Background and Objectives: Despite developments in cervical cancer (CC) treatment, an advanced stage is a poor prognostic factor. Cervical cancer is an immunogenic tumor in which viruses, like HPV, play a role in carcinogenesis. Therefore, systemic inflammatory markers (SIMs) may have prognostic value. Most studies on SIMs focus on the early stage by evaluating pretreatment levels. This study aims to evaluate the prognostic and predictive values of both pretreatment and post-treatment parameters at the advanced stage, as well as treatment efficacy after progression with first-line treatment. Materials and Methods: A total of 133 advanced-stage CC patients with progression on first-line platin–paclitaxel and bevacizumab were evaluated retrospectively. Demographic and histopathological characteristics were recorded along with treatment details. Pre-treatment baseline blood parameters and post-treatment follow-up values were recorded to calculate SIMs as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and systemic inflammatory response index (SIRI). Results: Median values for SIMs were accepted as cut-off values. Post-treatment values demonstrated stronger predictive power, with pre-treatment SIRI and NLR being significant only in univariate analysis, but not in multivariate analysis. High post-treatment SIRI (>2.1) was correlated with shorter overall survival (OS) and considered a poor prognostic factor. High post-treatment SIRI (>2.1), -SII (>746), and -PLR (>197) emerged as independent prognostic factors for progression-free survival (PFS). Their prognostic values were clearer in the whole population and the metachronous metastatic subgroup. Rechallenge of platinum-based chemotherapy was an option for those who had at least 6 months of PFS with first-line platinum-based chemotherapy. Bevacizumab addition to single-agent or combination regimens led to improved ORR as well. Conclusions: Post-treatment SIRI is a promising prognostic factor for OS, while post-treatment SIRI, SII, and PLR may serve as convenient SIMs for PFS. Platinum-based combination chemotherapy reinduction is a feasible second-line treatment strategy, especially with the addition of bevacizumab.

Objective: Extragonadal germ cell tumours have a more unfavourable prognosis than gonadal germ cell tumours. We aimed to evaluate the survival analysis, response rates, and factors affecting responses to high-dose chemotherapy (HDCT) and autologous stem cell transplantation (ASCT) in patients with relapsed/refractory extragonadal germ cell tumours. Methods: This study included patients diagnosed with extragonadal germ cell tumours who underwent HDCT + ASCT between November 2016 and January 2023 at Gülhane Training and Research Hospital. Clinical characteristics and follow-up data from patient records and the hospital’s electronic system were retrospectively analysed. Patients under 18 years of age and those without medical records were excluded. Patient characteristics, post-HDCT progression-free survival (PFS), overall survival (OS) data, and factors affecting survival were examined. The relationship between clinical factors and OS/PFS was analysed. Results: Twenty-five patients were included in this study. Complete response (CR) was observed in seven patients (28%), partial response (PR) was observed in nine patients (36%), stable disease (SD) was observed in one patient, and progressive disease (PD) was observed in eight patients (32%) after HDCT + ASCT. The median follow-up period was 25.4 months. The median PFS and OS after HDCT + ASCT were calculated as 6.1 months and 12.2 months, respectively. Conclusions: Salvage HDCT + ASCT is an option in the treatment of extragonadal germ cell tumours, offering the potential for prolonged survival and curing.

Background Relapsed or refractory Germ cell tumors are commonly treated with HDCT/ASCT, yet robust predictors of hematopoietic recovery are limited. Quantitative CT-based body-composition metrics are readily available in practice, but their prognostic value for post-transplant engraftment remains uncertain. We investigated whether muscle and fat indices derived from routine CT scans are associated with the pace of hematologic recovery after HDCT/ASCT Methods Retrospective single-center cohort (n=43) with relapsed/refractory GCT undergoing HDCT/ASCT. CT within ±6 months of ASCT was analyzed at L3 to derive SMI, PMI, SFA, VFA, TFA, and VFA/SFA. Primary endpoint: engraftment time post-ASCT. Univariable associations used Spearman ρ; multivariable linear regression adjusted for age, Hb, weight, and BSA evaluated independent effects. Significance: p< 0.05 Results Median hematologic engraftment duration was 12.0 days . Engraftment duration correlated positively with age and negatively with hemoglobin. In multivariable analysis, older age and lower hemoglobin independently predicted longer engraftment; body weight and BSA were not significant. Among morphometrics, only VFA/SFA associated with delayed engraftment. SMI, PMI, and TFA were not significant. As expected after HDCT, grade 4 neutropenia and thrombocytopenia occurred in all patients. Conclusions In relapsed/refractory GCT treated with HDCT/ASCT, older age and lower post-transplant hemoglobin independently predict prolonged engraftment. Beyond traditional muscle/fat areas, a higher VFA/SFA ratio—reflecting visceral adiposity—also associates with delayed recovery, suggesting fat distribution may influence hematopoietic regeneration. These variables may support pre-transplant risk stratification and individualized supportive care.

