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Simple Summary: Real-world studies comparing TNT and CRT are vital for advancing the treatment of LARC. Our study provides valuable insights reflecting the diverse patient populations and varied clinical practices encountered and demonstrates the advantage of TNT, providing a superior alternative to standard CRT and potentially enhancing treatment outcomes and quality of life. Total neoadjuvant therapy (TNT) has emerged as a promising approach for managing locally advanced rectal cancer (LARC), aiming to enhance resectability, increase pathological complete response (pCR), improve treatment compliance, survival, and sphincter preservation. This study compares the clinical outcomes of TNT, with either induction or consolidation chemotherapy, to those of the standard chemoradiotherapy (CRT). In this retrospective multi-institutional study, patients with stage II-III LARC who underwent CRT or TNT from seven oncology centers between 2021 and 2024 were retrospectively analyzed. The TNT group was categorized into induction or consolidation groups based on the sequence of chemotherapy and radiotherapy. Clinical and pathological data and treatment outcomes, including pCR, event-free survival (EFS), and overall survival (OS), were analyzed. Among the 276 patients, 105 received CRT and 171 underwent TNT. The TNT group showed significantly higher pCR (21.8% vs. 2.9%, p < 0.001) and lower lymphatic (26.3% vs. 42.6%, p = 0.009), vascular (15.8% vs. 32.7%, p = 0.002), and perineural invasion rates (20.3% vs. 37.6%, p = 0.003). Furthermore, 16.9% of TNT patients opted for non-operative management (NOM), compared to 0.9% in the CRT group (p < 0.001). The median interval between the end of radiotherapy and surgery was longer in the TNT group (17.6 weeks vs. 8.8 weeks, p < 0.001). The 3-year EFS was 58.3% for CRT and 71.1% for TNT (p = 0.06). TNT is associated with higher pCR, lower lymphatic and vascular invasion rates, and higher rates of NOM compared to CRT. This supports the use of TNT as a viable treatment strategy for LARC, offering potential benefits in quality of life. [ABSTRACT FROM AUTHOR]

Objective: Breast cancer is the most common and deadly female cancer. In breast cancer cases, survival is closely related to muscle mass, which is one of the components of body composition. Our aim was to investigate the usefulness of computed-tomography (CT)-based pectoral muscle measurements in detecting sarcopenia in patients with non-metastatic breast cancer and the relationship of these measurements with survival. Patients and Methods: Our study included 62 adult female breast cancer cases diagnosed with breast cancer between January 2012 and January 2018 and without metastasis in positron emission tomography/CT (PET/CT) examination obtained for pre-treatment staging. To evaluate sarcopenia, skeletal muscle index (SMI) and pectoral muscle index (PMI) were calculated by measuring pectoral muscle area and skeletal muscle area at L3 vertebra level on PET/CT images. Results: Deceased patients were significantly older (Median=73.90, IQR=27.04) than surviving patients (Median=54.60, IQR=13.37, p=0.025) and were diagnosed with cancer later in life (Median=63.92 IQR=30.16' vs. Median=47.51 IQR=15.0, p=0.030). When the threshold of 31 cm2/m2 was selected, there was a statistically significant difference in survival between sarcopenic and non-sarcopenic groups (p=0.031). Conclusion: In conclusion, the presence of sarcopenia in female breast cancer cases is a parameter that affects survival and can be measured using radiological imaging methods. In addition to the measurements accepted in the literature regarding sarcopenia, pectoral muscle measurements can be chosen as an alternative method in the diagnosis of sarcopenia. [ABSTRACT FROM AUTHOR]

