Objective: The Prognostic Nutritional Index (PNI), reflects the nutritional and immunological status of the patient and has been associated with outcomes in various cancers. In this study, the prognostic significance of PNI in metastatic hormone‐sensitive prostate cancer (mHSPC) and its potential role in guiding treatment decisions between abiraterone acetate and enzalutamide is investigated.Methods: Retrospective analysis was performed on 167 mHSPC patients treated between 2019 and 2024. PNI was calculated using the formula: 10 × serum albumin (g/dL) + 0.005 × total lymphocyte count (/mm³). Patients were stratified into high and low PNI groups according to a cutoff value of 49.98, determined via receiver operating characteristic (ROC) analysis. Survival outcomes, including overall survival (OS), radiographic progression‐free survival (rPFS), and PSA progression‐free survival (PSA‐PFS), were assessed. Treatment responses to abiraterone acetate and enzalutamide were compared within PNI strata.Results: Patients with PNI > 49.98 had significantly longer median OS than those with PNI ≤ 49.98 (36.6 months vs. 30.0 months, p < 0.01). Multivariate analysis identified high PNI, ECOG performance status 0–1, and absence of visceral metastasis as independent predictors of improved OS. Among patients with low PNI, those treated with enzalutamide had superior OS compared to those receiving abiraterone acetate (p = 0.004), while no significant OS difference was noted between treatments in the high PNI group (p = 0.55).Conclusion: PNI serves as a significant prognostic biomarker in mHSPC, correlating with overall survival and potentially influencing treatment efficacy between abiraterone acetate and enzalutamide. Integrating PNI into clinical practice may aid in tailoring individualized treatment options.

Objectives: In this study, it was aimed to evaluate the hypoxia-inducible factor-1α (HIF-1α) and ischemia-modified albumin (IMA) levels of patients diagnosed with COVID-19 in the intensive care unit (ICU) and healthy controls. To our knowledge, this is the first study investigate HIF-1α and IMA levels in COVID-19 patients in ICUs and comparing them with a healthy control group. For this reason, our study is original and will contribute to the literature. Methods: A total of 70 intensive care patients diagnosed with COVID-19, and 72 healthy controls were included in the study. Results: When we compared the patient and healthy control group; there were no statistically significant differences between the groups in terms of age and gender (p>0.05). No exitus was observed in the patient group. We found weak correlation between HIF-1α and IMA (r: 0.320). However, there were statistically significant differences in HIF-1α and IMA levels in the patient group. The receiver operating characteristic (ROC) curve demonstrated an area under curve (AUC) value of 0.651 for HIF-1α and 0.937 for IMA. Conclusions: The HIF-1α and IMA levels were significantly higher among COVID-19 patients in ICU compared with healthy controls. HIF-1α and IMA levels can be used as reliable markers for the prognosis of COVID-19.

Objectives: This study aimed to evaluate the calcium/magnesium (Ca/Mg) ratio in patients diagnosed with type 2 diabetes mellitus (T2DM). Methods: This study is a retrospective cross-sectional study. Mg levels were determined by measuring the total serum Mg levels. Magnesium was measured by colorimetric method and HbA _1c was measured by turbidimetric inhibition immunoassay method. Subject were divided into two groups (<7 % and ≥7 %) based on HbA _1c levels. Also, subjects were divided into four groups (quartiles) based on serum Mg concentrations. Results: A total of 891 (636F, 255M) patients diagnosed with T2DM were included in the study. The Mg increase in the group with good glycemic control was also remarkable. One of our most important findings is that as the Mg concentration increases, the fasting glucose, HbA _1c , and Ca/Mg rate decreased with increasing Mg concentration. In the ROC analysis performed between the poor and good glycemic control groups, we found the AUC was 0.672, 0.650, 0.611, and 0.578 for Ca/Mg ratio, Mg, K, and Ca, respectively. Conclusions: While the Ca/Mg ratio and Ca levels were significantly higher, Mg levels were significantly lower among poor glycemic control than good glycemic control T2DM. The Ca/mg ratio and Mg are important parameters for T2DM patients, but more comprehensive studies are needed before they can monitor glycemic control.

