The optimal sequencing of chemotherapy in locally advanced gastric cancer (LAGC) remains controversial. This study aimed to compare survival outcomes between adjuvant (ACT) and neoadjuvant (NACT) chemotherapy and to identify clinicopathological factors associated with progression-free survival (PFS) and overall survival (OS) in a real-world setting. Methods: We retrospectively analyzed 103 patients with non-metastatic gastric cancer treated between 2014 and 2024. Patients were categorized into ACT (n = 56) and NACT (n = 47) groups. Kaplan–Meier and Cox regression analyses were used to assess survival outcomes and prognostic factors. Results: The NACT group was younger and had more proximal tumors. Median OS was 48.7 months in the ACT group versus 17.7 months in the NACT group (p = 0.048). Median PFS was not reached in the ACT group and was 15.6 months in the NACT group (p = 0.008). Negative surgical margin status was independently associated with improved survival, whereas age was an independent negative prognostic factor for OS. No significant associations were found between OS or PFS and histologic subtype, lymphovascular invasion, perineural invasion, gender, D2 dissection, or type of surgery. Notably, 21% of NACT patients did not proceed to surgery due to progression, treatment intolerance, or refusal. Conclusion: Although ACT was associated with longer PFS and OS in this cohort, these differences are most likely explained by baseline imbalances, patient selection factors, and survivorship bias rather than the timing of chemotherapy itself. These findings highlight the importance of careful patient selection for NACT and underscore the need for prospective, randomized studies to define optimal sequencing strategies in LAGC. Our study contributes descriptive, real-world data rather than definitive evidence of treatment superiority.

En tr Aim: Acute upper gastrointestinal system (GIS) bleeding is one of the leading causes of mortality and morbidity. Presence of concomitant disease in upper GIS bleeding is a mortality-associated risk factor, and chronic renal insufficiency (CRI) is one of these concomitant diseases. In the present study, patients with CRI, who had upper GIS bleeding and been treated as inpatient between January 2016 and January 2017 at Tepecik Training and Research Hospital Clinic of Gastroenterology, and the patients that had upper GIS bleeding without renal insufficiency were comparatively investigated in terms of demographic characteristics, presence of concomitant disease, drug usage, endoscopic results, Forrest classification, and need for endoscopic intervention and mortality. Materials and Methods: A total of 194 patients were retrospectively evaluated. The CRI group with a glomerular filtration rate (GFR) lower than 60 mL/min/1.73 m² comprised 90 patients, whereas the control group with a GFR of 60 mL/min/1.73 m² and higher comprised 104 patients. Results: As the result of the study, it was determined that CRI group was older and 96% of the patients had a concomitant disease. Drug usage rate was higher than the control group with aspirin used most frequently. Endoscopy was performed on Day 1 in more than 70% of the cases. Conclusion: Hospital mortality rate was higher in CRI group (5.66% vs 2.88%, p=0.475) with lower total mortality rate found in the present study as compared to the literature . Amaç: Akut üst gastrointestinal sistem (GİS) kanamaları sık karşılaşılan mortalite ve morbidite nedenlerindendir. Üst GİS kanamalarında ek hastalık varlığı mortalite ile ilişkili bir risk faktörü olup kronik böbrek yetmezliği de (KBY) bunlardan biridir. Bu çalışmamızda, Tepecik Eğitim Araştırma Hastanesi Gastroenteroloji Kliniği’nde Ocak 2016-Ocak 2017 tarihleri arasında yatırılarak tedavi altına alınan üst GİS kanaması geçiren KBY’li hastalar ile üst GİS kanaması geçiren renal yetmezliği olmayan hastalar demografik özellikler, ek hastalık varlığı, ilaç kullanımı, endoskopik sonuçlar, Forrest sınıflaması ve endoskopik girişim gereksinimi ve mortalite açısından karşılaştırmalı olarak incelendi.  Gereç ve Yöntem: Toplam 194 hasta retrospektif olarak değerlendirilmeye alındı. Glomerüler filtrasyon hızı (GFR) 60 mL/dk/1.73 m^2’nin altı olan kronik böbrek yetmezliği grubunda 90 hasta, GFR 60 mL/dk/1.73 m²’nin ve üzerinde olan kontrol grubunda ise 104 hasta çalışmaya dahil edildi.  Bulgular: Çalışma sonucunda KBY grubunun daha yaşlı olduğu ve bu grupta hastaların %96’sında eşlik eden ek hastalık varlığı saptandı. İlaç kullanımı kontrol grubundan daha yüksekti ve en sık kullanılan ilaç olarak aspirin tespit edildi. Olguların % 70’inden fazlasına ilk gün endoskopi uygulandı. Sonuç: KBY grubunda hastane mortalite oranı kontrol grubuna göre yüksekti (%5.66’ye %2.88, p=0.475) ve total mortalite oranlarımız literatüre göre daha düşük tespit edildi.

