Background/Objectives: Community-acquired pneumonia is a major cause of morbidity and mortality, and various scoring systems and laboratory assessments are available for predicting prognosis. The untapped potential of combining the neutrophil/lymphocyte ratio (NLR) with the monocyte/lymphocyte ratio (MLR) and platelet/lymphocyte ratio (PLR) and their correlation with the pneumonia severity index (PSI) and CURB-65 motivated our research. We thought that this would provide more robust data for predicting CAP prognosis. We aimed to assess hematologic parameters’ associations with the PSI, CURB-65, and qSOFA scores for predicting the prognosis of hospitalized CAP patients. DESIGN AND SETTING: This is a multicenter, observational study conducted in three hospitals in Türkiye, Antalya. Methods: A total of 343 patients hospitalized with CAP in three centers in Turkey, Antalya, between 1 January 2020 and 30 September 2023 were retrospectively enrolled. The demographic data, comorbidities, vital signs, radiological images, laboratory findings, and 30-day mortality results of the patients were recorded. CURB-65, PSI, and qSOFA scores were calculated. Results: This study included 163 females (47%) with an average age of 74 ± 11.8. Hospital mortality occurred in 51 patients. Non-survivor CAP cases had higher ages (p = 0.007), CURB-65 scores (p < 0.001), PSIs (p < 0.001), and qSOFA scores (p < 0.001) and a longer hospital stay (p = 0.001) and total antibiotic duration (p < 0.001). Additionally, the NLR (p = 0.009), MLR (p = 0.018), and PLR (p = 0.025) were higher in the non-survivor group. The CURB-65, PSI, and qSOFA scores demonstrated strong predictive capabilities for in-hospital mortality. In the ROC analysis conducted to predict in-hospital mortality, the area under the curve (AUC) for CURB-65, the PSI, and qSOFA was determined to be 0.83, 0.82, and 0.82, respectively. The NLR correlated positively with CURB-65, the PSI, and qSOFA; the PLR correlated with the PSI and qSOFA; and the MLR correlated with CURB-65. Conclusions: CURB-65 and PSI scores remain highly effective for predicting in-hospital mortality in CAP patients, as demonstrated by their superior AUC values. While the NLR, MLR, and PLR showed weak predictive performance compared to these scores, their correlations suggest their potential as adjunctive markers.

Background and Aims: During liver transplantation, hepatocellular carcinoma (HCC) recurrence remains a critical challenge for patient survival. Targeted therapies, such as sorafenib and regorafenib, have been utilized to manage relapsed HCC in this unique setting. This study aimed to assess the efficacy of Sorafenib and Regorafenib in patients with HCC who experienced recurrence after liver transplantation. We focused on survival outcomes, treatment responses, and the management of side effects in this patient group. Methods: We conducted a retrospective analysis of 73 patients who experienced HCC recurrence post-liver transplantation between 2012 and 2022 across 11 oncology centers in Turkey. Patients were categorized according to Child–Pugh classification and treated with sorafenib as first-line therapy and Regorafenib in case of progression. Survival rates were analyzed using the Kaplan–Meier method, and risk factors were evaluated using Cox regression analysis. Results: Of the 73 patients included in the study, 62 were male (84.9%), and 11 were female (15.1%), with a mean age of 61.5 ± 10.9 years. All patients received sorafenib as first-line treatment. Among patients who experienced progression with sorafenib or discontinued treatment due to toxicity, 45.2% (n = 33) continued treatment with regorafenib. The median progression-free survival (PFS1) time with sorafenib was 5.6 months, and the one-year survival rate was 24.3%. The median progression-free survival (PFS2) time with regorafenib, which was administered as second-line treatment, was also calculated as 5.9 months. Overall survival (OS) duration was determined as 35.9 months. The most common side effects associated with both drugs included fatigue, hand and foot syndrome, and hypertension. Significantly better survival outcomes were shown in the Child–Pugh A group compared to other patients. Conclusions: These results suggest that Sorafenib and Regorafenib treatments offer a survival advantage in patients with relapsed HCC post-transplantation. However, individualized treatment strategies and close follow-up are crucial for optimizing outcomes. Further studies are needed to refine therapeutic protocols and enhance the care of this specific patient group.

