caregivers of cancer patients and evaluate the impact of DAN on PTG. Materials/ Methods: The caregivers of cancer patients were evaluated with structured questionnaires, including validated PTG scale and Templer death anxiety scale. Results: In 3 different cancer centers, 426 participants were evaluated. In multivariate analysis of factors associated with PTG, a high DAN score was the only parameter associated with high PTG scores. (OR: 1.6, CI (95%) 1.02?2.5, p = 0.03). In multivariate analysis of factors associated with DAN, the female gender was the only risk factor for high DAN scores. (OR: 1.6, CI(95%) 1.1?2.8, p = 0.049). There was a positive correlation between PTG and DAN scores (r = 0.15, p = 0.001). Higher DAN scores were associated with positive impacts on self - perception (37.0 vs 35.0, p = 0.02), philosophy of life (16.0 vs 13.0, p = 0.035) and changes in relationship (16.0 vs 14.0, p = 0.01) Conclusions: It is the first report regarding the association between DAN and PTG. We found a positive impact of death anxiety on psychological changes in caregivers of cancer patients.

Amaç: Çalışmamızda, torasik bölgeye radyoterapi (TRT)/ kemoradyoterapi (KRT) +/- immünoterapi (İO) alan hastalarda gelişen radyasyon pnömoniti sürecini ve etki eden faktörlerin ortaya konulması amaçlanmıştır. Yöntem: TRT alan hastaların verileri retrospektif olarak tarandı ve radyasyon pnömoniti gelişen 26 hastanın verileri analiz edildi. Bulgular: Hastaların ortanca yaşı 54.5 iken çoğu erkekti. Hastaların çoğunluğunda primer tanı akciğer kanseri idi. Ondört hasta (%53.8) eş zamalı KRT alırken, 13 hasta (%50) IO ile eş zamanlı RT almıştı. Toplamda ise 17 hasta (%65.4) tedavi sürecinde IO almıştı. Median RT dozu 44 Gy idi. Hastalarda RT ile pnömonit gelişene kadar geçen süre ortanca 5.8 ay iken IO başlangıcından pnömonitis gelişene kadar geçen süre ortanca 6.2 aydı. 20 hastada (%76.9) grad 2, 3 hastada (%11.5) grad 3 ve 3 hastada (%11.5) grad 1 pnömonitis görülmüştü. En sık görülen tomografi bulguları konsolidasyon ve septal kalınlaşma ve distorsiyon ile 5 hastada retikülonodüler görünüm ve 3 hastada buzlu cam görünümü şeklindeydi. Ortanca steroid kullanımı 1.95 ay idi . 14 hastada (%53.8) steroid dozu 1 mg/kg dozuna kadar çıkılmıştı. Ortanca 22.5 aylık takip süresinde, ortanca PFS 28.8 ay ve ortanca OS 54.1 aydı. Hiçbir hastada RT pnömonitine bağlı ölüm gözlenmedi. Grad 2-3 RT pnömoniti gelişimine etki eden faktörlerin analizi yapıldığında, her hangi bir predikte edici anlamlı faktör gösterilemedi. Sonuç: Çalışmamızda KRT+İO alan hastalarda RT pnömoniti İO almayanlara kıyasla daha fazla görülmedi. Fakat hasta sayısı az olduğu için daha fazla hasta sayıları ile geniş kapsamlı karşılaştırmalı çalışmalara ihtiyaç bulunmaktadır. RT pnömoniti zamanında akla getirilmediğinde ciddi mortal olabilen fakat erken farkedilerek, doğru tedavi edildiğinde yönetilebilir bir klinik antitedir.

Menopausal status, and glucose tolerance in endocrinology outpatients. Material and Methods: A total of 178 endocrinology outpatients with oral glucose tolerance test (OGTT) findings were included. Data on anthropometrics [body mass index (BMI), waist circumference (cm), body fat percentage (BFP), and fat mass], glycemic parameters [fasting blood glucose (FBG), insulin), C-peptide, HbA1c, and insulin resistance (HOMA-IR)], blood lipids, and serum osteocalcin (OCN) levels [total osteocalcin (tOCN) and uncarboxylated osteocalcin (uOCN)] were compared with sex, menopausal status, and glucose tolerance status. Results: No significant difference was noted in the tOCN and uOCN levels concerning gender and menopausal status. tOCN was negatively correlated with BMI, waist circumference, BFP, and fat mass in patients with normal glucose tolerance (p