The Effect of Adjuvant Treatment Preferences on Survival in Elderly Patients (≥65 Years) with Early-stage Breast Cancer - Journal of Oncological Sciences

Aims: Cancer and its treatment are often accompanied by psychological symptoms; this highlights the importance of psycho-oncological care. This study aimed to investigate the psychological symptoms and psycho-oncological awareness of cancer patients following a major earthquake. Methods: This single-center, cross-sectional study used prospective participant recruitment between July 1, 2026, and August 1, 2026. A total of 78 cancer patients aged 18 and older were included in the study, and they were administered a questionnaire and the Symptom Checklist-90-Revised (SCL-90-R). Results: Most participants were female, married, with children, unemployed, primary school graduates, and residents of the urban center. More than 20% of cancer patients were found to have high scores on subscales measuring depressive symptoms, additional items, obsessive-compulsive, and somatization symptoms. While 15.38% of participants indicated that they had heard of the term “psycho-oncology” before, 8.97% stated that they were knowledgeable about psycho-oncology. 14.10% of participants also stated that they received psychological support during the course of their illness. Higher psychological symptom scores were observed among participants reporting weight loss, pain, female gender, urban residence, lack of knowledge about the illness and the belief that the earthquake had caused their illness. Conclusion: In conclusion, the findings indicate a significant burden of psychological symptoms among cancer patients receiving treatment at an oncology center established after the February 6 earthquake, while also revealing that awareness of psycho-oncological services remains limited. Routine psychological assessment should be integrated into oncological care, and supportive interventions should be tailored to patients’ demographic, clinical, and psychosocial characteristics. Further multicenter studies with larger samples and more comprehensive assessments of earthquake-related experiences, psycho-oncological awareness, and access to psycho-oncological services are needed to better characterize psychological symptoms in oncology populations in post-disaster environments.

Aim: Early-onset gastric cancer (EOGC) represents a distinct subgroup with aggressive clinicopathological features; however, prognostic data in younger patients remain limited. This study aimed to evaluate clinicopathological characteristics and identify prognostic factors associated with survival in patients aged ≤ 50 years with gastric cancer.Materials and Methods: A total of 60 patients aged ≤ 50 years diagnosed with gastric cancer between 2014 and 2024 were included in this retrospective single-center study. Survival outcomes were analyzed using the Kaplan–Meier method, and prognostic factors were evaluated with Cox proportional hazards regression analysis.Results: The median age was 40.9 years, and 51.7% of patients were female. Diffuse or signet-ring cell histology and advanced-stage disease were frequently observed. Median progression-free survival (PFS) and overall survival (OS) were 19.3 and 26.0 months, respectively. Signet-ring cell histology, low Prognostic Nutritional Index (PNI), and elevated platelet-to-lymphocyte ratio (PLR) were associated with shorter PFS. In univariate analysis, poor Eastern Cooperative Oncology Group (ECOG) performance status (PS), low PNI, advanced stage, and total gastrectomy were associated with inferior survival. In multivariate analysis, ECOG PS 3 and elevated PLR independently predicted mortality.Conclusions: EOGC commonly presents with advanced disease and unfavorable outcomes. Both tumor-related factors and host-related parameters—including functional status, nutritional condition, and systemic inflammatory markers—play an important role in determining prognosis and may improve risk stratification in younger patients.