Search Results (2,062)

Background: Soft tissue sarcomas (STS) disproportionately affect older adults, yet patients aged ≥65 years remain markedly underrepresented in pivotal trials, limiting evidence on pazopanib in this population. We aimed to characterise the real-world efficacy and safety of pazopanib in elderly patients with advanced STS. Methods: This multicentre retrospective cohort study included consecutive patients aged ≥65 years with locally advanced unresectable or metastatic STS who received pazopanib between July 2010 and June 2022 at four tertiary Turkish oncology centres. The primary endpoint was progression-free survival (PFS); secondary endpoints were overall survival (OS) and the safety profile. Results: A total of 109 patients (median age, 70 years; 50.5% female; 48.6% with Eastern Cooperative Oncology Group [ECOG] performance status ≥ 2) were analysed. The objective response rate was 11.0% (95% CI, 5.8–18.4), and the disease control rate was 45.9%. Median PFS was 4.11 months (95% CI, 3.25–4.47), and median OS was 7.85 months (95% CI, 6.91–9.00) over a median follow-up of 17.6 months. PFS showed a borderline difference across age tertiles (log-rank p = 0.078), whereas a marked monotonic OS gradient was observed (9.00, 7.86, and 5.71 months for ages 65–69, 70–74, and ≥75 years, respectively; p < 0.001). In age-stratified multivariable Cox analysis, ECOG ≥ 2 (adjusted hazard ratio [aHR], 1.68; 95% CI, 1.01–2.80; p = 0.045) and female sex (aHR, 1.66; 95% CI, 1.02–2.72; p = 0.043) were independently associated with shorter OS. Grade ≥ 3 treatment-emergent adverse events occurred in 27.5% of patients, most commonly hypertension. Because only the single most clinically prominent treatment-emergent adverse event per patient was recorded, these figures represent a conservative, non-cumulative estimate of toxicity. No treatment-related deaths occurred. Conclusions: Pazopanib retains clinically meaningful activity in unselected patients aged ≥65 years with advanced STS. Performance status, rather than chronological age, is the dominant predictor of overall survival and should guide treatment decisions in this population. Full article

Background/Objectives: Prognostic stratification in non-metastatic nasopharyngeal carcinoma (NPC) remains challenging, particularly among patients within the same TNM stage. Readily available hematologic inflammatory indices may reflect host–tumor interactions and provide additional prognostic information beyond conventional clinicopathologic factors. This study evaluated the prognostic value of pretreatment hematologic inflammatory indices for overall survival (OS) and progression-free survival (PFS) in patients with non-metastatic NPC. Methods: This single-center retrospective cohort study included adult patients with non-metastatic NPC diagnosed at a tertiary referral center between 20 February 2014 and 2 May 2023, with outcomes ascertained through 12 December 2023. Pretreatment complete blood count and biochemical parameters were used to calculate the neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, systemic immune-inflammation index, pan-immune-inflammation value (PIV), and hemoglobin–albumin–lymphocyte–platelet score. Receiver operating characteristic analysis determined optimal cut-off values for mortality discrimination. Associations with OS and PFS were assessed using Cox regression models. Results: Forty-six patients were analyzed, including 37 males. Median OS and PFS were 45.90 and 37.05 months, respectively. Compared with survivors, non-survivors were older and had lower hemoglobin and albumin levels, higher PIV, NLR, PLR, and SII values, and lower HALP scores. Although NLR showed the highest conventional ROC performance for mortality discrimination, PIV retained prognostic significance in multivariable Cox models and showed stable time-dependent discrimination for PFS. Conclusions: These preliminary findings suggest that pretreatment inflammatory indices, particularly composite markers such as PIV, may provide adjunctive prognostic information in treatment-naïve non-metastatic NPC, pending larger prospective validation. Full article