Background: Mucosal malignant melanoma (MMM) is a rare and aggressive malignancy with a dismal prognosis. While the Systemic Immune-Inflammation Index (SII) has emerged as a prognostic marker in various solid tumors, its specific value in MMM remains undefined. This study investigated the association between pretreatment SII and overall survival (OS) in patients with MMM. Methods: We retrospectively analyzed 106 adults with histologically confirmed MMM treated at six oncology centers in Turkey between 2005 and 2025. The baseline SII was calculated as platelet × neutrophil/lymphocyte counts obtained before definitive treatment. A receiver operating characteristic (ROC) analysis identified an optimal SII cutoff of 776 for overall survival (OS), defining low (<776) and high (≥776) SII groups. Results: Gastrointestinal and head and neck mucosa were the most frequent primary sites, and one-third of patients presented with metastatic disease. The median OS for the entire cohort was 23.3 months. Patients with a high versus low SII had a shorter OS (16.2 vs. 35.2 months; HR 2.71, 95% CI 1.67–4.40; p < 0.001). In multivariable analysis, a high SII (HR 1.88, 95% CI 1.12–3.14; p = 0.016), gastrointestinal primary site (HR 1.99, 95% CI 1.23–3.23; p = 0.005), and metastatic disease at diagnosis (HR 4.01, 95% CI 2.32–6.94; p < 0.001) independently predicted a worse OS. Conclusions: The SII is a novel, independent prognostic biomarker in MMM. Elevated pretreatment SII correlates with aggressive clinicopathologic features and inferior survival. As a readily accessible and cost-effective marker, SII may facilitate improved risk stratification in routine clinical practice for MMM patients.

Introduction In the treatment of metastatic non-small cell lung cancer (mNSCLC), targeted therapies are utilized in the presence of driver mutations. Tyrosine kinase inhibitors (TKIs) have contributed positively to survival outcomes in this patient group. In driver mutant mNSCLC patients, caution is warranted for the development of small cell lung cancer (SCLC) differentiation following progression under TKI therapy. SCLC is associated with an aggressive course and shorter survival. The cornerstone of SCLC treatment is conventional chemotherapy. In this study, we aimed to present the development of SCLC differentiation in driver mutant mNSCLC patients who received at least one line of TKI therapy as a single-center experience. Patients and methods Between April 2013 and January 2024, the medical records of 144 patients diagnosed with mNSCLC and found to harbor driver mutations were retrospectively reviewed at Necmettin Erbakan University Faculty of Medicine Hospital, Oncology Clinic. All patients had received at least one line of TKI. The analysis included evaluation of driver mutations, treatments administered, and the rate of SCLC differentiation in this patient population. Results A total of 144 patients were included in the study. Among them, 122 patients (84.9%) had an EGFR mutation, 21 patients (15.1%) had an ALK mutation, and 1 patient had a ROS1 mutation. TKI therapy was administered as first-line treatment in 50% of the patients, as second-line in 40.3%, and as third-line in 6.3%. Biopsies were performed in 22 out of 144 patients after disease progression. Of these, 21 biopsies were from patients with EGFR mutations, and 1 was from a patient with an ALK mutation. Biopsies were conducted after first-line therapy in 8 cases, after second-line therapy in 11 cases, and after third-line therapy in 3 cases. SCLC differentiation was observed in 3 out of 22 patients (13.6%), all of whom had EGFR mutations. Additionally, 2 of these 3 patients developed SCLC differentiation following first-line TKI therapy, while 1 developed it after second-line TKI therapy. Discussion The rate of SCLC differentiation in NSCLC is generally low and is considered rare. It is estimated that the rate of SCLC differentiation in NSCLC ranges between 1% and 3%. In our clinic, when evaluating driver mutant mNSCLC patients who received at least one line of TKI therapy, SCLC differentiation was observed in 3 patients (13.6%). The limitations of our study include its retrospective nature and the small sample size. However, the findings suggest that SCLC differentiation is a potential occurrence in driver mutant mNSCLC patients treated with TKIs. Therefore, careful monitoring and the detection of possible differentiation are essential in the follow-up of these patients.

Introduction: Bloom syndrome (BS) is a rare autosomal recessive disorder caused by a loss-of-function mutation in the BLM gene encoding an RecQ helicase involved in DNA repair and maintenance of chromosomal stability. In patients with BS, significant sensitivity to both DNA-damaging chemotherapy (CT) and ionizing radiation complicates the management of neoplasms by exacerbating comorbidities and predisposing to toxicities and poor outcomes. Case report: A 30-year-old female patient diagnosed with BS who presented with early-stage triple-negative breast cancer was treated with four cycles of doxorubicin (60 mg/m²) and cyclophosphamide (600 mg/m²) followed by weekly paclitaxel (80 mg/m²) for 12 weeks as the chemotherapy protocol and a total of 5000 cGy curative radiotherapy (RT). Due to pancytopenia 8 months after completion of therapy, bone marrow biopsy and aspiration were performed, and a diagnosis of myelodysplastic syndrome with excess blasts 2 (MDS-EB2) was made. Two courses of the azacitidine (75 mg/m²) protocol were administered every 28 days in the hematology clinic. Two weeks after CT the patient was transferred from the emergency department to the hematology clinic with the diagnosis of pancytopenia and febrile neutropenia. She died at the age of 33 due to sepsis that developed during follow-up. Conclusion: Due to the rarity of BS, there is no prospective trial in patients with cancer and no evidence base upon which to design treatment programs. For these reasons, it is strongly recommended that patients receive multidisciplinary care, with precise assessment and discussion of the indication and an adequate dose of DNA-damaging agents such as chemotherapy and ionizing radiation.