Background andAims: During liver transplantation, hepatocellular carcinoma (HCC) recurrence remains a critical challenge for patient survival. Targeted therapies, such as Sorafenib and Regorafenib, have been utilized to manage relapsed HCC in this unique setting. This study aimed to assess the efficacy of Sorafenib and Regorafenib in patients with HCC who experienced recurrence after liver transplantation. We focused on survival outcomes, treatment responses, and the management of side effects in this patient group. Methods: We conducted a retrospective analysis of 73 patients who experienced HCC recurrence post-liver transplantation between 2012 and 2022, across 11oncology centers in Turkey. Patients were categorised according to Child-Pugh classification and treated with Sorafenib as first-line therapy and Regorafenib in case of progression. Survival rates were analysed by Kaplan-Meier method and risk factors were evaluated by Cox regression analysis. Results: Of the 73 patients included in the study, 62 were male (84,9%) and 11 were female (15,1%) with a mean age of 61,5 ± 10,9 years. All patients received sorafenib as first-line treatment. Among patients who experienced progression with sorafenib or discontinued treatment due to toxicity, 45,2% (n=33) continued treatment with regorafenib. The median progression-free survival (PFS1) time with Sorafenib was 5,6 months and the one-year survival rate was 24,3%. The median progression-free survival (PFS2) time with Regorafenib, which was administered as second-line treatment, was also calculated as 5,9 months. Overall survival (OS) duration was determined as 35,9 months. The most common side effects associated with both drugs included fatigue, hand-foot syndrome and hypertension. Significantly better survival outcomes were shown in the Child-Pugh A group compared to other patients. Conclusion: These results suggest that Sorafenib and Regorafenib treatments offer a survival advantage in patients with relapsed HCC post-transplantation. However, individualized treatment strategies and close follow-up are crucial for optimizing outcomes. Further studies are needed to refine therapeutic protocols and enhance the care of this specific patient group.

Introduction and Aim: Cancer affects people psychologically and organically. The emotional state of cancer patients is fragile and can be affected by many factors. We aimed to evaluate the effect of the COVID-19 pandemic on the mood and behavioral changes of cancer patients with solid cancer who are in follow-up and treatment. Material and Method: A face-to-face questionnaire was filled in solid cancer patients without known psychological disorders who applied to the Medical Oncology outpatient clinic between 1-30 September 2021. The Hospital Anxiety and Depression Scale (HADS) and the scale examining the perspectives on COVID-19 were applied to the patients whose consent was obtained. Results: A total of 235 people, participated in the survey. In the review of 202 completed surveys, 139 women and 63 men and the median age was 55 (23-83 years). In the study in which seventeen different solid cancer patients were evaluated, breast (52.5%), colon (19.3%) and lung (10.8%) cancers were most common. Most of the people who were more afraid of COVID-19 compared to cancer were patients who were on active cancer treatment. In the multivariate regression analysis, being on active treatment was found to be the only risk factor for 'being more afraid of COVID-19' compared to cancer. During COVID-19 pandemic, it was observed that 18 (8.9%) patients delayed their treatment/follow-up due to fear of COVID-19 infection. A high HADS anxiety score was observed in 58 (28.7%) patients, and a high HADS depression score was observed in 39 patients (19.3%). Conclusion: Cancer patients are seriously worried about the progression of their cancer due to changes in follow-up or treatment due to COVID-19 pandemic. However, despite the associated risks, they were found to want to continue their treatment as planned.