Background: Pembrolizumab-based therapy is a standard first-line option for advanced non-small-cell lung cancer (NSCLC), yet pivotal clinical-trial populations may not reflect patients encountered in routine practice. Real-world cohorts enriched for Eastern Cooperative Oncology Group performance status (ECOG PS) ≥2 and high metastatic burden remain underreported. We assessed real-world outcomes of first-line pembrolizumab in a heterogeneous cohort enriched for these. Methods: Retrospective cohort analysis of 45 patients with advanced NSCLC who received first-line pembrolizumab-based therapy (monotherapy or with platinum-based chemotherapy) at a single health maintenance organization in Israel between September 2017 and April 2020. Results: Mean age was 69.3 years (SD 9.0), 82.2% were male, 91.1% were current or former smokers, 37.8% had ECOG PS ≥2 (including 17.8% with ECOG ≥3), and 53.3% had three or more metastatic organ sites. PD-L1 expression was ≥50% in 46.7%, 1–49% in 13.3%, and <1% in 22.2%. After a median follow-up of 48.7 months (88.9% event rate), median overall survival (OS) was 8.87 months (95% CI, 5.88–14.32) and median progression-free survival (PFS) was 4.20 months (95% CI, 2.76–6.18), with an objective response rate of 46.7% and a disease control rate of 68.9%. On univariate Cox regression, the number of metastatic sites was most strongly associated with OS (HR 1.41 per site, 95% CI, 1.17–1.70, p = 0.0003). PD-L1 expression was significantly associated with both PFS (p < 0.0001) and OS (p = 0.0012), with the longest survival observed in patients with PD-L1 ≥50%. Conclusions: In this real-world cohort enriched for poor performance status and high metastatic burden, pembrolizumab-based therapy provided clinical benefit, but observed survival was substantially shorter than that reported in pivotal trials. Full article

Purpose: Vasomotor, sexual, and musculoskeletal symptoms are common adverse effects of adjuvant endocrine therapy in breast cancer survivors. Social media use has not been investigated with altered symptom perception in patients receiving adjuvant endocrine therapy. This study aimed to investigate whether social media use or addiction independently predicts endocrine therapy-related symptom burden in breast cancer survivors. Methods: A cross-sectional survey study was conducted among 153 breast cancer survivors receiving adjuvant endocrine therapy. The Social Media Use Scale (SMUS) and Bergen Social Media Addiction Scale (BSMAS) were assessed using validated Turkish versions of each scale. Endocrine therapy-related toxicities (specifically hot flashes, vaginal dryness, loss of libido, and musculoskeletal pain severity) were evaluated using specific self-reported 5-point Likert scale items. Results: All of the patients were female and menopausal, either neutral or induced with ovarian function suppression. In the univariate analysis, the BSMAS score showed a weak positive correlation with vasomotor/sexual symptoms (r = 0.194; p = 0.017), but this association disappeared after adjustment for clinical variables. Younger age was associated with greater vasomotor/sexual symptoms in univariate testing. Neither the SMUS nor BSMAS independently predicted musculoskeletal symptom severity in univariate and multivariate models, while higher educational attainment remained the only independent predictor of musculoskeletal pain severity (OR = 1.96; 95% CI: 1.06–3.57; p = 0.031). Conclusions: This study is unique in investigating unstructured social media use and endocrine therapy-related physical symptoms. In this cohort, unstructured social media use was not associated with the endocrine therapy-related physical symptom burden. While these cross-sectional findings do not support social media behavior as a significant predictor, clinical assessments should continue to prioritize established determinants such as age and educational background. Full article

Background: Pancreatic cancer is characterized by increasing incidence and high mortality in Poland and worldwide. The aim of this study was to assess the relationship between selected risk factors and the age-standardized incidence rate of pancreatic cancer at the voivodeship level in Poland, and to evaluate the accuracy of a prediction model. Methods: Age-standardized incidence rate data for 16 Polish voivodeships in 2011–2023 were obtained from the Polish National Cancer Registry. The risk factor burden for 2011–2019, expressed as disability-adjusted life years (DALYs) per 100,000 population, was obtained from the System Analysis and Implementation Database of the Polish Ministry of Health. A generalized estimating equation model was constructed to predict the age-standardized incidence rate, with multicollinearity addressed using variance inflation factor analysis. Predictions for 2020–2023 were validated against observed data, and forecasts for 2024–2030 were subsequently calculated. Results: The number of new pancreatic cancer cases in Poland increased in eight out of 16 voivodeships. The highest burden was recorded in the Masovian, Subcarpathian, Świętokrzyskie and Greater Poland voivodeships. Air pollution was positively associated with pancreatic cancer incidence. Predictions for 2020–2023 showed satisfactory agreement with observed data, with the largest discrepancy being equal to 4.1 in terms of the age-standardized incidence rate. Based on the models, the incidence of pancreatic cancer was projected for all of 16 voivodeships through to 2030. Conclusions: Air pollution is associated with the regional burden of pancreatic cancer in Poland. The generalized estimating equation prediction approach demonstrated acceptable accuracy and can support monitoring and public health planning at the voivodeship level. Full article

