To investigate clinicopathological features in patients with recurrent colorectal cancer within 1 year and more than 1 year after curative resection. We retrospectively evaluated 103 patients with disease recurrence before versus after 1 year of resection. Thirty-two patients (31%) were diagnosed with recurrence less than 1 year after curative resection for colorectal cancer (early recurrence) and 71 (69%) after more than 1 year (non-early recurrence). The early recurrence group displayed a significantly lower overall survival rate for both colon cancer (p=0, 01) and rectal cancer (p<0.001). Inadequate lymph node dissection was a significant predictor for early relapse. There were no statistically significant differences in clinicopathological variables such as age, sex, primary tumor localization, stage, depth of invasion, lymphovascular invasion and perineural invasion between the early and non-early recurrence groups. However, a K-ras mutation subgroup was significantly associated with early recurrence (p<0.001). Poor survival is associated with early recurrence for patients undergoing resection for non-metastatic colorectal cancer, as well as K-ras mutation.

Three-weekly cisplatin dose is accepted for standard treatment for concurrent chemo-radiotherapy in nasopharyngeal carcinoma. However, different chemotherapy schedules are presented in the literature. We intend to compare toxicity and outcomes of high dose 3-weekly cisplatin versus low dose weekly-cisplatin and cumulative dose of cisplatin in the patients with nasopharyngeal carcinoma. 98 patients were included in the study, between 2010 and 2018. Cumulative doses of cisplatin (≥200mg/m² and <200mg/m²) and different chemotherapy schedules (weekly and 3-weekly) were compared in terms of toxicity and survival. Besides prognostic factors including age, gender, T category, N category and radiotherapy technique were evaluated in uni-multivariate analysis. Median follow-up time 41.5 months (range: 2-93 months). Five year overall survival, local relapse-free survival, regional recurrence-free survival and distant metastasis-free survival rates were; 68.9% vs. 90.3% (p=0.11); 66.2% vs. 81.6% (p=0.15); 87.3% vs. 95.7% (p=0.18); 80.1% vs. 76.1% (p=0.74) for the group treated weekly and 3 weekly, respectively. There was no statistically significant difference between groups. Five year overall survival, local relapse-free survival, regional recurrence-free survival and distant metastasis-free survival rates were; 78.2% vs. 49.2% (p=0.003); 75.8% vs. 47.9% (p=0.055); 91% vs. 87.1% (p=0.46); 80% vs. 72.2% (p=0.46) for the group treated ≥200mg/m² and <200mg/m² cumulative dose cisplatin. There was statistically significant difference between groups for overall survival and there was close to being statistically significant difference between groups for local relapse-free survival. Age, gender, T category, N category, chemotherapy schedules were not associated with prognosis in the uni-variety analysis. Radiotherapy technique and cumulative dose of cisplatin was associated with prognosis in uni-variate analysis (HR=0.21; 95% CI: 0.071-0.628; p=0.005 and HR=0.29; 95% CI: 0.125-0.686; p=0.003, respectively). Only cumulative dose of cisplatin was found as an independent prognostic factor in multivariate analysis (HR=0.36; 95% CI: 0.146-0.912; p=0.03). When toxicities were evaluated, such as hematological toxicity, dermatitis, mucositis, nausea and vomiting, there were no statistically significant differences between cumulative dose of cisplatin groups (<200mg/m² and ≥200mg/m²) and chemotherapy schedules (3-weekly and weekly). But malnutrition was statistically significant higher in patients treated with 3-weekly cisplatin compared with patients treated with weekly cisplatin (p=0.001). A cisplatin dose with ≥200mg/m² is an independent prognostic factor for overall survival. Chemotherapy schedules weekly and 3-weekly have similar outcomes and adverse effects. If patients achieve ≥200mg/m² dose of cumulative cisplatin, weekly chemotherapy schedules may be used safely and effectively in nasopharyngeal carcinoma patients.

In this study, we aimed to evaluate the clinical impact of the Global Immune-Nutrition Information Index (GINI) in patients with Ras wild-type metastatic colorectal cancer (mCRC) who received first-line palliative chemotherapy Ras wild-type mCRC. We retrospectively reviewed 177 patients diagnosed with Ras Wild Type mCRC between March 2009 and December 2023. The GINI was defined as follows: GINI= [C-reactive protein×platelet×monocyte×neutrophil]/[albumin×lymphocyte]. According to threshold values determined by receiver operating characteristics (ROC) analysis, the GINI was divided into two groups with < 2000 and ≥ 2000. Survival probabilities were predicted with the Kaplan-Meier method and group comparisons were applied with the Log-rank test. Furthermore, univariate and multiple Cox regression analyses were used to determine the most substantial risk elements. Median progression-free survival (PFS) 15 months in the group with GINI ≥ 2000 (95% Confidence interval (CI): 10.5–19.48) and 27 months (95% CI: 17.5–36.4) in the group with GINI < 2000 (p = 0.00021). The median OS was 27 months (95% CI: 23.8–30.1) in the GINI ≥ 2000 group and 77 months (95% CI: 59.7–94.2) in the GINI < 2000 group (p < 0.001). The results of multivariate analysis for PFS showed that albumin (HR, 1.83, p = 0.009), and prechemotherapy GINI (HR 1.79, p = 0.004) were significant independent prognostic factors. The results of multivariate analysis for OS showed that performance status (HR, 1.65; p = 0.018), number of metastatic sites (HR, 1.74, 0.005), skin toxicity (HR, 1.79, p = 0.003), pre-chemotherapy NLR (HR, 1.49, p = 0.045) and prechemotherapy GINI (HR 3.25, p < 0.001) were significant independent prognostic factors. Higher GINI values were associated with worse survival outcomes in patients with RAS wild-type mCRC, supporting its potential clinical use as a prognostic biomarker.

Background: Increasing use of ¹⁸F-FDG PET/CT in cancer patients, has led to more common detection of ¹⁸F-FDG uptake in the gastrointestinal tract (GIT). Aims: The objective of this study was to assess ¹⁸F-FDG uptake in incidental and known GIT malignancy. Methods: A total of 6500 patients followed-up in a single and tertiary center between January 2010 and September 2016 were retrospectively reviewed. Of 2850 patients assessed with ¹⁸FDG-PET/CT, known GIT malignancy and ¹⁸F-FDG uptake cases during follow-up were included in the study. Results: Of 658 patients with ¹⁸F-FDG uptake, 150 patients who underwent endoscopy were included in the study. Seventy-seven of these patients had known GIT malignancy and 73 had incidental ¹⁸F-FDG uptake. Among these 73 patients; 7 (9.6%) had malignancy, 20 (27,2%) adenoma and 24 (32.9%) inflammation that were confirmed. Endoscopy was normal in 22 (30.2%) patients. One hundred forty-three (95.3%) patients had focal and 7 (4.7%) had diffuse uptake. While no malignancy was detected in patients with diffuse uptake, 58.7% (84/143) of the patients with focal uptake presented malignancy. Mean the standardized uptake value (SUV) max values were found as 15.0 ± 10.6 (range, 3.8–56.5) in malignant disease, 10.2 ± 4.3 (range, 2.4-19.7) in adenoma, 7.3 ± 3.6 (range, 3.6–18.7) in inflammation, and 9.8 ± 4.2 (range, 3.8–19.9) in normal endoscopy groups (p < 0.001, rho = 0.378). Conclusion: Although this study demonstrated high probability of malignant disease with increased ¹⁸F-FDG uptake in the GIT, it would be a more appropriate approach to confirm all patients with ¹⁸F-FDG uptake through endoscopy as SUVmax values vary in a wide range.