Background: Pathological complete response (pCR) following neoadjuvant therapy (NAT) is a key surrogate marker for long-term outcomes in HER2-positive breast cancer. Identifying clinical and biological predictors of pCR, including systemic inflammatory and nutritional markers such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), neutrophil-to-albumin ratio (NAR), C-reactive protein-to-albumin ratio (CAR), systemic immune-inflammation index (SII), and prognostic nutritional index (PNI), may help refine treatment strategies and improve patient outcomes. Methods: We retrospectively analyzed 174 patients with stage II–III HER2-positive breast cancer who received neoadjuvant anti-HER2-based regimens at multiple centers between 2010 and 2025. Demographic, clinicopathological, and laboratory data were collected, and inflammatory and nutritional indices (NLR, PLR, LMR, NAR, CAR, SII, PNI) were calculated. Predictors of pCR were evaluated using univariate and multivariate logistic regression analyses. Results: Overall, 49% of patients achieved pCR. In multivariate analysis, independent predictors of pCR were hormone receptor negativity, smaller tumor size, HER2 IHC 3+ expression, dual HER2 blockade, and a higher prognostic nutritional index (PNI ≥ 55). In contrast, systemic inflammatory indices such as NLR, PLR, LMR, NAR, CAR, and SII were not significantly associated with pCR. Conclusions: This multicenter real-world study demonstrates that conventional inflammatory markers have limited predictive value, whereas the PNI emerges as a simple and practical biomarker reflecting nutritional and immune status. Integrating PNI with clinicopathological factors may enhance risk stratification and help guide individualized neoadjuvant treatment strategies in HER2-positive breast cancer.

Stroke represents a major complication in Takayasu arteritis (TA). We aimed to determine clinical characteristics and neurological outcomes in TA patients with stroke compared to those without. We retrospectively analyzed 35 patients (27F/8 M) with documented stroke to 50 consecutive patients (47F/3 M) without stroke followed by the Istanbul University-Cerrahpasa Medical Faculty. Demographic data, clinical manifestations, arterial involvement patterns, treatments, and neurological outcomes were evaluated. Disability was assessed using the Expanded Disability Status Scale (EDSS), Barthel Index, and Modified Rankin Scale. Mean age at diagnosis among patients with stroke and non-stroke was similar (38.5 ± 10.7 vs. 35.6 ± 11.6 years). The mean age at stroke was 43.1 ± 10.3 years. Patients with stroke were more likely to be male (22.9% vs. 6.0%, p = 0.023). Strokes were predominantly ischemic (91.4%), affecting anterior circulation (82.8%) with left hemisphere predominance (72.4%). Internal carotid artery (ICA) involvement was significantly associated with stroke (right ICA: 51.4% vs 18.0%, p = 0.001; left ICA: 37.1% vs 18.0%, p = 0.047), while abdominal aorta involvement seemed to be protective (20.0% vs 42.0%, p = 0.028). Male gender (OR = 5.70, p = 0.038) and any ICA involvement (OR = 5.98, p = 0.004) were identified as independent predictors of stroke. Importantly, 40% experienced stroke as the initial TA manifestation. Among those developing stroke after TA diagnosis, 85.7% were already receiving immunosuppression and 47.6% antiplatelet therapy. Stroke patients demonstrated significant disability (mean EDSS: 3.63 ± 3.36 vs 0.02 ± 0.14, p < 0.001) and 11.4% mortality, median 5 years after stroke. Male patients and those with ICA involvement face the highest risk for stroke in TA. Long-term consequences are devastating with increased mortality, severe disability and high recurrence rates. The failure of immunosuppressive therapy to prevent stroke in the majority of treated patients, combined with substantial perioperative mortality, stress the inadequacy of current management strategies.

Background and Objectives: The prognostic significance of body mass index (BMI) in metastatic HER2-positive breast cancer (BC) remains unclear, with previous studies yielding conflicting results. This multicenter real-world study aimed to investigate the prognostic role of BMI in this patient population. Materials and Methods: A total of 169 female patients with metastatic HER2-positive BC who received trastuzumab-based treatment between 2010 and 2024 were included. Patients were categorized by BMI (<30 kg/m² vs. ≥30 kg/m²). The primary endpoints were overall survival (OS) and progression-free survival (PFS). Kaplan–Meier and Cox regression analyses were performed overall and in subgroups stratified by hormone receptor (HR) status. Results: In the overall cohort, a BMI ≥ 30 was not significantly associated with OS or PFS. However, in the HR-positive/HER2-positive subgroup, BMI ≥ 30 kg/m² was linked to significantly shorter OS (p = 0.024) and PFS (p = 0.047) by Kaplan–Meier analysis. However, these associations did not remain statistically significant in multivariate analyses. No significant BMI-related differences were observed in the HR-negative subgroup. Other independent negative prognostic factors included recurrent disease, the presence of brain metastases, and a high Ki-67 index. Conclusions: BMI was not identified as an independent prognostic factor in the overall population. However, among HR-positive/HER2-positive patients, obesity was associated with poorer survival in univariate analysis, but this was not confirmed in multivariate analysis. These findings underscore the need for prospective studies to clarify the prognostic role of adiposity, considering biological subtypes.

