Background/Objectives: Immune checkpoint inhibitor (ICI)-associated cardiovascular adverse events are relatively uncommon; they can be life-threatening, particularly when involving malignant ventricular arrhythmias. Electrocardiographic markers such as P-wave dispersion (PWD), QT dispersion (QTd), T-peak to T-end (Tp-e) interval, and Tp-e/QT and Tp-e/QTc ratios have been linked to an elevated risk of both atrial and ventricular arrhythmias and sudden cardiac death across various cardiac conditions. Monitoring these parameters may aid in identifying the risk of arrhythmogenic events in cancer patients undergoing ICI therapy. Methods: This retrospective cohort study analyzed 42 patients with cancer who received ICI therapy and had serial 12-lead electrocardiograms (ECGs) performed at baseline and at three-month intervals during the first year of treatment, from May 2022 to November 2023. ECG parameters including PWD, QTd, Tp-e interval, and Tp-e/QT and Tp-e/QTc ratios were measured and compared between baseline and follow-up time points. Results: The median follow-up duration was 5.3 months (range: 0.5–18.9 months). No statistically significant differences were observed in any of the ECG parameters between baseline and subsequent measurements (p > 0.05). One patient developed atrial fibrillation during the third month of treatment. Additionally, one patient exhibited a left anterior fascicular block, and another experienced frequent ventricular extrasystoles. No malignant ventricular arrhythmias were reported throughout the study period. Conclusions: This study found no significant changes in electrocardiographic markers associated with arrhythmia risk during ICI treatment. Larger, multicenter, prospective studies with extended follow-up are warranted to further elucidate the cardiovascular safety profile of ICIs.

Background and Objectives: Nasopharyngeal carcinoma (NPC) displays marked geographic and histopathological heterogeneity, and prognostic determinants in non-endemic regions remain incompletely defined. This study aimed to evaluate the impact of clinicopathological characteristics and treatment modalities on survival outcomes among patients with stage II–IVA NPC treated with curative intent at a single tertiary cancer center. Materials and Methods: A retrospective analysis was conducted on 81 consecutive patients with histologically confirmed NPC treated between 2000 and 2022. Demographic, clinical, and treatment parameters were extracted from institutional records. Survival outcomes—including disease-free survival (DFS), locoregional recurrence-free survival (LRFS), distant metastasis-free survival (DMFS), cancer-specific survival (CSS), and overall survival (OS)—were estimated using the Kaplan–Meier method and compared using the log-rank test. Prognostic variables identified in univariate analysis were further assessed by multivariable Cox proportional hazards regression (Cox’s model). Results: The cohort included 59 men (72.8%) and 22 women (27.2%), with a median age of 50.8 years (range, 19–78). Most patients presented with locally advanced disease (T3–T4, 53.1%; N2, 60.5%; stage III–IVA, 87.7%). Non-keratinizing undifferentiated carcinoma (World Health Organization [WHO] type III) was the predominant histology (71.6%), followed by the non-keratinizing differentiated subtype (17.3%). Median DFS and OS were 94.6 and 139.4 months, respectively. According to the univariate analysis, histological subtypes and a family history of cancer were significantly associated with DFS, whereas comorbid systemic disease showed an unexpected association with longer DMFS. The multivariable Cox model identified the histological subtype as an independent predictor of disease recurrence (HR = 2.23, 95% CI: 1.00–4.94; p = 0.049). For OS, both histological subtype (HR = 2.40, 95% CI: 1.10–5.25; p = 0.029) and age at diagnosis (HR = 1.05, 95% CI: 1.02–1.09; p = 0.005) were independent adverse prognostic factors. Conclusions: In this long-term, single-center study from a non-endemic region, histological subtype emerged as the most powerful determinant of prognosis, significantly influencing both DFS and OS. Patients with non-keratinizing undifferentiated (WHO type III) carcinoma demonstrated superior outcomes compared with those with differentiated histology. Additionally, increasing age at diagnosis was independently associated with poorer OS. In contrast, inflammatory and nutritional biomarkers, the Pan-Immune–Inflammation Value (PIV) and the Prognostic Nutritional Index (PNI), showed no prognostic significance. These findings underscore the continued prognostic relevance of histopathologic classification and age and highlight the need for large-scale, standardized studies integrating Epstein–Barr virus (EBV) status and host-related factors in non-endemic NPC populations.

Background and Objectives: Advanced solid organ tumors, particularly breast, lung, and prostate cancers, frequently metastasize to bone, leading to debilitating skeletal-related events (SREs). Denosumab, a RANKL inhibitor, is crucial in preventing SREs. This study aimed to comparatively evaluate the efficacy and adverse effect profiles of denosumab in patients with bone metastases originating from these three common cancer types. Materials and Methods: This retrospective study included 146 patients treated with denosumab for bone metastases. Data on demographics, SREs before and during denosumab treatment, serum creatinine, calcium, and magnesium levels (at baseline, 3, and 6 months), other adverse effects, and survival were analyzed. Results: Before denosumab, SREs were present in 36.3% of patients (breast: 43.4%, prostate: 28%, lung: 33.8%). During denosumab treatment, SRE rates markedly decreased across all groups (breast: 9.4%, prostate: 16.0%, lung: 8.8%), with no significant intergroup difference in on-treatment SREs. Significant decreases in serum calcium levels were observed at 3 and 6 months post-denosumab initiation in breast (p < 0.0001) and lung cancer patients (p = 0.001). Mean creatinine levels significantly decreased in lung (p < 0.0001) and prostate (p = 0.020) cancer patients at 3 and 6 months. Overall survival significantly differed, with lung cancer patients having the shortest median survival (p < 0.005). Conclusions: Denosumab effectively reduces the incidence of SREs in patients with bone metastases from breast, lung, and prostate cancer. However, clinicians must diligently monitor for hypocalcemia, a notable adverse effect, particularly at 3 and 6 months after starting denosumab, with specific caution warranted in patients with lung cancer.

