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With 500,000 new cases diagnosed each year, head and neck cancers (HNC) are among the most prevalent cancers in the world. The most effective organ-sparing therapy for patients with locally advanced HNC is concurrent chemoradiotherapy (C-CRT). Many HNC patients lose multiple teeth and develop soft and hard tissue defects over the course of the disease and treatment, leading to functional limitations and cosmetic deformity. Such devastating effects harm the patient's ability to eat, chew, and swallow as well as their psychological, financial, and social well-being. Additionally, multiple tooth losses and subpar oral rehabilitation services can cause cachexia, rapid weight loss, and weakened immunity. The use of conventional prostheses to address tooth losses may not be permitted due to detrimental changes in the structure of the oral cavity. Conventional prostheses may aggravate the harmful side effects of radiotherapy, including xerostomia, mucositis, and a deterioration of bone healing processes. Dental implants may be a better choice for oral rehabilitation. However, because the area of bone involved in implant placement is frequently within the irradiation zone, dental implant planning and timing in HNC patients can be extremely difficult. Additionally, the placement of dental implants may precipitate some specific side effects of cancer treatments, such as osteoradionecrosis. Because the best time to use dental implants is one of the essential components of successful dental rehabilitation for HNC survivors and has not yet been clarified in the literature, this review article aims to gather and provide information in the head and neck region by reviewing the available literature.

A significant contributor to cancer-related morbidity and mortality worldwide is head and neck cancer (HNC). Depending on the affected site, its etiology may include risk factors like geographic differences, genetic predisposition, gender, age, type of diet, smoking and/or alcohol consumption habits, and sexual preferences. Dysbiosis, or disruption of the oral microbiota balance, is another proposed causative factor for HNC. The oral microbiota is home to over 1,000 microbial species, including pathogenic and commensal strains. Disruption of the healthy balance of the oral cavity microbiota triggers the carcinogenic mechanisms by inducing chronic inflammation in the affected site, which acts as a pro-carcinogenic factor by inducing an immune-suppressed microenvironment that induces cell proliferation and inhibits apoptosis. Recent studies have also found that members of the human microbiome are strongly linked to a wide range of cancer types, with well-established associations between the oral microbiota and chronic inflammation and cell proliferation. Aside from chronic inflammation, the bacterial genome, toxins, and metabolites have been proposed as additional factors that induce or facilitate carcinogenesis and its progression in the head and neck region. However, the precise mechanisms remain largely unknown. However, a greater understanding of the underlying mechanisms may lead to the development of novel preventive or customized treatments that can be used in routine clinical practice. The link between oral dysbiosis and the development of HNC is a relatively new and well-received topic in the oncological and dental communities. Therefore, this review intends to provide a comprehensive summary of the currently available information on the potential mechanistic relationships between changes in the oral microbiota and the development of HNC, which is still in the research phase.

Radiation therapy is the most common cause of cancer-related trismus. Radiation therapy can lead to fibrosis and hypoxia in the temporomandibular joint ligaments, synovial fluid, and masticatory muscles. This makes it difficult for patients to move their jaws and eventually leads to restricted mouth opening. This devastating complication is called radiation-induced trismus, which occurs after radiation therapy in patients with head and neck cancers and affects their daily routine functions such as eating, speaking, chewing, swallowing, and oral hygiene habits, as well as impairs their psychosocial communication and decreases their quality of life. The evaluation in radiation-induced trismus determination is basically performed by measuring the maximum mouth opening. Previous studies evaluating radiation-induced trismus have used many maximum mouth opening cut-off values such as 40 mm, 35 mm, 30 mm, and 20 mm. The fact that no common and valid language is used to establish cut-off values means that the impact and prevalence of this serious complication are not fully revealed. In the absence of a widely accepted maximum mouth opening cutoff value or range for radiation-induced trismus definition that applies to all patients with head and neck cancers, a patient may be labeled as trismus in some studies but non-trismus in others. Preventative and therapeutic treatments may be disregarded in certain patients as a result of such ambiguity, which may cause severe declines in affected patients’ medical, psychological, social, sexual, and financial status. With a focus on the detrimental effects of such competing definitions on patient management, the current review aims to carefully compare and evaluate the pros and cons of each definition of radiation-induced trismus.

