Aim: The tumor microenvironment of NSCLC with driver mutations, such as EGFR, ALK and ROS, is less inflammatory. Materials & methods: This retrospective study included 38 patients with NSCLC driver... Plain language summary Lung cancer is the most common cancer worldwide and has a high mortality rate. Overall survival expectancy in metastatic NSCLC has increased from 11 months to 18 months. The ... Tweetable abstract Peripheral inflammatory parameters may be associated with survival in driver mutation NSCLC, in contrast to a less inflammatory tumor microenvironment.

Background: Finding dependable prognostic biomarkers for metastatic colorectal cancer (mCRC) is crucial. The albumin-to-carcinoembryonic antigen (CEA) ratio (ACR), a measure of nutritional-inflammatory status and tumor load, has emerged as a promising prognostic indicator. This study assessed ACR’s prognostic value of ACR in patients with mCRC. Methods: This retrospective study included 125 patients with mCRC followed at our institution between July 2010 and March 2022. ROC curve analysis was used to determine the optimal cutoff values for ACR, prognostic nutritional index (PNI), lymphocyte-to-monocyte ratio (LMR), and CEA. Kaplan–Meier and Cox regression analyses were used to evaluate progression-free survival (PFS) and overall survival (OS). Results: PFS and OS were 13.3 and 26.0 months, respectively. Patients with an ACR ≥ 4.24 experienced significantly longer PFS (16.8 vs. 11.0 months; p = 0.001) and OS (32.0 vs. 22.3 months; p < 0.001) compared with those with ACR < 4.24. In univariable analyses, ACR was significantly associated with both PFS and OS, whereas PNI, LMR, and CEA were associated with OS only. In multivariable Cox regression models ACR showed a significant association with both PFS (HR 0.413; 95% CI: 0.265–0.643; p < 0.001) and OS (HR 0.341; 95% CI: 0.210–0.551; p < 0.001), while maintenance therapy was significantly associated with PFS only and ECOG performance status, LMR and PNI with OS only. Conclusions: ACR appears to be a cost-effective biomarker that is associated with PFS and OS in mCRC. These findings suggest that ACR may have potential value for prognostic assessment and risk stratification in patients with mCRC.

Aim: Patients with acromegaly are at risk of metabolic diseases, such as diabetes mellitus, insulin resistance and hypertriglyceridemia. We aimed to investigate what is effective in the development of non-alcoholic fatty liver disease (NAFLD) in patients with acromegaly.Materials and Methods: 60 (33 female, 27 male) patients with acromegaly, and a healthy control group of 52 persons (27 female and 25 male) were retrospectively studied. Mean age of the patients and the control group were 44.11 ±13.83 and 39.12±14.99 respectively. Body mass index (BMI), liver ultrasound and laboratory findings were taken from the records in the files. Statistical analyzes were performed using SPSS statistical software package version 22 (IBM Corporation, USA).Results: Fasting blood sugar, triglyceride, insulin like growth factor, growth hormone(GH) and CRP levels were significantly higher, HDL levels were significantly lower in acromegaly group. BMI and NAFLD were similar between groups. We found that, BMI and GH are the most important two factors in the presence of NAFLD in patients with acromegaly. NAFLD correlates significantly positively with the patient's BMI, weight and age; significantly negatively with the GH levels. Conclusion: In people with acromegaly, BMI and GH levels are the things that affect development of NAFLD.

Background: Gastric cancer remains a leading cause of cancer mortality, and additional prognostic tools reflecting host inflammation and nutritional status are needed, particularly in patients receiving neoadjuvant regimens such as fluorouracil, leucovorin, oxaliplatin, and docetaxel (FLOT). This study aimed to evaluate the prognostic significance of the Gustave Roussy Immune (GRIm) score in patients with locally advanced gastric cancer treated with neoadjuvant FLOT. Methods: This retrospective single-center study included 128 patients with locally advanced gastric or gastroesophageal junction (GEJ) adenocarcinoma treated with neoadjuvant FLOT between 2018 and 2022. The GRIm score, based on albumin, lactate dehydrogenase (LDH), and neutrophil-to-lymphocyte ratio (NLR), was used to stratify patients into low- and high-risk groups. Overall survival (OS) and progression-free survival (PFS) were analyzed using Kaplan–Meier and Cox proportional hazards regression models. Results: Among 128 patients (mean age, 61.5 years; 63.3% male), 69.5% underwent surgical resection, and 24.7% achieved a pathological complete response. During a median follow-up of 36.9 months, 57.0% of patients experienced disease progression and 48.4% died. The median OS and PFS were 49.9 and 25.5 months, respectively. The GRIm score demonstrated moderate discriminative ability for mortality (area under the curve [AUC]: 0.704) and was significantly associated with survival. The median OS was shorter in the high-risk group than in the low-risk group (35.2 vs. 69.6 months, p < 0.001), and the median PFS was also shorter in the high-risk group (17.2 months vs. not reached, p < 0.001). In the multivariate analysis, high GRIm risk remained independently associated with worse OS (hazard ratio [HR]: 1.832, p = 0.030) and PFS (HR: 2.491, p < 0.001), along with age, clinical stage, and surgical resection status. Conclusions: In this single-center retrospective cohort study, the GRIm score was associated with survival outcomes in patients with locally advanced gastric or GEJ adenocarcinoma receiving neoadjuvant FLOT. These findings suggest that the GRIm score may provide additional risk stratification when interpreted in conjunction with established clinical factors. However, external validation in larger prospective cohorts is required before it can be applied in routine clinical practice.

