Background: Advanced-stage epithelial ovarian cancer is associated with variable survival outcomes, despite standardized treatments. Identifying reliable and accessible prognostic markers is critical to guide clinical decision-making. Objective: The aim of this study was to evaluate the prognostic significance of the modified Glasgow Prognostic Score (mGPS) in patients with FIGO stage III–IV epithelial ovarian cancer. Methods: In this retrospective cohort study, 89 patients diagnosed between 2018 and 2023 were analyzed. The mGPS was calculated from pre-treatment serum C-reactive protein (CRP) and albumin levels. Overall survival (OS) was assessed using Kaplan–Meier and Cox regression analyses. Results: The median OS was 32.3 months. When stratified by mGPS categories, the 2-year survival rates were 94%, 75%, and 34% in the mGPS 0, 1, and 2 groups, respectively (p < 0.001). In the multivariate Cox proportional hazards model, both mGPS (HR = 1.85; 95% CI: 1.12–3.07; p = 0.016) and ECOG performance status (HR = 1.67; 95% CI: 1.02–2.75; p = 0.043) were identified as independent predictors of overall survival. Conclusions: The mGPS is a simple, low-cost, and independently predictive tool for overall survival in advanced ovarian cancer. By capturing both systemic inflammation and nutritional status, it enhances risk stratification and may support individualized treatment planning. Prospective validation is warranted.

Background: Metastatic bladder cancer (mBC) presents a significant global health challenge with a poor prognosis and considerably limited survival. Despite advancements in therapies, long-term survival remains difficult to predict. This study aimed to evaluate the prognostic potential of various pretreatment blood-based biomarkers, including the NLR, dNLR, LMR, PLR, SII, mGPS, CAR, AGR, PNI, PIV, and Bellmunt score, in mBC patients. Methods: A retrospective cohort of 133 patients from Hacettepe University Cancer Institute was analyzed. Kaplan–Meier survival analysis and Cox regression models were used to assess overall survival (OS) and progression-free survival (PFS). Results: There was a significant association between multiple biomarkers and OS in the univariate analysis, with a higher NLR, PLR, and SII linked to worse outcomes. However, in the multivariate analysis, only the modified Glasgow Prognostic Score (mGPS) maintained independent prognostic significance for OS (HR: 1.984, p = 0.013). This suggests that the mGPS, which reflects systemic inflammation and nutritional status, is a robust predictor of survival in mBC. Conclusions: This study highlights the potential of integrating blood-based biomarkers into clinical decision-making to improve personalized treatment strategies. However, prospective studies are needed to validate these findings and assess their applicability to newer therapies such as immune checkpoint inhibitors and antibody–drug conjugates.

Background: Thymic carcinoma (TC) is a rare and aggressive malignancy with limited evidence guiding second-line treatment after prior systemic therapy. We evaluated real-world outcomes of second-line systemic therapy in a multicenter cohort. Methods: Adults with unresectable, recurrent, or metastatic TC who received second-line systemic therapy after prior systemic therapy between 2010 and 2023 were retrospectively analyzed. Treatments were categorized as multidrug chemotherapy, gemcitabine monotherapy, PD-1 inhibitor therapy, or targeted therapy (sunitinib). For the primary comparison of multidrug chemotherapy versus gemcitabine monotherapy, propensity scores based on age, sex, ECOG performance status, Masaoka–Koga stage IV, prior surgery, and calendar year were used to generate overlap weights. Weighted Cox models used robust standard errors clustered by treatment center. A sensitivity propensity-score model additionally included first-line carboplatin–paclitaxel exposure (yes/no). Results: A total of 107 patients from 20 treatment centers were included. Median age was 53.2 years (IQR, 41.5–58.0), 78 (72.9%) were male, 81 of 106 patients with available data (76.4%) had ECOG 0–1, and 61 (57.0%) had Masaoka–Koga stage IV disease at diagnosis. At a median follow-up of 35 months, median PFS and OS for the overall cohort were 13.6 and 35.0 months, respectively. In the primary overlap-weighted comparison ( n = 89), multidrug chemotherapy was associated with a lower hazard of progression or death than gemcitabine monotherapy (HR, 0.29; 95% CI, 0.14–0.59; p < 0.001) and a lower hazard of death (HR, 0.42; 95% CI, 0.18–0.97; p = 0.043). In a sensitivity model additionally incorporating first-line carboplatin–paclitaxel exposure, the PFS estimate remained significant (HR, 0.32; 95% CI, 0.16–0.65; p = 0.0015), whereas the OS estimate remained directionally similar but was less precise (HR, 0.46; 95% CI, 0.19–1.11; p = 0.083). The PD-1 inhibitor group ( n = 13) had median PFS and OS of 15.0 and 48.0 months, respectively, in unadjusted descriptive analyses. Conclusions: In this retrospective cohort, multidrug chemotherapy was associated with lower hazards of progression or death and of death than gemcitabine monotherapy in the primary overlap-weighted analysis. A sensitivity analysis additionally accounting for first-line carboplatin–paclitaxel exposure preserved the PFS association and yielded a similar but less precise OS estimate. Outcomes observed with PD-1 inhibitors were favorable but should be interpreted descriptively because of the small sample size, later treatment era, and potential residual confounding. These findings are hypothesis-generating and require prospective validation.

