Background/Objectives: Coronary artery bypass surgery (CABG) with multiple arterial grafting (MAG) has shown potential to improve patient survival compared to single arterial bypass grafting. Whether this superiority in survival also exists in diabetics is uncertain. We therefore aimed to compare short and long-term outcomes of MAG in diabetic versus non-diabetic patients. Methods: In this retrospective study, we investigated short- and long-term clinical outcomes of diabetic (n = 256) and non-diabetic (n = 800) patients undergoing CABG with MAG between January 1999 and December 2019 at our institution. Results: Diabetics had a significantly higher EuroScore II (1.37 ± 2.4 vs. 0.88 ± 1.58, p < 0.0001) and underwent significantly less bilateral internal thoracic artery (BITA) grafting (51.95% vs. 67.75%; p < 0.0001) compared to non-diabetics. The incidence of postoperative adverse events, such as pneumonia, stroke, and sepsis, did not differ between the two groups. However, diabetics suffered significantly more often from post-cardiotomy cardiogenic shock, renal failure requiring dialysis, and sternal wound infections over the entire follow-up period. Non-diabetics had a significantly higher median survival time of 19.6 years compared to 14.54 years found in diabetic patients (p < 0.0001). Conclusions: Among patients undergoing MAG, diabetic individuals were found to have a significantly lower overall median survival. This emphasizes the importance of diabetes as a risk factor in choosing individual surgical strategies.

Melanoma causes the majority of skin cancer-related deaths. Despite novel therapy options, metastatic melanoma still has a poor prognosis. Immune checkpoint inhibition (ICI) therapy has been shown to prolong overall survival in patients with advanced melanoma, but mucosal melanomas respond less favorably compared to melanomas of cutaneous origin. We report on a patient with a mucosal melanoma of the rectum diagnosed in June 2020. Since a surgical intervention in order to achieve a tumor-free situation would have required an amputation of the rectum, a neo-adjuvant systemic immunotherapy with ipilimumab and nivolumab was initiated. As restaging and colonoscopy after four doses of this combination immunotherapy showed a partial response, the patient decided against the pre-planned surgery and a maintenance therapy with nivolumab was started. Repeated colonoscopy showed a complete response after four doses of nivolumab. After ongoing ICI therapy with nivolumab and no evidence of tumor relapse, immunotherapy was stopped in July 2022 after nearly 2 years of continuous treatment. The patient remained tumor-free during further follow-up. Neo-adjuvant immunotherapy is getting more explored in advanced melanoma. By administering ICI therapy before surgical resection of an essentially operable tumor, a stronger and more diverse immunological response is supposed to be achieved. Our reported case demonstrates that this approach could also be effective in mucosal melanoma despite of its generally lower response to immunotherapy.