Background: Metastasectomy is a cornerstone of multimodal management in metastatic colorectal cancer (mCRC), yet contemporary real-world data focusing specifically on RAS wild-type (RAS-WT) disease remain limited. We aimed to evaluate survival outcomes and prognostic factors associated with metastasectomy in patients with RAS-WT mCRC using a large national multicentre registry. Methods: This retrospective cohort study utilized data from the ONKO-KOLON Türkiye registry. A total of 1079 patients with pathologically confirmed KRAS/NRAS wild-type mCRC were identified and categorized according to receipt of metastasectomy. Overall survival (OS) and progression-free survival (PFS) were estimated using the Kaplan–Meier method and compared with log-rank tests across multiple clinically relevant time origins, including metastatic diagnosis, initial colorectal cancer diagnosis, and time of metastasectomy. Prognostic factors within the metastasectomy cohort were assessed using univariate Cox proportional hazards models. Serum CEA and CA19-9 were analyzed after log₁₀ transformation. Results: Among 1079 patients, 185 (17.1%) underwent metastasectomy. Patients receiving metastasectomy demonstrated significantly longer OS compared with those managed non-surgically when survival was calculated from the time of metastatic diagnosis (hazard ratio [HR] for death 0.36, 95% CI 0.27–0.47; p < 0.001), as well as improved PFS (HR for progression or death 0.39, 95% CI 0.30–0.52; p < 0.001). The survival advantage remained consistent when OS was measured from the time of initial colorectal cancer diagnosis (HR 0.37, 95% CI 0.25–0.50; p < 0.001). Median OS following metastasectomy was 43 months (95% CI 31.4–45.6). In univariate analyses within the metastasectomy cohort, higher baseline CA19-9 levels were significantly associated with inferior OS when analyzed both as a continuous variable (per log₁₀ increase; HR 1.81, 95% CI 1.20–2.75; p = 0.005) and as a categorical variable (above vs. below threshold; HR 0.37, 95% CI 0.16–0.86; p = 0.021). Other clinicopathologic factors, including age, CEA, tumor sidedness, grade, MSI status, and metastatic burden, were not significantly associated with survival. Conclusions: In this large, real-world national cohort of RAS-WT mCRC, metastasectomy was strongly associated with prolonged survival across multiple clinically relevant time frames. Within surgically treated patients, baseline CA19-9 emerged as the most informative prognostic marker, while traditional clinicopathologic variables showed limited discriminatory value. These findings highlight the importance of careful patient selection and support further prospective studies integrating molecular and biomarker-based strategies to refine prognostication and optimize surgical decision-making in RAS-WT mCRC.

Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality globally, and factors such as biomass exposure, demographic characteristics, and comorbidities significantly influence patient outcomes during exacerbations. Aim: This study aims to clarify the impact of patient characteristics on key hospital outcomes, including ICU admissions, hospital length of stay, and in-hospital mortality, focusing on the contextual role of biomass exposure rather than its direct impact. Methods: Using a multicenter, retrospective cohort design, we analyzed the medical records of patients admitted with COPD exacerbations from January 2021 to December 2023. Eligible patients were over 40 years old with confirmed COPD exacerbation, excluding those with other significant lung conditions, severe organ dysfunction, or incomplete data. The collected data included demographics, smoking history, comorbidities, medications, laboratory results, and clinical outcomes, with smoking status categorized into current, former, or never smokers. Results: Our analysis comprised 334 patients with a mean age of 69 ± 8.8 years, including 52 (15.6%) females. Biomass exposure, observed in 22% of patients, was associated with a higher likelihood of being female (p < 0.001), lower smoking rates (p < 0.001), higher prevalence of diabetes mellitus type 2 (p = 0.020), lower peripheral blood eosinophilia (p = 0.001), increased intensive care unit (ICU) admissions (p = 0.034), and higher in-hospital mortality (p = 0.043). Non-survivors tended to be older and had a higher prevalence of hypertension, a history of childhood pneumonia, longer COPD duration, greater need for non-invasive ventilation (NIV) during hospitalization, and more frequent ICU admissions. Univariate Cox regression analysis revealed no significant associations between characteristics and outcomes. Conclusions: Patients with biomass exposure were more likely to be female and had higher rates of ICU admission and in-hospital mortality.