Osteoradionecrosis of the jaws (ORNJ) is a severe radiotherapy (RT) complication that occurs in 2% to 22% of individuals with head and neck cancers (HNC) who are treated with RT or concurrent chemo-RT. The accurate diagnosis of ORNJ is crucial for appropriate and prompt management. On the other hand, various ORNJ stages can resemble osteomyelitis, medication-related osteonecrosis of the jaw (MRONJ), and tumor recurrences. This challenging situation is primarily due to the clinical and radiologic similarities between ORNJ and these non-RT-related conditions. Image analysis techniques such as panoramic imaging (PI), computed tomography (CT), magnetic resonance imaging (MRI), bone scintigraphy, positron emission tomography (PET), and single photon emission CT (SPECT) might help to avoid diagnostic obstacles. Despite the fact that the general characteristics of ORNJ have been reported in the literature, there is no clear consensus on its definitive diagnosis. Therefore, the current review aims to address ORNJ and its clinical and radiological aspects, as well as provide evidence to inform on the approaches to be used in removing the complexity in diagnosis, with a specific focus on radiological and nuclear medicine techniques.

One of the most serious and debilitating complications of radiation therapy (RT) for patients with head and neck cancer (HNC) is osteoradionecrosis of the jaws (ORNJ). ORNJ is defined as radiation-induced ischemic bone necrosis with soft tissue necrosis in the absence of primary tumor, recurrence, or metastatic disease. Even though the incidence of ORNJ has dropped from about 20% to 2–8% as a result of recent advancements in RT techniques, this serious complication is still very challenging to predict, prevent, and treat. It is beyond dispute that ORNJ has detrimental effects on patients' quality of life (QoL). Pain, halitosis, taste disturbance, dysesthesia or anesthesia, trismus, difficulty chewing, swallowing, feeding, and speaking, fistula formation, pathological fracture, and localized or systemic infections are the most frequent symptoms of ORNJ that have an impact on the victim's QoL measures. However, ORNJ-specific QoL studies are scarce in this patient group despite ORNJ's significant harmful effects on the sufferers' physical appearance and functions, mood, and social relationships. By providing readily available information about the physical, social, and emotional effects of ORNJ as measured by general or HNC-specific QoL surveys, this review article aims to serve as a foundation for future studies addressing novel ORNJ-specific questionnaires.

Head and neck cancers (HNC) account for 10–15% of all cancers globally. Curative radiation therapy (RT) and concurrent chemoradiotherapy (CCRT) with or without surgery are widely accepted standard treatment modalities for these patients. Radiation-induced fibrosis is one of the side effects of these treatments, and it causes degeneration, inflammation, pain, and atrophy of the masticatory muscle fibers and the temporomandibular joint, resulting in trismus. Trismus, also known as hypomobility of the mouth, is defined as a restricted opening of the mouth. Radiation-induced trismus (RIT) can occur within the first three months of treatment or up to 12–48 months later during the follow-up period. It has a significant negative influence on daily activities and vital oral functions, including speech problems, difficulty eating or drinking, psychological problems, malnutrition, dehydration, and difficulty with oral hygiene, reducing the quality of life (QoL). Given the underappreciated nature of trismus and its negative consequences in HNC patients receiving RT or C-CRT, the purpose of this review was to provide a concise review of the physical, social, and emotional implications of RIT and their impact on QoL measures, as well as the available evaluation methods for physicians in the related medical fields.