Aim: The addition of atezolizumab to platinum-etoposide chemotherapy has become the standard first-line treatment for extensive-stage small-cell lung cancer (ES-SCLC). However, real-world data regarding treatment outcomes and prognostic factors remain limited. This study evaluated the effectiveness of first-line carboplatin-etoposide-atezolizumab and investigated clinical and PET/CT-derived prognostic factors in patients with ES-SCLC.Materials and Methods: We retrospectively analyzed 59 consecutive patients with ES-SCLC who received first-line carboplatin, etoposide, and atezolizumab between January 2022 and December 2025. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan–Meier method. Prognostic factors for OS were evaluated using univariate and multivariable Cox proportional hazards regression analyses.Results: The median PFS and OS were 6.1 months (95% CI, 5.6–6.6) and 8.9 months (95% CI, 6.9–10.9), respectively. Patients with ECOG performance status (PS) 0–1 had significantly longer PFS (6.3 vs. 4.9 months, p=0.001) and OS (13.9 vs. 6.5 months, p=0.002) than those with ECOG PS 2–3. In multivariable analysis, ECOG PS remained the only independent prognostic factor for OS (HR 2.104, 95% CI 1.183–3.741; p=0.016). Brain, liver, and bone metastases, prophylactic cranial irradiation status, and PET/CT-derived nodal and metastatic SUVmax values were not significantly associated with survival.Conclusions: In this real-world cohort of patients with ES-SCLC treated with first-line carboplatin-etoposide-atezolizumab, ECOG performance status was the only independent prognostic factor for overall survival. PET/CT-derived metabolic parameters did not demonstrate prognostic value, emphasizing the continued importance of simple clinical assessment in the chemoimmunotherapy era.

Background: Minor salivary gland biopsy (MSGB) is commonly done when neuro-Sjögren's is suspected in neurology inpatients, but its yield, specificity, and spinal cord imaging features are uncharacterised in consecutive biopsied patients. We aimed to assess these and clarify what a high-grade biopsy does and does not establish about neuro-Sjögren's.Methods: In this single-centre retrospective cohort study in Ankara, Türkiye, consecutive neurology inpatients aged 18 years or older who underwent MSGB after a rheumatology consultation between Jan 1, 2014, and Sept 22, 2024, were included. High-grade MSGB was defined as Chisholm–Mason grade 3 or 4 (focus score ≥1). Final diagnoses were re-evaluated by rheumatologists and neurologists, while neuroimaging was reviewed by neuroradiologists. Clinical, serological, and imaging features associated with high-grade MSGB and a final diagnosis of neuro-Sjögren’s were examined using Firth-penalized logistic regression.Findings: Of 778 neurology inpatients, 342 underwent MSGB and 323 were analysed (225 [69.7%] women; mean age 50.2 years [SD 15.1]). High-grade MSGB was present in 41 patients (12.7%) and neuro-Sjögren's in 35 (10·8%). High-grade MSGB was strongly associated with neuro-Sjögren's (univariable OR 33.1 [95% CI 14.5–80.3]; p<0.001), although this association partly reflects the incorporation of the biopsy result into the diagnostic process. For Sjögren’s syndrome, high-grade MSGB was highly specific (97.4% [94.7–98.7]) but only moderately sensitive (63.0% [49.6–74.6]). 7 (17%) patients with high-grade MSGB did not have Sjögren's syndrome. Anti-Ro/La positivity (OR, 2.34; 95% CI, 1.02–5.16; p=0.03) and short-segment spinal cord T2 hyperintensity (OR, 2.57; 95% CI, 1.10-6.12; p=0.03) were independently associated with high-grade MSGB. Longitudinally extensive cord lesions and leptomeningeal enhancement were uncommon, and neuroimaging didn’t improve discrimination beyond biopsy findings, serology, and clinical features.Interpretation: High-grade MSGB is specific but not pathognomonic for Sjögren's syndrome, and cord involvement is more often short-segment than longitudinally extensive. Findings from disease-enriched series might not apply to routinely biopsied patients; biopsy findings should be interpreted alongside clinical, serological, and imaging findings.