Renal cell carcinoma (RCC) is a significant cause of death, particularly in the elderly, and makes accounting for about 3% of all cancer cases. In kidney cancer, as in many other malignancies, treatment response and strategy are largely dependent on the prognosis at the time of diagnosis. Targeted therapies have been the subject of many studies in kidney cancer treatment in recent years. We looked into the objective response rate (ORR), overall survival (OS), progression-free survival (PFS), treatment options, adverse effects, and demographics of patients with kidney cancer in our study. Patients having a diagnosis of kidney cancer were included in the study, received tyrosine kinase inhibitor treatment, and were treated and followed up in our center between January 2005 and September 2017 at the Medical Oncology Clinic of Internal Medicine, Faculty of Medicine, Ondokuz Mayıs University. The files of these patients were analyzed retrospectively. 160 RCC patients in all who had treatment and followed up in our center were evaluated. The study included 62 patients who received tyrosine kinase inhibitors after first-line interferon in the metastatic period. The age range was 24-79 years old 24 to 79 years, with a median age of 62.7 years at the time of diagnosis. Forty-four (70.9%) patients were treated with sunitinib and 18 (29.1%) patients were treated with pazopanib in the first-line setting after metastatic interferon. PFS was 10.8 months for pazopanib and 11.4 months for sunitinib. OS was 23.6 months with for pazopanib and 25 months with for sunitinib therapy. ORR was 19% with sunitinib. Anemia was the most common hematologic adverse effect and fatigue was the most frequent non-hematologic side effect after sunitinib treatment, according to evaluations of side effects both hematological and non-hematological. according to evaluations of both hematological and non-hematological side effects. Individuals treated with sunitinib with pazopanib exhibited prolonged progression-free survival and overall survival. The results suggest that created treatments for m-RCC are successful. [ABSTRACT FROM AUTHOR]

Triple negative breast cancer (TNBC) is characterized by high rates of recurrence, especially in patients with residual disease after neoadjuvant chemotherapy (NAC). Capecitabine is being used as standard adjuvant treatment in residual TNBC. We aimed to investigate the real-life data regarding the efficacy of capecitabine in residual TNBC. In this retrospective multicenter study, TNBC patients with residual disease were evaluated. Patients, who received standard anthracycline and taxane-based NAC and adjuvant capecitabine were eligible. Overall survival (OS), disease free survival (DFS) and toxicity were analyzed. 170 TNBC patients with residual disease were included. Of these, 62.9% were premenopausal. At the time of analysis, the recurrence rate was 30% and death rate was 18%. The 3-year DFS and OS were 66% and 74%, respectively. In patients treated with adjuvant capecitabine, residual node positive disease stood out as an independent predictor of DFS (p = 0.024) and OS (p = 0.032). Undergoing mastectomy and the presence of T2 residual tumor was independent predictors of DFS (p = 0.016) and OS (p = 0.006), respectively. The efficacy of capecitabine was found lower compared to previous studies. Selected patients may have further benefit from addition of capecitabine. The toxicity associated with capecitabine was found lower than anticipated. [ABSTRACT FROM AUTHOR]

Osteosarcoma is a curable tumor. Surgery is performed after neoadjuvant chemotherapy as the primary standard treatment, followed by adjuvant therapy again. However, it is seen in patients who have undergone surgery without neoadjuvant chemotherapy. Adjuvant treatment is always given in this group. However, it is controversial how many cycles of adjuvant treatment should be given. In our study, 42 patients with osteosarcoma who received only adjuvant treatment without neoadjuvant treatment were analyzed for the effects of epidemiologic factors, treatment regimens on overall survival and disease-free survival. Retrospectively, 42 osteosarcoma patients (5 centers) with a current age of 18years and older who were followed up between 2001-2022 were examined. Twenty-five (60.0%) were below 8 cm, and 16 (38.0%) were 8 cm and above. The median number of cycles of adjuvant chemotherapy was 4 (range; 1-6). The 4-year DFS rate was 50.2%. In patients with primary tumors smaller and larger than 8cm, the 4-year DFS rates were 66.1% and 22.2%, respectively. The 4-year DFS rates for patients with 4 or less and more than 4 cycles of adjuvant chemotherapy were 27.1% and 69.2%, respectively. The 4-year OS rate was 78.5% in patients with primary tumors smaller than 8 cm and 18.8% in patients with tumors larger than 8 cm. The 4-year OS rate was 24.3% in patients who received 4 or less adjuvant cycles and 79.5% in patients who received more than 4 cycles. We have demonstrated that the number of adjuvant therapy courses above 4 and the presence of primary tumors smaller than 8 cm are influential over overall and disease-free survival in the patients who did not receive neoadjuvant therapy. The number of postoperative adjuvant treatment cycles should be forced as much as possible in these patients who haven't had neoadjuvant therapy. [ABSTRACT FROM AUTHOR]