Background This retrospective study aimed to investigate whether the pretreatment hemoglobin-to-platelet ratio (HPR) could predict the risk of osteoradionecrosis (ORN) in patients receiving concurrent chemoradiotherapy (C-CRT) for locally advanced nasopharyngeal carcinoma (LA-NPC). Methods ORN cases were reported from the records of LA-NPC patients who had oral examinations before and after C-CRT. The pretreatment HPR values were calculated on the first day of C-CRT. The connection between HPR values and ORN occurrences was determined using receiver operating characteristic curve analysis. The primary endpoint was the relationship between the pretreatment HPR values and post-C-CRT ORN incidence rates, while secondary endpoints included the identification of other putative ORN risk factors. Results We distinguished 10.9% incidences of ORN during the post-C-CRT follow-up period among 193 LA-NPC patients. The optimal cutoff for pre-C-CRT HPR was 0.48 that grouped the patients into two HPR groups with fundamentally different post-C-CRT ORN incidence rates: Group 1: HPR ≤ 0.48 (N = 60), and Group 2: HPR > 0.48 (N = 133). The comparative analysis indicated a significantly higher ORN incidence in HPR ≤ 0.48 group (30%; P 5.5 months. Conclusion Low pretreatment HPR levels were independently and unequivocally linked to significantly increased incidence of ORN post-C-CRT. Pre-C-CRT HPR levels may be used to estimate the incidence of ORN and be useful for taking preventive and therapeutic measures in these patients such as monitoring oral hygiene with strict follow-up, avoidance of unnecessary tooth extractions, particularly after C-CRT, and use of more rigorous mandibular RT dose limits.

Background: to evaluate the utility of pretreatment systemic immune-inflammation index (SII) in predicting the teeth caries and need for tooth extraction after concurrent chemoradiotherapy (C-CRT) for locally advanced squamous-cell head and neck cancer (LASCHNC) patients. Methods: the records of LA-SCHNC patients who underwent formal dental evaluations at pre and post-C-CRT periods were retrospectively analyzed. The pretreatment SII values were calculated using the platelet, neutrophil, and lymphocyte measures acquired on the first day of C-CRT: SII=Plateletsxneutrophils/lymphocytes. Receiver operating characteristic (ROC) curve analysis was employed to identify the ideal pre-C-CRT SII cutoff that may predict the teeth caries and the need for tooth extraction after the C-CRT. The primary endpoint was the link between the pre-C-CRT SII and the need for tooth extraction during the follow-up period. Results: a sum of 126 patients were included. Median follow-up was 4.9 years (range: 2.7-7.8). Nasopharyngeal and laryngeal cancers comprised the majority (75.4%) study cohort. Posttreatment teeth extractions were reported in 62.7% patients. The optimal cutoff was 558 [Area under the curve (AUC): %76.8 sensitivity: 72.3%; and specificity: 70.9%] that grouped the patients into two subgroups with significantly different post-C-CRT tooth extraction rates: Group 1: SII558 (n = 56), respectively. Correlation analysis revealed a significant relationship between the pretreatment SII and the tooth extraction rates after the C-CRT (rs:0.89: P = 0.001). The comparative analysis displayed that the teeth extractions rates were significantly higher in the SII>558 group (77.1% versus 51.4% for SII558 was the unique factor associated with meaningfully higher necessities for post-C-CRT teeth extractions. Conclusion: the present outcomes intimated that high pretreatment SII levels were linked to significantly increased post-treatment teeth extractions in LA-SCHNC patients undergoing definitive C-CRT., NA

