Synchronous bilateral Wilms tumor (BWT) demands oncologic control while protecting lifelong kidney function. In mesenchymal-predominant tumors, radiologic shrinkage after neoadjuvant therapy may be minimal and can mislead size-based surgical sequencing. In BWT with discordant radiologic response, split renal function can decisively guide sequencing and expand nephron preservation.

Objective The aim of this study was to evaluate the role of baseline oxygenation parameters, including PaO2/FiO2 and SpO2, as well as the inflammatory marker IL-6, in predicting in-hospital mortality among patients treated in the intensive care unit with a diagnosis of acute respiratory distress syndrome (ARDS). Methods This retrospective cohort study included 97 patients diagnosed with ARDS who were treated in the intensive care unit and had available baseline PaO2/FiO2, SpO2, and IL-6 measurements. Patients were divided into two groups according to clinical outcome: survivors and non-survivors. Baseline oxygenation and inflammatory parameters were compared between the groups. Factors associated with in-hospital mortality were evaluated using logistic regression analysis. The prognostic performance of individual parameters and the combined model was assessed using receiver operating characteristic (ROC) analysis. Results Among the 97 patients included in the study, 58 survived and 39 died during hospitalization, resulting in an overall in-hospital mortality rate of 40.2%. Non-survivors had significantly lower PaO2/FiO2 and SpO2 values compared with survivors, while IL-6 levels were significantly higher. In ROC analysis, PaO2/FiO2 showed the highest prognostic performance among individual parameters, with an area under the curve (AUC) of 0.944. The AUC values were 0.911 for SpO2 and 0.868 for IL-6. The combined model including PaO2/FiO2, SpO2, and IL-6 demonstrated the highest discrimination ability, with an AUC of 0.962. Conclusion Low baseline PaO2/FiO2 and SpO2 levels and elevated IL-6 values are strongly associated with in-hospital mortality in patients with ARDS. The combined use of oxygenation parameters and IL-6 may provide a simple, accessible, and clinically useful approach for early mortality risk stratification in intensive care settings.

The androgen receptor (AR) is an emerging biomarker in breast cancer (BC), yet its prognostic relevance in patients undergoing neoadjuvant chemotherapy (NACT) remains inconclusive. While most studies focus on Western populations, data from the Caucasus are scarce. Given regional differences in tumor biology and treatment access, evaluating AR’s clinical significance in these populations is crucial. This study aimed to investigate the association between AR expression, pathological response, and disease-free survival (DFS) in stage II to III BC patients receiving NACT. A retrospective cohort study was conducted on 132 female BC patients treated with NACT at Bonadea Hospital. AR expression patterns were categorized as negative, weak, moderate, or strong. Statistical analyses included chi-square tests, Kaplan–Meier survival analysis, and univariate Cox regression to evaluate associations between AR expression and clinicopathological features, pathological complete response (pCR), and DFS. The median age at diagnosis was 47 years. Invasive ductal carcinoma accounted for 91.1% of cases, with 50.0% of tumors graded as II or III. pCR was achieved in 28.6% of patients. Moderate-to-strong AR expression was observed in 15% of cases and was associated with a significantly lower Ki-67 index ( P = .047). Although dichotomized AR expression did not significantly predict DFS (hazard ratio [HR]: 0.35, 95% confidence interval [CI]: 0.08–1.47, P = .151), Cox regression using all 4 AR categories revealed a significant reduction in recurrence risk (HR = 0.384, 95% CI: 0.160–0.918, P = .031). In multivariable model adjusting for estrogen receptor, human epidermal growth factor receptor 2, and Ki-67 expression, moderate-to-strong AR expression remained the most influential prognostic factor, although the association did not reach statistical significance (adjusted HR: 0.31, 95% CI: 0.07–1.41, P = .129; concordance index = 0.83). Among patients with residual disease (non-pCR), moderate-to-strong AR expression was associated with a higher 2-year DFS rate (90.9% vs 46.4%, P = .089). Sensitivity analysis demonstrated no evidence of selection bias related to AR data availability, as 2-year DFS was comparable between patients with and without available AR assessment (76.1% vs 71.6%, log-rank P = .975). Moderate-to-strong AR expression may be associated with improved DFS in patients treated with NACT, especially in those with incomplete pathological response. These findings highlight the potential of AR as a prognostic biomarker and therapeutic target, warranting validation in prospective studies.