Background: The role of high-dose chemotherapy followed by autologous stem-cell transplantation (HDCT–ASCT) in advanced Ewing sarcoma remains uncertain, with mixed prospective data and heterogeneous retrospective findings. Materials and Methods: We performed a single-center, retrospective cohort study of consecutive patients with histologically confirmed ES who received HDCT–ASCT after ≥1 prior systemic therapy line (N=46). Conditioning was ICE. Prespecified endpoints were overall survival (OS; diagnosis → death), post-transplant overall survival OS-2 (ASCT → death), and progression-free survival PFS (ASCT → progression/death). Survival was estimated by Kaplan – Meier and compared by log-rank. Prognostic factors (age at diagnosis, primary tumor site, metastatic organ involvement) were evaluated using Cox models. Results: Median age at diagnosis was 23.5 years (14–55); 69.6% were male and 21.7% had metastatic disease at presentation. Median OS was 42.0 months, median PFS and OS-2 after HDCT–ASCT were 5.0 months and 8.0 months, respectively. Younger age (≤23 years) was associated with longer OS (50.0 vs 34.0 months; p=0.027). Primary tumor site was not independently associated with PFS, OS-2, or OS. Metastatic site showed endpoint-specific effects: liver metastasis independently predicted worse OS (HR 5.411; p=0.006), while lung metastasis was associated with shorter PFS (HR 6.037; p=0.016) and OS-2 (HR 2.672; p=0.025). Post-transplant best responses were CR 8.7%, PR 17.4%, SD 15.2%, and PD 58.7%. Grade 3–4 hematologic toxicities were universal (febrile neutropenia, neutropenia, thrombocytopenia 100%; anemia 86.9%); common non-hematologic events included nausea/vomiting (82.6%), diarrhea (78.2%), and mucositis/stomatitis (65.2%). Treatment-related mortality was 2.1% (1/46). Conclusions: In this young-adult–predominant cohort, HDCT–ASCT achieved limited disease control with substantial but manageable toxicity. Prognosis was driven more by age and metastatic organ involvement than by primary site, with liver metastasis portending inferior OS and lung metastasis adversely affecting PFS/OS-2. These data support risk-adapted patient selection and exploration of post-transplant maintenance strategies in future prospective studies.

Background and Objectives: Gastric cancer is one of the most common malignancies worldwide and continues to be associated with high mortality. The hemoglobin-to-red cell distribution width (HGB/RDW) ratio has emerged as a promising hematological prognostic biomarker in various cancers. However, its prognostic significance in patients with curative-intent resection of non-metastatic gastric cancer remains insufficiently investigated. This study aimed to evaluate the association between the pretreatment HGB/RDW ratio and progression-free survival (PFS) as well as overall survival (OS) in patients with non-metastatic gastric cancer. Materials and Methods: In this multicenter study, a total of 175 patients with non-metastatic gastric cancer who received perioperative FLOT chemotherapy (four preoperative and four postoperative cycles) and underwent curative-intent surgical resection were retrospectively analyzed. A cut-off value for the HGB/RDW ratio was calculated using receiver operating characteristic (ROC) curve analysis. Survival outcomes, including progression-free survival (PFS) and overall survival (OS), were analyzed using the Kaplan–Meier method. Multivariate Cox proportional hazards regression analysis was performed to identify independent prognostic factors. Results: Patients with an HGB/RDW ratio > 0.85 demonstrated significantly superior 2-year and 5-year OS rates (76.2% vs. 59.6% and 51.6% vs. 27.7%, respectively; p = 0.003) and PFS rates (69.4% vs. 49.6% and 53.7% vs. 36.4%, respectively; p = 0.047) compared to those with HGB/RDW ≤ 0.85. Multivariate analysis identified HGB/RDW ≤ 0.85 as an independent predictor of both increased mortality risk (HR: 1.88, 95% CI: 1.16–3.06; p = 0.011) and disease progression risk (HR: 1.79, 95% CI: 1.18–2.72; p = 0.006). Conclusions: The pretreatment HGB/RDW ratio is an independent prognostic factor for OS and PFS in patients with curative-intent resection of non-metastatic gastric cancer and may be considered a practical marker that could contribute to treatment planning in this patient population.