Background: Programmed death-1 (PD-1) inhibitors have significantly improved survival outcomes in melanoma; however, questions persist regarding comparative efficacy across regimens and the predictive value of PD-L1 expression as a biomarker. We therefore performed a meta-analysis evaluating outcomes according to PD-L1 expression status using the most recent follow-up data from each study. Methods: A systematic search was conducted in PubMed, Cochrane and ClinicalTrials.gov from 1 January 2010 to 1 April 2025 for phase II and III randomized clinical trials (RCTs) investigating PD-1 inhibitors as monotherapy or combined with other immune checkpoint inhibitors (ICIs) or targeted therapy in the adjuvant/metastatic setting. Pooled estimates were calculated with random-effects models, and risk of bias was assessed using the Cochrane RoB 2 tool. The present meta-analysis was performed following PRISMA guidelines and was registered in PROSPERO (ID: CRD420251090090). Results: Fifteen RCTs including 9979 patients were included. In the overall analysis, PD-1 inhibitors were associated with significantly improved overall survival (OS, HR = 0.75, 95% CI: 0.66–0.86) compared with control treatments. In the unresectable or metastatic setting, progression-free survival (PFS) was also significantly improved (HR = 0.61, 95% CI: 0.49–0.76). Survival benefits were observed in both PD-L1-positive and PD-L1-negative tumors, with improved PFS in PD-L1-positive (HR = 0.63, 95% CI: 0.48–0.83) and PD-L1-negative patients (HR = 0.58, 95% CI: 0.44–0.77), as well as improved OS in PD-L1-positive (HR = 0.69, 95% CI: 0.59–0.80) and PD-L1-negative patients (HR = 0.79, 95% CI: 0.67–0.93), without evidence of effect modification by PD-L1 expression. PD-1 inhibitor-based regimens were not associated with a statistically significant increase in grade 3–4 treatment-related adverse events (RR = 1.13, 95% CI: 0.71–1.79); however, heterogeneity was substantial (I² = 96.0%). Conclusions: PD-1 inhibitor-based therapies significantly improve survival outcomes in advanced melanoma across PD-L1 subgroups. No clear evidence of differential treatment benefit according to PD-L1 expression was observed, suggesting limited utility as a standalone predictive biomarker. Further studies integrating molecular and immune profiling are warranted to optimize individualized treatment selection. Full article

Background/Objectives: Melanoma is a major and growing public health concern in Poland, with a five-year survival around 60–70%. While UV radiation and genetic susceptibility are well-known risk factors, lifestyle and environmental exposures may also contribute. This study examined how selected risk factors relate to one-year melanoma prevalence across Poland’s 16 voivodeships and assessed whether these factors can support short-term prediction. Methods: Annual melanoma prevalence for 2011–2021 was obtained from the Polish National Cancer Registry, and voivodeship-level estimates of metabolic risk factors, physical inactivity, alcohol consumption, smoking, high BMI, air pollution, water pollution and limited data on UV exposure were used to build a general estimating equations model. Model predictions for 2020–2021 were compared with observed data, and forecasts were generated through 2030. Results: Melanoma cases increased in every voivodeship between 2011 and 2021. Metabolic risk factors, high BMI, low physical activity and smoking were associated with higher melanoma prevalence. When other factors were considered, air pollution showed an inverse association, suggesting complex relationships that warrant further analysis. Forecasts indicated increasing prevalence in all of 16 voivodeships through 2030, although three regions showed large prediction errors for 2020–2021. A key limitation was the lack of sufficient UV exposure data. Conclusions: The findings support further evaluation of public health actions targeting the reduction of unhealthy lifestyle regarding diet, low physical activity, and smoking to help slow the projected rise in melanoma. Full article

Background: In locally advanced squamous cell esophageal cancer, concurrent chemoradiotherapy (CRT) is the standard of care, as it especially improves local control and overall survival compared to radiotherapy alone. In contrast, treatment strategies for esophageal adenocarcinoma often parallel those used in gastric cancer, particularly regarding systemic therapy. Objectives: This study aimed to evaluate the clinicopathological factors affecting event-free survival (EFS) and overall survival (OS) following trimodality treatment in patients with non-metastatic esophageal cancer. Methods: A total of 155 patients diagnosed with esophageal cancer between March 2019 and November 2025 were retrospectively analyzed. Response to concurrent chemoradiotherapy was assessed via thoracic magnetic resonance imaging and endoscopic biopsy. Results: Clinicopathological analysis showed that male sex, the presence of lymphovascular invasion, adenocarcinoma histology, poor pathological response and advanced-stage tumors were significantly associated with worse EFS (all p < 0.001). In multivariate analysis, stage IVa disease was identified as an independent predictor of both mortality and relapse, with an approximately five-fold increased risk of death (p = 0.028) and relapse (p = 0.019). Patients with squamous cell carcinoma had a longer median EFS compared to those with adenocarcinoma (18 vs. 8.4 months, respectively). The 3- and 5-year OS rates were 59.2% and 56% in patients with squamous cell carcinoma, compared with 40% and 26% in those with adenocarcinoma, respectively. Conclusions: Survival outcomes were more favorable in patients with squamous cell histology and those diagnosed at an early stage. Active surveillance may be considered in selected patients with a complete clinical response to avoid the perioperative mortality associated with surgery. Full article