Amaç: Hepatoselüler karsinom, dünya genelinde önemli bir sağlık sorunu olan bir karaciğer kanseridir. Çoğu hasta unrezektabl evrede tanı alır. Lokal bölgesel tedaviler ve sorafenib gibi sistemik tedaviler, Hepatoselüler kanser tedavisinde kullanılan önemli yöntemlerdir. Bu çalışmada, Lokal bölgesel tedaviler ve sorafenib kombinasyonunun Hepatoselüler kanser hastalarındaki etkinliği ve güvenilirliği retrospektif olarak araştırılmıştır. Gereç ve Yöntem: 2018 2023 yılları arasında Medipol Mega Üniversite Hastanesi’nde takip edilen 20 Hepatoselüler kanser tanılı hasta çalışmaya dahil edildi. Hastaların tümüne Lokal bölgesel tedaviler ve sorafenib tedavisi uygulandı. Progresyonsuz sağkalım ve genel sağkalım süreleri, yan etkiler ve prognostik faktörler değerlendirildi. Bulgular: Kombinasyon tedavi sonrası objektif yanıt oranı %90, hastalık kontrol oranı %95 olarak bulundu. Ortanca progresyonsuz sağkalım 11,1 ay, ortanca genel sağkalım 18,6 ay olarak saptandı. Çok değişkenli analizde, progresyonsuz sağkalım için lokal bölgesel tedavi tipi ve nakil varlığı, genel sağkalım için ise ECOG performans durumu bağımsız prognostik faktörler olarak belirlendi. En sık görülen yan etki dermatolojik yan etkiler oldu. Sonuç: Çalışmamız, Hepatoselüler Kanser hastalarında Lokal bölgesel tedaviler ve sorafenib kombinasyonunun güvenli ve etkili olabileceğini göstermektedir. Bu kombinasyon, progresyonsuz sağkalım ve genel sağkalım sürelerini uzatabilir. Ancak, bu konuda daha büyük, prospektif çalışmalara ihtiyaç vardır.

Background: Lymph node metastasis (LNM) is a major determinant of prognosis in gastric adenocarcinoma. Although lymphovascular invasion (LVI) and perineural invasion (PNI) are established markers of aggressive tumor behavior, their combined association with nodal dissemination has not been systematically evaluated. This study investigated the relationship between invasive histopathologic features and LNM and developed a composite invasion score. Methods: This retrospective study included 395 patients with gastric adenocarcinoma. Clinicopathological analyses involving LNM were performed in the surgical resection cohort. A composite invasion score (0–2) was generated based on the presence of LVI and PNI. Associations with LNM, metastatic lymph node burden, and lymph node ratio (LNR) were evaluated using non-parametric tests and multivariable logistic regression. Predictive performance was assessed using receiver operating characteristic (ROC) analysis. An exploratory external transcriptomic analysis was performed using the GSE15459 dataset. Results: Both LVI and PNI were significantly associated with LNM (both p < 0.001). The composite invasion score showed a stepwise association with nodal dissemination, with median metastatic lymph node counts increasing from 0 in score-0 tumors to 3.5 in score-1 and 9 in score-2 tumors (p < 0.001). After adjustment for pathological T stage, histological grade, Lauren classification, age, and tumor location, the composite invasion score remained an independent predictor of LNM (OR = 4.53, 95% CI: 1.81–13.00, p = 0.002). LNR also increased significantly across score categories (p < 0.001). The composite invasion score demonstrated good discriminatory performance for LNM (AUC = 0.848, 95% CI: 0.773–0.923). The exploratory transcriptomic analysis demonstrated significant upregulation of MMP11, MMP14, and FAP in advanced-stage tumors, consistent with increased extracellular matrix remodeling and stromal activation. Conclusions: A simple composite invasion score integrating LVI and PNI is independently associated with lymph node metastasis and metastatic burden in gastric adenocarcinoma. The accompanying exploratory transcriptomic analysis provides biological context for these clinicopathological findings by demonstrating stage-associated extracellular matrix remodeling rather than direct molecular validation of the proposed score. These findings support the potential utility of the composite invasion score as a postoperative pathology-derived risk stratification tool.

Objective: Among recently developed treatment strategies for advanced prostate cancer, 177Lu-PSMA-617–based radioligand therapy has shown considerable clinical potential in patients with metastatic castration-resistant disease. However, predictors of treatment response and survival outcomes remain incompletely defined. Methods: This retrospective analysis included 38 patients who received up to 6 cycles of 177Lu‑PSMA‑617 (4.0-6.8 GBq/cycle; mean 5.5 GBq) administered every 6-9 weeks. Clinical variables, laboratory findings, and prostate-specific membrane antigen–positron emission tomography/computed tomography metrics, including prostate-specific antigen (PSA), alkaline phosphatase (ALP), and maximum standardized uptake value (SUVmax), were evaluated for their association with treatment response, progression‑free survival (PFS), and overall survival (OS). Results: At the time of analysis, the median follow-up duration was 12.2 months (range: 1.1-65.8 months). Median PFS was 5.8 months, whereas median OS reached 12.3 months. Objective response to therapy was observed in 36.8% of the study population. Adverse events were common, occurring in 86.8% of patients overall, with grade 3-4 toxicities recorded in 57.9% of cases. Posttherapy SUVmax below 4 independently predicted prolonged PFS, whereas Eastern Cooperative Oncology Group (ECOG) performance status, ALP, PSA, and post‑treatment SUVmax independently influenced OS. Conclusion: 177Lu-PSMA-617 demonstrated meaningful clinical activity in this heavily pretreated cohort. However, the relatively high frequency of severe treatment-related toxicities highlights the importance of careful patient selection and close clinical monitoring. Functional imaging findings (post-treatment SUVmax), together with ECOG performance status and biochemical markers, may improve prognostic stratification in patients receiving this therapy. Cite this article as: Karcı E, Atasever T,Ç.akır T, et al. Real-world outcomes of lu-PSMA-617 radioligand therapy in elderly patients with metastatic castration-resistant prostate cancer. Cerrahpaşa Med J. 2026, 50, 0082, doi: 10.5152/cjm.2026.26082.