Background: The SIOP-RTSG and NWTSG/COG approaches differ primarily in the timing of nephrectomy and the clinical information used for risk stratification. Direct comparisons are complicated because protocol selection is closely linked to treatment center, institutional practice, and healthcare-system context. We compared real-world survival outcomes between two protocol–care ecosystems after adjustment for harmonizable baseline risk factors. Methods: This retrospective, two-country, multicenter cohort study included 183 consecutive children treated for Wilms tumor between 1997 and 2025 at centers in Azerbaijan and Türkiye. Of these, 78 received SIOP-RTSG-based treatment and 105 received NWTSG/COG-based treatment. Overall survival (OS) and event-free survival (EFS) were estimated using the Kaplan–Meier method and compared using the log-rank test. Cox proportional hazards models were used to evaluate the association of protocol–care ecosystem with OS and EFS after adjustment for age category and harmonized disease stage. Preoperative response and histological risk were evaluated exploratively within the SIOP-RTSG cohort. Results: Five-year OS was 84.8% in the SIOP-RTSG group and 87.0% in the NWTSG/COG group, with no difference between the survival curves (log-rank p=0.978). Five-year EFS was 76.3% and 80.7%, respectively (log-rank p=0.661). In the multivariable OS model, the protocol–care ecosystem was not independently associated with mortality (adjusted hazard ratio [aHR] 1.046, 95% confidence interval [CI] 0.453–2.413; p=0.916). Older age category (aHR 2.858, 95% CI 1.513–5.400; p=0.0012) and stage III–V disease (aHR 3.364, 95% CI 1.117–10.132; p=0.031) were independently associated with poorer OS. Similarly, the protocol–care ecosystem was not associated with EFS (aHR 0.963, 95% CI 0.501–1.853; p=0.911), whereas older age category (aHR 1.869, 95% CI 1.173–2.978; p=0.0085) and stage III–V disease (aHR 2.556, 95% CI 1.186–5.510; p=0.0166) were associated with a higher event risk. Within the SIOP-RTSG cohort, poor preoperative response was associated with inferior OS (HR 5.957, 95% CI 1.542–23.016; p=0.0097) and EFS (HR 3.640, 95% CI 1.341–9.883; p=0.0112). High-risk histology was associated with inferior EFS (HR 3.748, 95% CI 1.010–13.903; p=0.0482), but not significantly with OS.Conclusions: After adjustment for age and stage, the protocol–care ecosystem was not independently associated with OS or EFS. Older age and advanced-stage disease were the principal unfavorable prognostic factors, while poor preoperative response and high-risk histology provided additional prognostic information within the SIOP-RTSG cohort. These findings do not establish equivalence between the SIOP-RTSG and NWTSG/COG strategies but indicate that both may achieve satisfactory survival outcomes when implemented within structured multidisciplinary care systems. Due to the retrospective, observational nature of the study and the use of anonymized patient data, the requirement for written informed consent was waived by the institutional review boards.

Gastric cancer (GC) is a leading cause of cancer-related mortality globally, with a 5-year survival rate remaining below 50% despite advancements in treatment. The standard care for locally advanced GC includes curative gastrectomy combined with perioperative chemotherapy. Different factors may influence chemotherapy responses, underscoring the need for biomarkers to tailor treatment. GP73, a Golgi-associated protein, has been implicated in cancer progression and prognosis, though its role in GC remains poorly understood. This study aimed to evaluate the association between pretreatment GP73 expression and overall survival (OS) and chemotherapy response in locally advanced GC patients. This was a retrospective study of 92 locally advanced GC patients who received neoadjuvant chemotherapy and underwent surgery between 2017 and 2024. GP73 expression was assessed in pretreatment biopsy samples via immunohistochemistry. Clinicopathological data were analyzed, and the correlation between GP73 expression and survival, as well as chemotherapy response, was evaluated. Tumor regression was graded using the Mandard Tumor Regression Grade scale. Continuous variables were demonstrated as median and interquartile range. High GP73 expression was observed in 64% of patients and correlated with poor tumor differentiation and reduced likelihood of radical surgery. Univariate analysis revealed that high GP73 expression was significantly associated with poorer overall survival (p < 0.001). Multivariate Cox model identified high GP73 status as an independent prognostic factor for poor OS (HR 4.53, p < 0.001). However, no significant correlation was found between GP73 expression and chemotherapy response (p = 0.32). This study suggests that high pretreatment GP73 expression is a marker of poor prognosis in locally advanced GC, linked to poorer survival and less favorable tumor characteristics. These results highlight the need for personalized treatment strategies incorporating GP73 and other clinicopathological factors to optimize outcomes for GC patients. The online version contains supplementary material available at 10.1186/s12876-026-04713-9.