Background: Neuroendocrine neoplasms (NEN) originate in many body parts, with 70% reported from the gastrointestinal system, 25% from the lungs. NENs of the breast account for < 1% of all NENs. The primary breast NEN nomenclature was changed in the most recent World Health Organization classification in 2019. Since the pathological classification has changed several times, there are no definitive data on treatment management. Methods: In this study, patients followed up in our clinic were pathologically reevaluated according to the latest classification. Results: The clinical characteristics, treatments, recurrence, and survival status of 36 patients with early stage primary breast NEN were examined. A statistically significant difference was determined in respect of overall survival (OS) for the Eastern Cooperative Oncology Group Performance Score (ECOG PS), type of surgery, age ≥ 70 years, PR positivity, and tumor size. A low ECOG PS, younger age, breast-conserving surgery (BCS), and small tumor diameter were associated with better survival. A low ECOG PS, early stage, BCS, and fewer than 4 malignant lymph nodes were associated with better disease-free survival. All the patients in this study were at an early stage and were treated for typical breast cancer, although some patients diagnosed with neuroendocrine carcinoma (NEC) received cisplatin and etoposide treatment. Conclusions: In our study, the prognosis of breast NEN patients was better than the literature data. Maybe the prognosis of patients evaluated as breast NEN according to the new classification is better than the older classification groups.

Background/Objectives: Perioperative chemotherapy is the standard treatment for locally advanced gastric and gastroesophageal junction adenocarcinoma; however, substantial uncertainty remains regarding the optimal management of non-responding patients and the prognostic relevance of biological and inflammatory biomarkers. This study aimed to determine, using real-world data integrated with a comprehensive literature review, whether long-term survival is driven primarily by the choice of chemotherapy regimen or by the tumor’s intrinsic biological aggressiveness and the host’s systemic inflammatory response. Methods: A retrospective analysis was performed of 43 patients with locally advanced gastric cancer who received neoadjuvant chemotherapy. Survival outcomes were stratified by regimen (FLOT versus non-FLOT) and analyzed using Kaplan–Meier methods. The prognostic value of clinicopathological features and systemic inflammatory indices was assessed using multivariate Cox regression models to identify independent predictors of mortality. Results: Although FLOT showed a trend toward improved overall survival (OS) (median not reached vs. 18.9 months), this difference did not reach statistical significance. Univariate analysis linked lymphovascular invasion (LVI) (HR = 4.17; p = 0.003), pan-cytokeratin (panCK) (HR = 2.44; p = 0.032), and monocyte-to-lymphocyte ratio (MLR) (HR = 1.73; p = 0.027) with survival. To minimize overfitting, two multivariate models were constructed. The first confirmed LVI (HR = 7.32; p < 0.001) and panCK (HR = 4.30; p = 0.006) as independent prognostic markers. The second identified MLR (HR = 1.65; p = 0.033) and panCK (HR = 2.42; p = 0.034) as independent adverse factors. Conclusions: Our findings suggest a paradigm shift in prognostic assessment for locally advanced gastric cancer: therapeutic success appears to depend more on underlying tumor biology and the immune microenvironment than on any specific neoadjuvant regimen. High MLR and LVI serve as strong surrogate markers of a biologically aggressive, chemotherapy-resistant phenotype. Consequently, future clinical strategies should move beyond a “one-size-fits-all” chemotherapy approach and prioritize these biomarkers for risk stratification and personalization of multimodal therapy.

The survival outcomes of cancer patients exposed to Coronavirus Disease 2019 (COVID-19), the duration required to resume oncological treatment, and the subsequent course of their malignancy remain areas with limited data. This retrospective study evaluated 128 cancer patients hospitalized for COVID-19 treatment between April 2020 and October 2023. Of the cohort, 39.8% were women and 60.2% were men. Findings revealed that patients with metastatic lung involvement faced a 3.34-fold increased risk of death during the acute infection. In the post-COVID survival cohort, multivariate analysis indicated that younger age, higher hemoglobin levels, higher systemic inflammatory index, lower pan-immune inflammation value, and absence of active cancer were associated with longer survival. Additionally, vaccine-related survival differences were observed; however, these findings should be interpreted cautiously as they likely reflect confounding factors such as prioritizing high-risk patients for certain vaccine types rather than a direct causal relationship. Notably, while treatment delays were common among patients with disease progression, these delays did not result in a statistically significant difference in overall survival during the long-term follow-up.