Aims: The COVID-19 pandemic disrupted diagnostic services worldwide, particularly gastrointestinal (GI) endoscopy, raising concerns about delayed diagnoses and stage migration in gastric cancer. Helicobacter pylori (H. pylori), a key factor in gastric carcinogenesis, may also influence mucosal susceptibility to SARS-CoV-2. However, data on how these disruptions affected gastric cancer profiles remain limited. To compare clinical, endoscopic, and pathological features of patients undergoing upper GI endoscopy during and after the COVID-19 pandemic, and to evaluate the association between nutritional status and tumor burden in gastric cancer patients. Methods: This retrospective cohort study included 478 patients who underwent diagnostic upper GI endoscopy due to dyspeptic or alarm symptoms at a tertiary care center in Turkiye. Patients were divided into two groups: pandemic (June 2021 to June 2022; n=216) and post-pandemic (May to October 2023; n=262). Demographics, symptoms, endoscopic and histopathological findings, and body-mass index (BMI) were analyzed. Statistical methods included t-tests, Chi-square tests, logistic regression, and Spearman correlation. Results: Patients evaluated during the pandemic more frequently reported alarm symptoms and had significantly lower weight and BMI. H. pylori positivity (41.7% vs. 28.2%; p=0.03), peptic ulcer (16.7% vs. 8.4%; p=0.04), and gastric cancer (7.4% vs. 2.3%; p=0.02) were all more prevalent in the pandemic group. Among 22 patients with gastric cancer, those diagnosed during the pandemic exhibited more advanced disease (T3-T4: 75.0% vs. 33.3%; p=0.02), more frequent nodal involvement (62.5% vs. 16.7%; p=0.01), and BMI. Pandemic-period endoscopy remained an independent predictor of advanced-stage gastric cancer in multivariable analysis (OR=3.41; 95% CI: 1.31-8.88; p=0.008). Strong inverse correlations were found between BMI and tumor depth (p=-0.73), and between BMI and nodal involvement (p=-0.87). Conclusion: The COVID-19 pandemic was associated with diagnostic delays and increased frequency of advanced-stage gastric cancer. BMI showed a strong inverse relationship with tumor aggressiveness and has potential to serve as a practical indicator of disease burden. These findings underscore the importance of preserving access to endoscopic diagnostics and highlight the prognostic value of nutritional parameters during public health emergencies.

Background and Objectives: Anorectal malignant melanoma (ARMM) is a rare and aggressive mucosal melanoma with a poor prognosis. Due to its rarity and nonspecific clinical presentation, diagnosis is often delayed, and prognostic data remain limited. Methods: In this retrospective study, 17 patients diagnosed with ARMM were identified from a cohort of 404 malignant melanoma cases treated at our center; however, only 14 patients with complete clinical and pathological data were included in the final analysis. Demographic, clinical, and histopathological data were collected. Disease stage, treatment modalities, and survival outcomes were analyzed. Event-free survival (EFS) and overall survival (OS) were calculated, and potential prognostic factors were evaluated using univariate and multivariate analyses. Results: The mean age at diagnosis was 58 ± 12 years, and six patients (42.9%) were female. The median follow-up duration was 13.3 months, and the median OS was 12.6 months. Six patients (42.9%) were initially misdiagnosed due to overlapping symptoms with benign anorectal conditions. At presentation, seven patients had localized disease, while six had distant metastases. Univariate analysis identified male sex and liver metastasis as adverse prognostic factors for OS; however, these associations were not statistically significant in multivariate analysis. Conclusions: ARMM is associated with poor survival outcomes, and liver metastasis and male sex may be linked to worse prognosis. Diagnostic delay is common due to nonspecific symptoms and frequent initial misdiagnosis, highlighting the need for increased clinical awareness. Further large-scale studies are warranted to better define prognostic markers and optimize management strategies.

BACKGROUND Microscopically positive margins (R1) after gastrectomy are uncommon but are associated with poor outcomes. Whether R1 reflects inadequate surgery or aggressive tumor biology remains unclear. MATERIAL AND METHODS We retrospectively analyzed 28 patients who underwent R1 resection for gastric adenocarcinoma between 2010 and 2023. Clinicopathologic features, recurrence patterns, and overall survival (OS) were evaluated. Prognostic factors were identified using univariate and multivariate Cox regression. RESULTS After a median follow-up of 82 months, the 5-year OS was 21.4%. Recurrence occurred in 50% of patients, all of whom subsequently died. On univariate analysis, HER2 negativity (HR 0.60, 95% CI 0.41-0.87, P=0.007), high Ki-67 index (HR 1.03, 95% CI 1.01-1.05, P=0.004), poor differentiation (HR 2.40, 95% CI 1.26-4.55, P=0.008), advanced pathological stage (HR 15.87, 95% CI 3.79-66.40, P<0.001), high lymph node ratio (HR 245.63, 95% CI 20.60-2929.13, P<0.001), and signet ring histology (HR 5.29, 95% CI 1.94-14.43, P=0.001) were associated with inferior OS. Multivariate analysis confirmed signet ring histology (HR 6.00, 95% CI 1.32-27.22, P=0.020) and advanced pathological stage (HR 13.28, 95% CI 2.76-63.89, P=0.001) as independent adverse prognostic factors, whereas lymph node ratio demonstrated borderline significance (HR 35.77, 95% CI 0.98-1308.06, P=0.051). CONCLUSIONS Survival after R1 resection is determined mainly by tumor biology - particularly signet ring features and advanced stage - rather than surgical technique. These findings call for risk-adapted adjuvant strategies and refined prognostic models in this high-risk subgroup.