To investigate the link between pretreatment neutrophil-to-lymphocyte ratio(NLR) and the incidence of radiation-induced trismus(RIT) in parotid gland cancers(PGC) patients after postoperative radiotherapy(PORT).Data of PGC patients who had oral examinations before and after PORT were reviewed retrospectively. We comprised patients who had maximum mouth opening (MMO) assessments before and after PORT and complete blood count test on the first day of PORT. MMO of ≤35 mm was considered as RIT. The receiver operating characteristic (ROC) curve analysis was used to search for an ideal NLR threshold value that might be linked to RIT rates.Fifty-one patients were included, with a RIT incidence of 15.7%. The NLR cutoff that showed a link with the prevalence of RIT in the ROC curve analysis was 2.7[Area under the curve (AUC):82.0%; sensitivity:87.5%; specificity:74.4%]. The patients were divided into groups based on this value:Group 1: NLR≤2.7 (N = 34) and;NLR 2.7 (N = 17). In comparative analysis, the incidence of RIT was found to be statistically higher in the NLR 2.7 than counterpart (35.2%vs.5.8%;rThis study showed that high pre-PORT NLR levels were a robust and independent predictor of significantly elevated rates of RIT.

Amaç: Birçok çalışmada, nötrofil (N), trombosit (T) ve lenfosit (L) bazlı sistemik immün inflamasyon indeksinin (Sİİ) çeşitli solid tümör tiplerin de sağ kalım sonuçlarını öngörebildiği gösterilmiştir. Daha önce sadece SE-KHAK hastalarından oluşan gruplarda eşzamanlı kemoradyoterapi (E-KRT) öncesi Sİİ’nin prognostik önemini araştıran çalışma olmaması nedeniyle Sİİ’nin bu hasta grubundaki prognostik önemini araştırmayı amaçladık. Yöntem: Ocak 2007-Aralık 2018 tarihleri arasında iki radyasyon onkolojisi merkezinde E-KRT ile tedavi edilen SE-KHAK hastalarını içeren retrospektif veriler analiz edilmiştir. Sİİ değerleri E-KRT'nin başlamasından önceki 7 gün içerisinde elde edilen toplam 139 hastanın periferik kan örneklerinde Sİİ = N×T/L formülü kullanılarak hesaplandı. Çalışma popülasyonunu farklı genel sağ kalım (GS) sonuçlarına sahip iki gruba ayırabilecek tedavi öncesi Sİİ’nin optimal eşik değeri receiver operating characteristic (ROC) analizi ile değerlendirildi. Genel sağ kalım (GS) Kaplan-Meier eğrileri kullanılarak bulunmuştur. Birincil sonlanım noktası Sİİ değeri ve GS sonuçları arasındaki ilişkiydi. Bulgular: Tedavi öncesi Sİİ’nin optimal eşik değeri 524 olarak bulunan hastalar iki gruba ayrılmıştır [Eğri altındaki alan (AAA): %68.1; duyarlılık: %68.6; özgüllük: %66.4]: Grup 1: Sİİ

Veysel Haksoyler,1 Erkan Topkan2 1Medline Hospital, Department of Medical Oncology, Adana, Turkey; 2Baskent University Medical Faculty, Department of Radiation Oncology, Adana, TurkeyCorrespondence: Erkan TopkanBaskent University Medical Faculty, Department of Radiation Oncology, Adana, 01120, TurkeyTel +90-533-7381069Fax +90-322-3444452Email docdretopkan@gmail.comPurpose: In a lack of similar research, we assessed the prognostic utility of pretreatment platelet-to-albumin ratio (PAR) in locally advanced nasopharyngeal carcinoma (LANPC) patients managed with concurrent chemoradiotherapy (CCRT).Patients and Methods: Present retrospective analysis included a sum of 128 consecutively treated LANPC patients who underwent cisplatinum-based radical CCRT. Availability of an ideal pretreatment PAR cutoff that may stratify the study population into two cohorts with significantly distinct survival outcomes was sought by utilizing the receiver operating characteristic (ROC) curve analysis. The primary and secondary endpoints were overall survival (OS) and progression-free survival (PFS), respectively.Results: A rounded 5.2 [area under the curve (AUC): 68.9%; sensitivity: 67.4%; and specificity: 65.2%] value was identified as the ideal PAR cutoff that grouped patients into two gatherings [PAR≥ 5.2 (N=60) versus < 5.2 (N=68)]. The median follow-up duration was 86.4 months (range: 9– 147). Kaplan–Meier comparisons between the two PAR groups revealed significantly diminished median PFS (69.4 versus 106.8 months for PAR< 5.2; P< 0.012) and OS (88.3 versus not reached yet for PAR< 5.2; P= 0.023) for the PAR ≥ 5.2 group. The results of multivariate analyses affirmed the pretreatment PAR≥ 5.2 as an independent prognostic factor that indicates diminished PFS (P= 0.016) and OS (P= 0.019) together with the respective N2-3 nodal stage (versus N0-1; P< 0.05 for PFS and OS, respectively) and weight loss > 5% at past six months (≤ 5%; P< 0.05 for PFS and OS, respectively).Conclusion: The results of the current retrospective analysis provided a robust and independent adverse prognostic value for pretreatment PAR ≥ 5.2 in terms of median and long-term PFS and OS outcomes in LA-NPC patients this patient group treated with conclusive CCRT.Keywords: concurrent chemoradiotherapy nasopharyngeal cancer, platelet-to-albumin ratio, prognostic worth, survival results