Background: This retrospective cohort study evaluated the role of the PILE score as a prognostic biomarker for overall survival (OS) and progression-free survival (PFS) in patients with locally advanced esophageal squamous cell carcinoma (ESCC) who were treated with neoadjuvant chemoradiotherapy (nCRT). Methods: This study included 108 patients with ESCC treated with weekly paclitaxel-carboplatin and concurrent radiotherapy at Erzurum Atatürk University Faculty of Medicine Hospital between January 2018 and April 2024. Patients were categorized into low- (PILE score 0–1) and high-risk (PILE score 2–3) groups. Kaplan–Meier analysis and Cox regression models were used to evaluate the association between the PILE score and survival outcomes. Results: The results showed that the high-risk PILE group had significantly shorter median OS (18.6 months vs. not reached; p < 0.001) and PFS (12.4 months vs. not reached; p < 0.001) than the low-risk group. Multivariate analysis showed that the PILE risk classification [hazard ratio (HR) = 2.527; 95% confidence interval (CI): 1.380–4.629; p = 0.003] and surgical resection (HR = 0.249; 95% CI: 0.090–0.683; p = 0.007) were independent prognostic factors for OS, whereas the PILE risk classification (HR = 2.932; 95% CI: 1.525–5.639; p = 0.001) and surgical resection (HR = 0.131; 95% CI: 0.044–0.394; p < 0.001) were independent prognostic factors for PFS. Conclusions: The study concludes that the PILE score is a robust prognostic tool for OS and PFS in patients with ESCC undergoing nCRT, highlighting its potential for risk stratification and personalized treatment planning.

Background: Accurate prognostication in terminal cancer patients receiving best supportive care (BSC) is essential for guiding end-of-life decision-making and avoiding non-beneficial interventions. Several prognostic models have been developed for advanced cancer, including the Palliative Prognostic Index (PPI) and the Objective Prognostic Score (OPS). However, prospective data evaluating their performance specifically in patients managed with BSC are limited. This study evaluated the prognostic performance of PPI and OPS in terminal cancer patients receiving BSC. It also examined whether their combined use provides additional value for short-term mortality risk stratification. Methods: This prospective observational cohort study included hospitalized adult patients with terminal-stage cancer and a documented BSC decision. Terminal-stage cancer was operationally defined as stage IV malignancy with poor performance status and no remaining feasible disease-directed oncological treatment option due to severe clinical deterioration and/or major organ dysfunction. Patients were prospectively enrolled from 12 April 2024 to 13 December 2024 and followed until death. Eligible patients had poor Eastern Cooperative Oncology Group performance status (ECOG 3–4) and had not received oncologic treatment within the preceding month. PPI and OPS were calculated at baseline using predefined criteria. Survival time was defined as the interval between baseline assessment and death. The prognostic performance of the scores for 3-, 4-, and 6-week mortality was evaluated, and survival outcomes were analyzed using standard survival analysis methods. Results: A total of 112 patients were included in the final analysis. The mean age was 62.3 ± 12.3 years; 66 patients (58.9%) were male and 46 (41.1%) were female. The most common primary tumor sites were colon cancer (20.5%), non-small cell lung cancer (17.0%), and gastric cancer (15.2%). Both PPI > 6 and OPS ≥ 3 were associated with higher short-term mortality, although their individual discriminatory performance was modest. The combined OPS–PPI approach showed statistically significant but still modest discrimination at all time points. Although this difference was limited, the combined approach supported the stratification of a clinically relevant subgroup at particularly high risk of imminent death. Patients with both OPS ≥ 3 and PPI > 6 had the poorest survival, with a median overall survival (OS) of 11 days. In multivariable Cox regression analysis, the combined high-risk group remained independently associated with poorer OS (HR 1.53, 95% CI 1.01–2.31; p = 0.046). Conclusions: Although the individual discriminatory performance of PPI and OPS was modest, their combined use may provide additional risk stratification value and may help identify patients at particularly high risk of short-term mortality among terminal cancer patients receiving BSC. These findings should be interpreted as supporting bedside risk stratification rather than indicating a definitive individual-level prediction model.