Background and Objectives: Kaposi’s sarcoma (KS) is a rare malignancy with limited prospective data. The aim of this study was to evaluate the clinical features and prognostic factors of KS in a cohort of patients treated at a single center. Materials and Methods: Records of 83 patients with KS were retrospectively analyzed. Patient demographics, clinical features, and treatments were analyzed. Univariate and multivariate analyses were performed to evaluate factors affecting overall survival (OS). Results: The median age of the cohort was 65 years, and 22.9% were female. The classical type of KS was the most common (84.3%), with the most common site of localization being the feet (30.2%). The 5-year and 10-year OS rates were 82.7% and 70.8%, respectively. Univariate analysis identified age, performance score (ECOG PS), lymph node involvement, and disease stage as significant prognostic factors. However, in multivariate analysis, only the ECOG PS remained a significant predictor of OS. Conclusions: KS is a condition that requires long-term follow-up, and performance status is particularly critical for patient survival. In addition to our findings, comprehensive prospective studies are still needed to better understand the factors influencing patient survival in KS.

Amaç: Apendiks kanseri (AC), çok nadir görülmektedir. Çoğu hasta akut apandisit nedeniyle opere olduktan sonra veya çekilen bilgisayarlı tomografi sırasında tesadüfen saptanan abdominal kitle nedeniyle tanı almaktadır. Bu çalışmanın amacı, primer apendiks malign tümörlerinin klinik prezantasyonuna göre hastaların tümör histolojik özelliklerini ve hastalara uygulanan tedavi modalitelerini araştırmaktır. Yöntem: Şubat 2012 ile Kasım 2021 tarihleri arasında XXX Üniversitesi ile XXX Eğitim ve Araştırma Hastanesi’ne başvuran ve primer AC tanısı alan 29 hastanın verileri retrospektif olarak incelendi. Hastalar başvuru klinik prezantasyonlarına göre; akut apandisit ve apandisit-dışı klinik şikayetleri ile tanı alan hastalar şeklinde iki gruba ayrıldı. Bulgular: Çalışmamıza toplam 29 hasta alındı. Tüm hastaların medyan yaşı 58 (25-76, min-max) yıldı. Hastaların 19’u (%65,5) kadın hastalardan oluşmaktaydı. Akut apandisit kliniği ile başvuran 11 (%37,9) hasta, apandisit-dışı klinik ile başvuran 18 (%62,1) hasta bulunmaktaydı. Akut apandisit kliniği ile prezante olan grupta iki hasta (%18,2) apandisit-dışı klinik ile prezante olan grupta ise 11 (%61,1) hasta evre-IV olarak tanı almıştı. Sonuç: Çalışmamızda akut apandisit kliniği sonrası tanı konulan apendiks kanserlerinin daha erken evrelerde tanı aldıklarını, daha düşük psödomiksoma peritonei (PMP) oranlarının olduğunu tespit ettik. Akut apandisit kliniği ile tanı konulan grupta hayatını kaybeden hastamız bulunmamaktaydı. Bu da genel sağkalımın bu hasta grubunda daha iyi olacağını düşündürmektedir. Akut apandisit ile prezante olanların daha erken evrede olması göz önüne alınınca sağkalım farklılıkları buradan kaynaklanıyor olabilir.

Objective:This review will outline the correlation of tumor markers and NLR (Neutrophil/lymphocyte ratio) with measures such as MTV (mean total volume), TLG (total lesion glycolysis), and SUV (standart uptake value) in 18F FDG PET/CT in pancreatic carcinoma with the goal of selection of appropriate treatment modality and decrease rates of treatment failure and recurrences in pancreatic carcinoma by using tumor markers. In this way, we can predict the results of imaging modalities, using easy lab technics such as NLR and tm markers. Methods:45 patients that new diagnosed pancreatic cancer were included in the study. Diagnosis were confirmed by cytology. Their tumor marker levels (CA 19.9, CEA and AFP), NLR and PET/CT measurements (SUVmax, SUVmean, TLG, MTV) were obtained. Patients that already diagnosed, followed up or treated by oncology department, were excluded. Results:When tumor markers were compared with PET/CT measurements (SUVmax, SUVmean, TLG, MTV and tumor size) there were no significant difference between them. Also, total uptake values of organs (liver, spleen, pancreas) were not related with tm marker levels. However, there were positive significant correlation between tumor size and SUVmax, SUVmean, TLG (p=0.02 r = 0.347, p=0.022 r = 0.340, p=0.008 r =0.392). Conclusions:Tumor markers may help diagnosing or managing of pancreatic malignities, but we cannot predict PET/CT results according to tumor marker levels. So, tumor markers must be used as an adjunctive method for diagnosing malignities. They cannot be major determiner for malignities. Diagnosing and following up malignities should be supported by other laboratory technics and imaging methods.