The significance of pre-hemoglobin-to-platelet ratio (HPR) in predicting the occurrence of radiation-induced trismus (RIT) in locally advanced nasopharyngeal carcinoma patients (LA-NPC) who received concurrent chemoradiotherapy (C-CRT).The records of LA-NPC patients with oral examination before and after C-CRT were analyzed. Maximum mouth openings (MMO) were measured before and after C-CRT to confirm RIT status, with an MMO of ≤35 mm defined as RIT. HPR values were calculated on the first day of C-CRT. The relationship between the HPR values and RIT status was discovered using the receiver operating characteristic curve analysis.A total of 43 patients RIT cases among 198 individuals were diagnosed. The optimal HPR cutoff that stratified the patients into two groups was 0.54. RIT incidence was found to be significantly higher in the HPR ≤0.54 group than its HPR0.54 counterpart(p 0.001). Univariately TThe risk of post-C-CRT RIT may be significantly increased when pre-treatment HPR levels are low.

Objective: this study sought to determine whether pretreatment pan-immune-inflammation value (PIV) could be used to predict prognosis in patients with locally advanced pancreatic adenocarcinoma (LA-PAC) following definitive concurrent chemoradiotherapy (C-CRT). Methods: the outcomes of 178 LA-PAC patients who received definitive C-CRT were analyzed retrospectively. For all patients, the PIV was calculated using the peripheral blood platelet (P), monocyte (M), neutrophil (N), and lymphocyte (L) counts obtained on the first day of C-CRT: PIV=P×M×N÷L. The optimum cutoff values for PIV connected to progression-free (PFS) and overall survival (OS) results were sought using receiver operating characteristic (ROC) curve analysis. The OS and PFS differences between the PIV groups constituted the primary and secondary endpoints, respectively. Results: ROC curve analysis indicated that the ideal PIV cutoff was 464 (AUC: 75.9%, sensitivity: 74.1%, specificity: 71.9%), which categorized patients into two groups based on PFS and OS results: low PIV (L-PIV; N = 69) and high PIV (H-PIV; N = 109). According to comparative survival analyses, patients in the L-PIV group had significantly longer median PFS (14.3 vs 7.3 months; HR: 3.04; P, NA

