Background/Objectives: Preoperative prognostic assessment is essential for optimizing treatment strategies in pancreatic ductal adenocarcinoma (PDAC). This study aimed to evaluate and compare the prognostic value of the Heidelberg Pancreatic Prognostic (HELPP) score and the C-reactive protein–albumin–lymphocyte (CALLY) index in patients with resectable PDAC. Methods: We retrospectively analyzed clinical and laboratory data of 109 patients with resectable PDAC who underwent curative-intent surgery and adjuvant therapy. Patients were stratified based on preoperative HELPP and CALLY scores. Overall survival (OS) and disease-free survival (DFS) were assessed using Kaplan–Meier analysis, while independent prognostic factors were determined through multivariate Cox regression. Results: Kaplan–Meier survival analyses demonstrated that a HELPP score > 3 and a low CALLY index (≤1.029) were significantly associated with worse OS and DFS (log-rank p < 0.05). In multivariate analysis, the HELPP score was identified as an independent predictor of survival, whereas the CALLY index, although associated with survival in univariate analysis, did not reach statistical significance. In ROC analysis, both models exhibited acceptable discrimination, with the HELPP score achieving superior AUC values in predicting 1-year OS compared to the CALLY index. Conclusions: The HELPP score demonstrated independent prognostic value in multivariate analysis and may serve as a robust preoperative tool in resectable PDAC. The CALLY index, although not independently significant in multivariate analysis, showed strong prognostic separation in Kaplan–Meier survival analyses and may still aid in preoperative risk stratification, particularly where access to comprehensive scoring systems is limited.

Aim: We evaluated the prognostic significance of the KELIM score, which is derived from CA-125 kinetics, in predicting survival outcomes among patients with advanced epithelial ovarian cancer in a real-world clinical context. Material and Methods: This retrospective study analyzed 238 patients with stage III-IV ovarian cancer treated between 2017-2024. KELIM scores, calculated from CA-125 kinetics during the first 100 treatment days, were categorized as high (favorable, >0.9) or low (unfavorable, ≤0.9) based on the ROC analysis. Survival outcomes were assessed using Kaplan-Meier and Cox regression analyses. Results: Patients with low KELIM scores had significantly shorter median overall survival (33 vs. 68 months, p < 0.001) and progression-free survival (11 vs. 18 months, p < 0.001) than those with high scores. Multivariate Cox regression analysis identified a low KELIM score as a significant predictor of poor overall survival (HR, 4.062; 95% CI, 2.711–6.087; p < 0.001). Additionally, disease progression was more frequent in patients with a low KELIM score (89.4%) than in those with a high KELIM score (69.9%, p = 0.001). Conclusion: The KELIM score serves as a practical and accessible prognostic biomarker for advanced ovarian cancer with the potential to inform early treatment decisions for patients who are unlikely to benefit from standard chemotherapy. Further prospective studies are warranted to validate their roles in personalized therapeutic strategies.

Objective: To conduct a comparative analysis of layer-by-layer macular thickness, peripapillary retinal nerve fiber layer (pRNFL), and minimum rim width (MRW) between the eyes of patients with prostate cancer undergoing treatment with androgen receptor pathway inhibitors (ARPIs) and those of age- and sex-matched healthy controls, with the aim of assessing the potential effects of ARPIs on retinal structure. Methods: In this prospective cross-sectional study, 80 eyes of 80 patients with ARPI-treated metastatic prostate cancer and 80 eyes of 80 age-matched healthy controls were evaluated using Heidelberg Spectralis optical coherence tomography (OCT). Layer-by-layer macular thickness, pRNFL, and MRW were measured and compared between groups. Results: Thickness in most segments of retinal layers and pRNFL, as well as all MRW values, were significantly lower in the ARPI-treated group than in the controls (p < 0.05). No significant differences were observed between groups in terms of age, visual acuity, intraocular pressure, central corneal thickness, or lens status. Conclusions: This study is the first to evaluate layer-by-layer macular thickness in patients with metastatic prostate cancer treated with ARPIs, revealing significant thinning in nearly all macular layers, pRNFL, and MRW. These findings suggest that ARPI therapy may induce neurodegenerative changes in retinal and optic nerve structures. Therefore, further research is warranted to assess the ocular safety of these therapeutic agents.