Background: Neuroendocrine tumours (NETs) are heterogeneous neoplasms with several treatment options. Response rates, disease progression, and haematological toxicities can limit the use of some indicated treatments. Case Presentation: A 73-year-old woman with a well-differentiated grade 2 pancreatic NET (Ki-67 18%) underwent surgical resection and later developed hepatic recurrence. First-line treatment with sunitinib plus octreotide achieved temporary disease stabilisation. Upon progression, peptide receptor radionuclide therapy (PRRT) with ¹⁷⁷Lu-DOTATATE was initiated, resulting in stable disease but complicated by grade 3 thrombocytopenia. Two years later, PRRT retreatment was performed due to disease progression, which led to grade 4 thrombocytopenia. Further treatments with capecitabine and everolimus were limited by progression and significant thrombocytopenia. Therapy was switched to streptozocin plus 5-fluorouracil, which resulted in recovery of platelet counts, absence of haematological toxicity, and a sustained radiologic response until March 2025, when she presented with hepatic progression. FOLFOX chemotherapy was initiated but discontinued after one cycle due to severe thrombocytopenia. Deterioration in general condition ultimately led to supportive care and death in March 2026. Conclusions: This case highlights the risk of cumulative haematological toxicity with PRRT, particularly in retreatment settings. Careful patient selection and close monitoring are essential. Streptozocin-based chemotherapy may be an effective and well-tolerated alternative for patients with treatment-limiting toxicity. Full article

Introduction: Low back pain is one of the commonly overlooked late complications of an intestinal stoma. Its severity may be associated with impaired quality of life across multiple dimensions of patient functioning. Objective: This cross-sectional study evaluated the impact of low back pain on self-reported health-related quality of life in colostomy patients. Material and Methods: The study was conducted using a cross-sectional questionnaire-based design across 12 regional branches of the Pol-ILKO Association in Poland between December 2023 and September 2024. The study sample consisted of 95 patients. The standardized Oswestry Disability Index (ODI) questionnaire, which assesses the level of disability in patients with back pain, and the WHOQOL-BREF questionnaire, which assesses health-related quality of life, were used in the survey. In addition, detailed data on medical history, past surgical interventions, and stoma self-care skills were collected using an author-developed tool. Results: Greater disability due to back pain is associated with lower self-rated quality of life. The higher the degree of disability as assessed by the Oswestry questionnaire and the higher the number of postoperative complications, the worse the subjective rating of health-related quality of life (HRQoL) (p < 0.05). Factors associated with a significantly (p < 0.05) increased risk of lower back pain include postoperative complications, irrespective of the time since stoma creation, as well as avoidance or restriction of full trunk movements. Preoperative agreement on the stoma site was associated with greater independence in stoma hygiene. Conclusions: The results underscore the importance of early and targeted interventions to improve physical and psychosocial well-being in the subject population, especially at the preoperative stage. More attention should be paid to the needs of colostomy patients, both in hospitals and in outpatient specialty care centers, to improve their overall quality of life and self-assessment of their condition. Full article