Radiotherapy (RT) or concurrent chemoradiotherapy (CCRT) is the cornerstone of organ-sparing or adjuvant therapy for nearly all head and neck cancers. Unfortunately, aggressive RT or CCRT can result in severe late toxicities, such as osteoradionecrosis of the jaws (ORNJ). The incidence of ORNJ is currently less than 5–6% due to advances in dental preventive care programs, RT planning systems, and RT techniques. Although numerous patient-, tumor-, and treatment-related factors may influence the incidence rates of ORNJ, RT modality (equipment), technique, and dose-volume-related factors are three of the most influential factors. This is mainly because different RT equipment and techniques have different levels of success at delivering the prescribed dose to the focal volume of the treatment while keeping the “organ at risk” safe. ORNJ risk is ultimately determined by mandibular dose, despite the RT technique and method being known predictors. Regardless of the photon delivery method, the radiobiological effects will be identical if the total dose, dose per fraction, and dose distribution within the tissue remain constant. Therefore, contemporary RT procedures mitigate this risk by reducing mandibular dosages rather than altering the ionizing radiation behavior in irradiated tissues. In light of the paucity of studies that have examined the impact of RT modality, technique, and dose-volume-related parameters, as well as their radiobiological bases, the present review aims to provide a comprehensive overview of the published literature on these specific issues to establish a common language among related disciplines and provide a more reliable comparison of research results.

Purpose: in a lack of similar research, we meant to retrospectively investigate the prognostic significance of pre-chemoradiotherapy (C-CRT) platelet-to-albumin ratio (PAR) on the survival results of locally advanced unresectable pancreatic adenocarcinoma (LAPC) patients. Patients and methods: the present analysis included 139 LAPC patients who received C-CRT in total. The utility of pre-C-CRT cutoff(s) reshaping survival data was explored using receiver operating characteristic (ROC) curve analysis. The primary and secondary objectives were the associations between PAR levels and overall survival (OS) and progression-free survival (PFS) outcomes. Results: at a median follow-up of 15.7 months (95% CI: 11.6-19.8), the overall cohort's median and 5-year OS rates were 14.4 months (95% CI: 11.8-17) and 14.7%, respectively, while the corresponding PFS rates were 7.8 months (95% CI: 6.5-9.1) and 11.2%. Because the ROC curve analysis found 4.9 as the optimal PAR cutoff for both OS and PFS [area under the curve (AUC): 75.4%; sensitivity: 72.4%; specificity: 70.3%], we divided the patients into two PAR cohorts: PAR4.9 (N=79). Comparative analysis per PAR group exhibited significantly worse OS (11.2 vs 18.6 months, and 9.8% vs 20.9% at 5 years, P=0.003) and DFS (7 vs 14.3 months, and 7.6% vs 16.2% at 5 years, P=0.001) with PAR>4.9 versus PAR4.9) robustly and independently prognosticated significantly worse OS and PFS results in inoperable LAPC patients who underwent definitive C-CRT., NA

Perpetual advances in the diagnostic tools, local plus systemic cancer treatments, and ensued lengthened survival times led to striking increments in the incidence rates of brain metastases (BMs), with a collective incidence range of 20-40% for all solid cancers. Stereotactic radiosurgery (SRS) and innovative molecularly targeted therapies are continuously gaining growing significance in the triumphant management of BMs, as the brain represents a sanctuary site for the vast majority of the conventional cytotoxic chemotherapies. In this scenario, the molecularly targeted agents appear to be an attractive alternative to traditional chemotherapeutics as they can modulate cancer metabolism and progression and exert synergism with radiation therapy. Therefore, the present paper intends to sum up the accessible proof on the consolidated utilization of SRS and molecularly targeted agents in the precise management of BMs from certain solid cancers, specifically the non-small-cell lung, breast, and renal-cell carcinomas, and malignant melanomas.