Objectives: In this study, the relationship between response to second-line nivolumab treatment in advanced nonsmall cell lung cancer (NSCLC) and systemic immune inflammation index (SII) was investigated. Methods: One hundred and twenty-nine patients with advanced NSCLC who received nivolumab in second line between July 2018 and July 2023 were included. The optimum cutoff value for neutrophil/lymphocyte ratio (NLR), SII, platelet/lymphocyte ratio (PLR) and body mass index (BMI) was calculated. Progression free survival (PFS) and overall survival (OS) were evaluated. Univariate and multivariate analysis were performed for all parameters for prognostic evaluation. Results: In univariate analysis, patients with low SII found longer PFS and OS (HR = 1.762 for PFS, 95% CI 1.053-2.949, p=0.031, for OS HR=1.433, 95% CI 1.011-2.031, p=0.043). However, in multivariate analysis, no significance was found between low SII and OS (HR=1.614 for OS, 95%CI 0.984-2.648, p=0.058). No statistically significant relationship was found between NLR, PLR, BMI and Glasgow prognostic score (GPS) with OS and PFS. OS was found to be longer in patients with programmed cell death ligand 1 (PD-L1) of 1% and above and without liver metastasis (p=0.031 and p=0.040, respectively). Conclusion: Low SII before nivolumab treatment was associated with long PFS. A significant correlation was found between PD-L1 of 1% and above and OS. [ABSTRACT FROM AUTHOR]

Prostate cancer is one of the most common solid organ tumors to metastasize testis. However testicular metastases, especially bilateral testicular metastases, are rarely seen cases. We present this rare case report about a 68-year-old patient with prostate cancer presented with complaints of swelling in the testis. Physical examination and radiological imaging revealed testicular metastasis of prostate cancer. As a result we believe that if patient presents with active complaints or a mass in the testicle, we should evaluate further with scrotal ultrasonography at the time of diagnosis and follow-up. Following those, testicular biopsy or orchiectomy should be performed if seen necessary. [ABSTRACT FROM AUTHOR]

The prognosis of patients with advanced HCC can vary widely depending on factors such as the stage of the cancer, the patient's overall health, and treatment regimens. This study aimed to investigate survival outcomes and associated factors in patients with hepatocellular carcinoma (HCC). In this retrospective study, data from 23 medical oncology clinics were analyzed. Progression-free survival (PFS) and overall survival (OS) values were estimated using the Kaplan-Meier method. Prognostic factors associated with survival which were identified in univariate analysis were subsequently evaluated in a multivariate Cox-regression survival analysis was conducted using the backward stepwise (Conditional LR) method to determine the independent predictors of PFS and OS. Of 280 patients, 131 received chemotherapy and 142 received sorafenib, 6 received atezolizumab plus bevacizumab and 1 received nivolumab for first-line setting. The median follow-up time was 30.4 (95%CI 27.1-33.6) months. For-first line, median PFS was 3.1 (95%CI2.7-3.5) months, and it was significantly longer in patients who received sorafenib or atezolizumab-bevacizumab or nivolumab (PFS 5.8 (95%CI 4.2-7.5) than in those received chemotherapy (PFS 2.1 (95%CI 1.9-2.3) in the first-line setting (p < 0.001). Multivariate analysis revealed that male gender (HR: 2.75, 95% CI: 1.53-4.94, p = 0.01), poor ECOG performance score (HR: 1.88, 95% CI: 1.10-3.21, p = 0.02), higher baseline AFP level (HR: 2.38, 95% CI: 1.54-3.67, p < 0.001) and upfront sorafenib treatment (HR,0.38; 95% CI: 0.23-0.62, p < 0.001) were significantly associated with shorter PFS. The median OS was 13.2 (95%CI 11.1-15.2) months. It was significantly longer in patients who received sorafenib or atezolizumab-bevacizumab or nivolumab in the first-line setting followed by TKIs (sorafenib or regorafenib, OS 18.6 (95%CI 13.8-23.5)) compared to those who received chemotherapy (OS 10.3 (95%CI 6.6-14.1)) in the first-line setting. The multivariate analysis revealed that upfront chemotherapy treatment approach, male gender (HR: 1.77, 95% CI: 1.07-2.94, p = 0.02), poor ECOG performance score (HR: 1.96, 95% CI: 1.24-3.09, p = 0.004) and Child-Pugh score, presence of extrahepatic disease (HR: 1.54, 95% CI: 1.09-2.18, p = 0.01), and higher baseline AFP value (HR: 1.50, 95% CI: 1.03-2.19, p = 0.03) were significantly associated with poor prognosis. Additionally, regarding of treatment sequence, upfront sorafenib followed by regorafenib showed a significantly lower risk of mortality (HR: 0.40, 95% CI: 0.25-0.66, p < 0.001). Sorafenib followed by regorafenib treatment was associated with a significantly lower risk of mortality rather than upfront sorafenib followed by BSC group or upfront chemotherapy followed by TKIs. These findings underscore the importance of the optimal treatment sequences to improve survival in patients with advanced HCC.