Baş boyun kanserleri içinde hipopfarenks kanseri nadir görülen ve agresif seyreden tümörlerden olduğundan tedavisi düzenli takibi gerekmektedir. Hastalarda özellikle ilk iki yıl içinde nüks en sık görüldüğünden dolayı radyolojik görüntüleme ve semptomların takibi son derece önem arz etmektedir. Erken evrede tanı; lokal ileri veya boyun metastazı mevcut olana kadar klinik semptomların pek olmaması nedeniyle oldukça zordur. Tedavi sonrası düzenli takip, nüks hastalığı tespit etmeyi, gelişebilecek ikinci maligniteleri teşhis etmeyi ve geç komplikasyonları yönetebilmeyi sağlar. Hastaların uzun sağkalım ve yaşam kalitesi açısından yapılan kontroller oldukça önem arz etmektedir. Tüm hastaların olası tümör nüksünü, sağlık davranışlarını, beslenmeyi, diş sağlığını, konuşma ve yutma işlevini değerlendirmek için düzenli takipleri yapılmalı, klinik semptomları sorgulanmalıdır. Hypopharynx cancer is rare and aggressive tumor among head and neck cancers, and regular surveillance is requred. Since reccurrence is most common in patients, especially in the first two years, clinical, radiological and personalized symptom follow-up is extremely important. Early diagnosis; that is difficult the lack of clinical symptoms until locally advanced or neck metastases are pressent. Regular follow-up after treatment allows the diagnosis of recurrent disease, the diagnosis of possible second malignancies and the management of late complications. The controls of the patients in terms of long-term survival and quality of life are really important. All patients should be regularly followed up for possible tumor recurrence, health status, nutrition, dental treatment, speech and swallowing functions, and should be interviewed clinical symptoms.

Son yıllarda tamamlayıcı ve geleneksel tıp kullanımı onkoloji alanında gittikçe artmaktadır. Kanser hastalarında vücutta oluşan oksidatif hasarı azaltmak için antioksidanların alınmasının faydası ve önemi sürekli vurgulanmaktadır. Biz de güçlü antioksidan, anti-inflamatuar ve apoptotik aktivitesi olan ve aynı zamanda günümüzde diyabetik hastalarda nöropati tedavisinde verilen alfa lipoik asitin faydalarını, alternatif tıpta kullanımını ve kanser hastalarının tedavisindeki yerinin önemini yapılan çalışmalar doğrultusunda ve klinik kullanımı açısından anlatmaya çalıştık. In recent years, the use of complementary and traditional medicine has been increasing department of oncology. The benefit and importance of taking antioxidant supplements in cancer patients to reduce the oxidative damage in the body emphasized. We tried to explain the benefits of alpha lipoic acid, which has strong antioxidant, anti-inflammatory and apoptotic activity and is also given treatment of neuropathy in diabetic patients, its use in alternative medicine and the importance in the treatment of cancer patients, in line with the studies and in terms of clinical use.

PURPOSE: Primary bone sarcomas, including osteosarcoma, chondrosarcoma, and Ewing sarcoma, have poor prognoses, with 5-year overall survival (OS) rates of < 20%-30% in metastatic or recurrent disease. Although tyrosine kinase inhibitors (TKIs) targeting angiogenic and oncogenic pathways have shown efficacy in phase II trials, there is a lack of supporting real-world data. This study aimed to evaluate the efficacy and safety of TKI use in patients with advanced bone sarcomas in a real-world setting. MATERIALS AND METHODS: This multicenter, retrospective study included 72 patients with advanced or metastatic osteosarcoma, chondrosarcoma, or Ewing sarcoma who received at least one TKI (regorafenib, pazopanib, sorafenib, or cabozantinib) at multiple centers in Türkiye. Progression-free survival (PFS) and OS were estimated using the Kaplan-Meier method. Adverse events were recorded and graded according to standard criteria. RESULTS: The median age was 28.5 years (range, 17-72 years), and 62.5% (n = 45) of the patients were male. The most frequently used TKIs were regorafenib (n = 31, 43.1%) and pazopanib (n = 22, 30.6%); in the majority of patients (n = 68, 94.4%), TKIs were used as second-line or subsequent treatment. The median PFS for the entire cohort was 4.8 months (95% CI, 3.05 to 6.48), and the median OS was 9.9 months (95% CI, 6.48 to 13.25). In histologic subgroup analyses, the median PFS was 4.4 months for osteosarcoma, 4.8 months for chondrosarcoma, and 5.4 months for Ewing sarcoma. Adverse events were observed in 50% (n = 36) of patients, and 89.2% (n = 58) of these were grade 1-2. Dose reduction was required in 27.8% (n = 20) of patients, and permanent treatment discontinuation due to toxicity was necessary in 6.9% (n = 5) of patients. CONCLUSION: In this real-world cohort, although TKIs were associated with limited survival outcomes, they had an acceptable safety profile in patients with advanced bone sarcomas. These findings are consistent with the results of phase II studies and suggest that TKIs may be a treatment option for patients who have disease progression after standard therapies.