Objectives: we endeavored to retrospectively assess the prognostic merit of pretreatment systemic immune response index (SIRI) in glioblastoma multiforme (GBM) patients who underwent postoperative partial brain radiotherapy (RT) and concurrent plus adjuvant temozolomide (TMZ), namely, the Stupp protocol. Methods: the records of 181 newly diagnosed GBM patients who received the postoperative Stupp protocol were retrospectively analyzed. The SIRI value for each eligible patient was calculated by utilizing the platelet, neutrophil, and lymphocyte measures obtained on the first day of treatment: SIRI=NeutrophilsxMonocytes/Lymphocytes. The ideal cutoff values for SIRI connected with the progression-free- (PFS) and overall survival (OS) results were methodically searched through using the receiver operating characteristic (ROC) curve analysis. Primary and secondary end-points constituted the potential OS and PFS distinctions among the SIRI groups, respectively. Results: the ROC curve analysis labeled the ideal SIRI cutoffs at 1.74 (Area under the curve (AUC): 74.9%; sensitivity: 74.2%; specificity: 71.4%) and 1.78 (AUC: 73.6%; sensitivity: 73.1%; specificity: 70.8%) for PFS and OS status, individually. The SIRI cutoff of 1.78 of the OS status was chosen as the common cutoff for the stratification of the study population (Group 1: SIRI 1.78 (N=85)) and further comparative PFS and OS analyses. Comparisons between the two SIRI cohorts manifested that the SIRI 1.78 counterparts. The results of multivariate Cox regression analyses ratified the independent and significant alliance between a low SIRI and longer PFS (P, NA

Objectives: to investigate the influence of pretreatment primary tumor or nodal photopenia (PP) on F-18-fluorodeoxyglu- case positron emission tomography-computed tomography (FDG PET-CT), an indicator of tumor ischemia, on survival results of nasopharyngeal cancers (NPCs) treated with concurrent chemoradiotherapy (C-CRT). Methods: the pre-C-CRT FDG PET-CT scans of 104 patients with NPC (cT1-4 N0-3 M0) were retrospectively examined to determine the presence of PP (PP+). Our primary endpoint was the influence of PP+ on overall survival (OS), while the progression-free survival (PFS) and locoregional PFS (LRPFS) constituted the secondary endpoints. Results: the PP+ was detected in 29 (27.9%): nine (8.7%), seven (6.7%), and 13 (12.5%) in the primary tumor alone, primary tumor plus neck nodes, and neck nodes alone, respectively. Because the PP+ cases were small by count per location, all comparative analyses were performed according to overall PP+/PP- status instead of per detected site. At a median follow-up of 67.8 months (range, 9 to 130 months), the median survival times were not reached (NR) for the entire population. while 5-year OS, LRPFS, and PFS rates were 73.3%, 68.2%, and 63.4%, respectively. Comparatively the PP patients exhibited significantly poorer median OS (49.8 months vs. NR, P, NA

Aim: The significance of the novel gastric cancer prognostic index, hich combines albumin and metastatic lymph node count, on the outcomes of patients with locally advanced gastric cancer who received radical gastrectomy and concurrent chemoradiotherapy, was investigated. Method: Patients who between January 2014 and December 2019 were included in this retrospective analysis. According to the literature, the ideal cutoff value for albumin was determined to be 3.5 g/dL. While, the optimal cutoff for metastatic lymph node count was determined using receiver operating characteristic curve analysis. Results: This retrospective study comprised a total of 137 locally advanced gastric cancer patients. The ideal albumin cutoff was chosen to be the classically referred 3.5 g/dL (, Amaç: Radikal gastrektomi sonrası eş zamanlı kemoradyoterapi ile tedavi edilen lokal ileri evre mide kanseri hastalarında albümin ve metastatik lenf nodu sayısının bir kombinasyonu olan yeni mide kanseri prognostik indeksinin önemi araştırılmıştır. Yöntem: Bu retrospektif çalışmamıza Ocak 2014 ile Aralık 2019 tarihleri arasındaki hastalar dahil edilmiştir. Albümin için eşik değer 3.5 g/dL kabul edilirken, metastatik lenf nodu sayısı için ideal eşik değerini tanımlamak amacıyla ‘’receiver operating characteristic’’ eğrisi analizi kullanılmıştır. Bulgular: Çalışmamıza toplam 137 hasta dahil edilmiştir. Albümin 3.5 g/dL (