Many developing countries lack access to recommended first-line treatments for metastatic renal cell carcinoma (mRCC), such as immune checkpoint inhibitors (ICIs) or ICI-tyrosine kinase inhibitor (TKI) combinations. As a result, predictive markers are necessary to identify patients who may benefit from single-agent TKIs for long-term response. This study aims to identify such parameters. This was a multi-centre, retrospective study of patients with mRCC who were undergoing first-line treatment with sunitinib or pazopanib. Patients who had been diagnosed with mRCC and had not experienced disease progression for 36 months or more were deemed to have achieved a long-term response. Predictive clinical and pathological characteristics of patients who did not experience long-term disease progression were investigated. A total of 320 patients from four hospitals were included in the study. The median age of the patients was 60 years (range 20-89 years). According to the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) risk classification, 109 patients were classified as having favourable risk and 211 were in the intermediate-poor risk group. The median progression-free survival (PFS) and overall survival (OS) for all patients were 12.5 months and 76.4 months, respectively. In the long-term responder's group, the median PFS was 78.4 months. Among all patients, prior nephrectomy, the Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) <1, and the absence of brain metastasis were predictive factors for long-term response. For patients in the favourable risk group, the lack of brain metastasis was a predictor of long-term response. In the intermediate-poor risk group, prior nephrectomy and ECOG PS <1 were predictive factors for long-term response. Some individuals with mRCC may experience a durable response to TKIs. The likelihood of a long-term response can be determined by factors such as nephrectomy, ECOG PS < 1, and the absence of brain metastases.

Aim: Pancreatic cancer is the 11th most common cancer in the world. The importance of early diagnosis and treatment for curative treatment is very high. Many studies have shown a relationship between diabetes mellitus (DM), smoking, genetic factors, obesity, nutritional habits and sedentary life and pancreatic ductal adenocarcinoma (PDAC). In this study, we aimed to investigate the relationship between DM onset age and PDAC., Materials and Methods: 158 patients with PDAC and DM were compared with 244 patients with DM in the control group. We retrospectively analyzed PDAC risk factors with a focus on DM onset age., Results: It was calculated that the risk of PDAC increased 8.5 times in patients diagnosed with DM after 60 years of age compared to those diagnosed with DM before 60 years of age (HR = 8.54, 95% CI 5.66-12.90, p<0.0001). The interval between the diagnosis of DM and the diagnosis of PDAC peaked at 32 months (95% CI 27.90-35.56). When the age of DM onset was evaluated, it was observed that peaks were around 50 years in the group without PDAC and 60 years in the group with PDAC., Conclusion: In patients with DM onset after the age of 60, we recommend keeping in mind the increased risk of PDAC and evaluating these patients for PDAC, even if they are asymptomatic., Key Words: Diabetes, Early detection of cancer, New onset diabetes, Pancreatic cancer, Relative risk, Screening.