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.

Objectives: Carcinoid tumors are rare neuroendocrine neoplasms of the lung. Although typical and atypical carcinoids have different clinical courses, most studies in the literature evaluate them together. Therefore, we aimed to investigate prognostic factors in patients with atypical carcinoids, excluding typical carcinoids. Methods: We included 32 patients with atypical carcinoids according to WHO 2021 criteria admitted to Uludag University Hospital. We retrospectively extracted the clinicopathological characteristics from electronic medical records. The log-rank tests were used to determine the prognostic factors on survival. Results: Median age was 57 (24-71) years. Pathological stages were as follows: stage I in 41%, II in 9%, III in 34%, and IV in 16%. Median Ki-67 index was 11% (1-50). Median follow-up time was 46.2 (0.7-184.2) months. 12-month and 48-month disease-free survival (DFS) rates were 92.3% and 79.2%, respectively. 12-month and 48-month overall survival (OS) rates were 93.8% and 86.2, respectively. Receiver operating characteristic curve analysis determined the Ki-67 cut-off as 12.5%. The log-rank test indicated that Ki-67 and stage were statistically significant prognostic factors for DFS and OS. The patients with a Ki-67 index lower than 12.5% had longer DFS and OS (p = 0.007 and p = 0.020, respectively). Conclusions: The Ki-67 index and 8th TNM staging have prognostic value on DFS and OS in patients with atypical carcinoids. Large-scale studies are needed to define the optimal cut-off value of Ki-67.

Background/Objectives: In metastatic renal cell carcinoma (mRCC), the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) and Memorial Sloan Kettering Cancer Center (MSKCC) risk models remain the primary tools for prognostic stratification but may not fully capture outcome heterogeneity in the contemporary treatment era. Systemic inflammatory–nutritional biomarkers such as the pan-immune-inflammation value (PIV) and the hemoglobin–albumin–lymphocyte–platelet (HALP) score have emerged as complementary, readily available prognostic indicators, yet their added value alongside established risk models, nephrectomy status, and modern predictive approaches such as machine learning remains poorly defined in real-world cohorts. This study jointly evaluated established risk models, inflammatory–nutritional biomarkers, and an exploratory neural-network survival model for prognostication in mRCC. Methods: In this retrospective, single-center cohort study, 96 patients with mRCC diagnosed and treated between January 2010 and January 2025 were evaluated, with clinical outcomes retrospectively reviewed up to a data cut-off of 17 November 2025. Clinicopathological characteristics, IMDC and MSKCC risk classification, nephrectomy status, and baseline PIV and HALP values were assessed for their association with progression-free survival (PFS) and overall survival (OS) using Kaplan–Meier and multivariable Cox regression analyses. As an exploratory analysis, a dual-head neural network predicting both the risk of death and survival time was developed; feature screening and hyperparameter tuning were nested within stratified 5-fold cross-validation repeated 10 times, and the network was benchmarked on identical splits against IMDC, MSKCC, Cox, elastic-net Cox and random survival forest models. Results: At a median follow-up of 82.6 months, 77 PFS events and 57 deaths had occurred; median PFS and OS were 17.8 and 46.3 months, respectively. IMDC risk classification was significantly associated with both PFS and OS, whereas MSKCC risk classification was associated with OS but not PFS; PIV and HALP were associated with OS only. In multivariable analyses, nephrectomy status remained independently associated with both PFS and OS, whereas IMDC and MSKCC classifications remained associated with OS in separate adjusted models, although the MSKCC estimates should be interpreted cautiously because of the relatively small poor-risk subgroup. The neural network achieved a nested cross-validated C-index of 0.685 (95% CI, 0.608–0.764), comparable to a Cox model with IMDC risk group and nephrectomy status (0.692) and a random survival forest (0.695), numerically higher than the IMDC risk group alone (0.629) and higher than the MSKCC risk group alone (0.594). Its integrated Brier score was 0.189, compared with 0.164 for the IMDC-plus-nephrectomy Cox model, 0.183 for the random survival forest, and 0.221 for the Kaplan–Meier reference; its calibration slope was 0.54, indicating overly extreme predictions. Conclusions: Established risk models remained informative, particularly for OS, while nephrectomy status was the most consistent prognostic factor across conventional and neural-network analyses; PIV and HALP were associated with overall survival in unadjusted analyses but did not show independent prognostic value. An exploratory neural-network model showed discrimination comparable to conventional Cox-based models; however, its individualized survival-probability estimates had greater prediction error than those of the IMDC-plus-nephrectomy Cox model and were poorly calibrated in slope. Recalibration and external validation in larger, contemporary cohorts are required before clinical implementation.

Mucosal malignant melanoma (MMM) is a rare, aggressive malignancy with poor prognosis in the advanced setting. Although the Royal Marsden Hospital (RMH) sc

Objectives: The aim of this study was to evaluate the effect of different systemic therapies after CDK4/6 inhibitor therapy on survival outcomes in HR+/HER2− metastatic breast cancer (MBC) patients. Methods: In this retrospective multicenter study, patients who continued chemotherapy (CT), everolimus + endocrine therapy (HT), and other hormonotherapy after treatment with a CDK4/6 inhibitor were compared. Clinicopathological data and survival outcomes were analyzed. Statistical analyses were performed using the SPSS v25 program, survival analyses were performed using the Kaplan–Meier method, and comparisons were made using the log-rank test. Results: A total of 145 patients were included in the study. The groups were similar in terms of baseline characteristics such as age, menopausal status, histology, stage, adjuvant treatment status, and metastatic spread pattern. The rate of recurrent disease was significantly higher in the CT and Everolimus + HT groups compared to the “Other” group (p = 0.027). However, there was no significant difference between the groups in terms of PFS and OS in the general population (p > 0.05). In subgroup analyses, OS was significantly longer in the everolimus + HT group compared to the CT group in those with recurrence duration ≥ 1 year and stable disease course > 6 months during CDK4/6 inhibitor treatment (p = 0.010 and p = 0.039). Conclusions: Although there was no significant difference in overall survival regarding the choice of treatment after a CDK4/6 inhibitor, everolimus + endocrine therapy was observed to have a positive effect on survival in some subgroups. This finding supports individualized treatment.

This multicentre real-world study evaluated the efficacy of targeted therapies in Turkish patients with metastatic squamous cell lung carcinoma harbouring driver mutations. Sixty-four patients with alterations such as EGFR, ALK, and ROS1 who received targeted agents were retrospectively analysed. EGFR mutations were most common (67.2%). Among EGFR-TKI-treated patients, median progression-free survival (PFS) and overall survival (OS) were 12.4 and 14.3 months, respectively. Alectinib yielded a median PFS of 18.6 months and OS of 29.8 months in ALK-positive patients, while crizotinib produced a median PFS and OS of 7 months in ROS1-positive patients. The overall response rate was 50% and the disease control rate 84.4%. Although targeted therapies prolonged PFS compared with chemotherapy, this improvement did not translate into a significant OS advantage, likely influenced by retrospective design and treatment crossover. Findings represent real-world outcomes in a molecularly defined subgroup.