Background and Objectives: Metastatic pancreatic ductal adenocarcinoma carries a dismal prognosis and there is an unmet need for simple, widely available prognostic biomarkers to guide risk stratification and treatment planning. This study aimed to evaluate whether baseline EASIX score, calculated from routine laboratory parameters (LDH, creatinine, platelet count), predicts overall survival (OS) in patients with de novo metastatic pancreatic cancer. Materials and Methods: We performed a retrospective cohort study at a single tertiary center (Medical Oncology Department, Kocaeli University Faculty of Medicine) including 332 patients diagnosed with de novo metastatic pancreatic ductal adenocarcinoma between January 2019 and October 2025. Baseline EASIX was calculated using LDH, creatinine, and platelet count. Statistical analyses included ROC analysis with Youden index to determine exploratory cut-off, Kaplan–Meier survival estimation with log-rank test, and univariate and multivariate Cox proportional hazards regression to identify independent prognostic factors. The primary endpoint was OS, defined as time from initiation of first-line therapy to death from any cause. Results: A total of 332 patients were included. Median OS was 8.0 months overall. Patients with high EASIX (>2.505) had significantly shorter median OS compared with low EASIX patients (8.4 vs. 27.6 months, p < 0.001). ROC analysis was considered exploratory for overall survival; therefore, an additional fixed-time (12-month mortality) ROC analysis was performed to provide a discrimination estimate accounting for censoring. The AUC for EASIX was 0.887 (95% CI: 0.816–0.958), and the exploratory cut-off determined was 2.505 (sensitivity 96.95%, specificity 72.97%). In multivariate Cox regression, high EASIX remained an independent predictor of worse OS (HR 4.124; 95% CI: 2.011–8.457; p < 0.001) after adjustment for relevant covariates. Conclusions: Baseline EASIX score is an independent prognostic marker for overall survival in de novo metastatic pancreatic cancer, based on routine laboratory tests, and may facilitate exploratory risk stratification. Prospective validation in independent cohorts is warranted before clinical implementation.

Aims: Pleural mesothelioma is an aggressive malignancy with poor prognosis and limited therapeutic options. Reliable prognostic models are essential for risk stratification and clinical decision-making. The recently developed PLACE score has shown promising results in Chinese populations; however, its generalizability remains uncertain. This study aimed to externally validate the PLACE prognostic score in a Turkish cohort of patients with metastatic epithelioid pleural mesothelioma. Methods: This retrospective cohort study included patients diagnosed with metastatic epithelioid pleural mesothelioma at a single tertiary center between January 2016 and September 2025. Clinical and laboratory data at diagnosis were collected, and the PLACE score was calculated for each patient. Overall survival (OS) was analyzed using the Kaplan–Meier method, and differences between risk groups were compared using the log-rank test. Cox proportional hazards regression analysis was performed to evaluate the association between prognostic variables and survival. The discriminative ability of the PLACE score was assessed using receiver operating characteristic (ROC) curve analysis. Results: A total of 48 patients were included, with a median age of 66 years. According to the PLACE score, 33.3% of patients were classified as low-risk and 66.7% as high-risk. The median overall survival was 21.06 months. Patients in the low-risk group had significantly longer survival compared to the high-risk group (37.98 vs. 15.6 months, p=0.033). The PLACE score demonstrated limited discriminative ability, with an area under the curve (AUC) of 0.617 (95% CI: 0.413–0.821). In Cox regression analysis, high-risk patients had a significantly increased risk of mortality (HR: 2.28, 95% CI: 1.04–4.95, p=0.037). In multivariable analysis, the PLACE risk group remained an independent predictor of overall survival. Conclusion: The PLACE score retains prognostic significance in Turkish patients with metastatic pleural mesothelioma but demonstrates reduced discriminative performance compared to the original study. These findings emphasize the need for external validation and potential population-specific recalibration of prognostic models.

Background: Percutaneous nephrostomy (PCN) is frequently employed to relieve malignant ureteral obstruction in patients with muscle-invasive bladder cancer (MIBC), yet its prognostic and infectious implications in non-metastatic disease remain poorly characterized. This study aimed to evaluate the association between PCN at diagnosis and clinical outcomes in patients with non-metastatic MIBC. Methods: We retrospectively analyzed 199 patients with non-metastatic MIBC treated between January 2019 and March 2025 at two centers in Türkiye. Patients were grouped by PCN status at diagnosis. The primary endpoint was overall survival (OS); secondary endpoints were metastasis-free survival (MFS) and infection-related outcomes. Survival was analyzed using Kaplan–Meier and multivariable Cox regression, including ECOG performance status and treatment modality as covariates. Logistic regression was used to assess infectious outcomes. Collinearity was evaluated using variance inflation factor analysis. Results: PCN was present in 27.1% of patients. Median OS was shorter in the PCN group compared with those without PCN (24 vs. 41 months; p = 0.004); however, PCN did not retain independent prognostic significance in the multivariable model after adjustment for ECOG performance status, CRP, N stage, and treatment modality (HR 0.433; 95% CI 0.175–1.068; p = 0.069). ECOG performance status (HR 1.819; p = 0.039), CRP (HR 1.005; p = 0.01), and N stage (HR 1.724; p = 0.023) were independent predictors of OS. A subgroup analysis within the hydronephrosis-positive population showed no significant difference in OS between PCN and non-PCN patients (26 vs. 29 months; p = 0.785). Treatment modality was the sole independent predictor of MFS (HR 0.594; p = 0.008). PCN was a strong and independent predictor of positive urine cultures (OR 2.685; 95% CI 1.055–6.837; p = 0.038) and infection-related hospitalizations (OR 13.995; 95% CI 4.923–39.785; p < 0.001). Conclusions: In patients with non-metastatic MIBC, PCN was not an independent predictor of OS after comprehensive adjustment, suggesting that the survival disadvantage observed in unadjusted analysis reflects baseline clinical vulnerability rather than a direct effect of the procedure. PCN was, however, independently and strongly associated with infectious morbidity. These findings position PCN as a marker of clinical frailty that warrants careful multidisciplinary evaluation before placement and proactive management of infectious complications thereafter.