Background: Biliary drainage is a key component of palliative management in patients with malignant biliary obstruction. In cases where endoscopic approaches are unsuccessful or cannot be performed, percutaneous transhepatic biliary drainage (PTBD) represents an established alternative for achieving biliary decompression. The C-reactive protein–albumin–lymphocyte (CALLY) index combines inflammatory, nutritional, and immune-related parameters into a single marker, while the modified Glasgow Prognostic Score (mGPS), based on C-reactive protein and albumin concentrations, reflects the systemic inflammatory status of the patient. This study aimed to evaluate the prognostic value of the preprocedural CALLY index and mGPS in predicting 30-day mortality among patients with advanced malignant biliary obstruction undergoing palliative PTBD. Methods: This single-center retrospective study was conducted in a total of 179 patients who underwent palliative PTBD for malignant biliary obstruction at Ankara Etlik City Hospital between December 2022 and June 2025. Results: The 30-day mortality rate was 25.1%. The cut-off value for CALLY was determined as 67 based on receiver operating characteristic (ROC) curve analysis, and mGPS was categorized as 0–1 versus 2. In univariable Cox regression analyses, pancreaticobiliary tumor type, mGPS = 2, and CALLY < 67 were associated with early mortality. In multivariable Cox analysis, CALLY ≥ 67 was independently associated with a reduced risk of 30-day mortality, whereas pancreaticobiliary tumor type was independently associated with an increased risk. In the CALLY–mGPS risk stratification, 30-day mortality rates were 8.0%, 13.5%, and 44.1% in the low-, intermediate-, and high-risk groups, respectively. Conclusions: In this retrospective cohort, preprocedural inflammation- and nutrition-based markers were found to be associated with early mortality in patients with malignant biliary obstruction undergoing PTBD. Accordingly, risk stratification using readily available parameters such as CALLY and mGPS appears feasible in the preprocedural setting. The CALLY–mGPS-based approach may provide a practical framework for clinical risk assessment; however, prospective multicenter validation, including tumor-specific subgroup analyses, is warranted. Full article

Background/Objectives: Insomnia is one of the most prevalent and persistent symptoms among patients with breast cancer, yet it remains under-recognized and undertreated in routine clinical practice. Beyond its impact on sleep quality, insomnia is increasingly understood as a multidimensional condition involving neurobiological, psychological, and behavioral mechanisms, closely intertwined with cancer-related stress and psychiatric comorbidities. This narrative review aims to provide a comprehensive and integrative overview of insomnia in breast cancer, focusing on its epidemiology, pathophysiological underpinnings, neuropsychiatric correlates, and clinical implications, while highlighting gaps in current research and management. Methods: A narrative review of the literature was conducted, including studies published in major medical databases (PubMed, Scopus, and Web of Science) up to 2025. Relevant articles addressing insomnia, sleep disturbances, psychiatric symptoms, and neurobiological mechanisms in breast cancer populations were selected and synthesized. Results: Insomnia affects a substantial proportion of breast cancer patients across the disease trajectory, from diagnosis to survivorship. Its etiology is multifactorial, involving dysregulation of the hypothalamic–pituitary–adrenal axis, inflammatory processes, and circadian rhythm, as well as treatment-related factors such as chemotherapy, endocrine therapy, and menopausal symptoms. Insomnia frequently co-occurs with depression, anxiety, fatigue, and pain, forming symptom clusters that significantly impair quality of life and may influence clinical outcomes. Emerging evidence supports a bidirectional relationship between insomnia and psychiatric vulnerability, suggesting a shared neurobiological substrate within the brain–body stress axis. Conclusions: Insomnia in breast cancer should be conceptualized as a neuropsychiatric condition embedded within a broader stress-related symptom network rather than as an isolated sleep disturbance. Improved screening, interdisciplinary management, and the integration of evidence-based interventions such as cognitive behavioral therapy for insomnia are essential. Research should focus on personalized and mechanistically informed approaches to better address this highly prevalent yet insufficiently managed condition. Full article

Background: Anthracycline- and taxane-based chemotherapy regimens are widely used in the treatment of breast cancer; however, their effects on body composition and fluid distribution are not fully elucidated. Conventional assessment methods are often insufficient to distinguish true tissue changes from treatment-related fluid shifts. The primary objective of this study was to evaluate longitudinal changes in body composition and fluid distribution during chemotherapy in breast cancer patients using bioelectrical impedance spectroscopy. The secondary objective was to investigate the impact of anthracycline and docetaxel exposure on these changes and to identify patterns suggestive of masked sarcopenia. Methods: This prospective, single-center, longitudinal observational study was conducted between October 2024 and October 2025. Follow-up assessments at 3 and 6 months were completed by October 2025. A total of 51 female breast cancer patients undergoing systemic chemotherapy were evaluated using multifrequency bioelectrical impedance spectroscopy (BCM^®). Measurements were performed at baseline, 3 months, and 6 months. Changes in total body water (TBW), extracellular water (ECW), intracellular water (ICW), extracellular-to-intracellular water ratio (E/I), lean tissue mass (LTM), adipose tissue mass (ATM), and volume status were analyzed longitudinally and according to treatment exposure. Results: The cohort consisted of 51 women (median age, 55 years), of whom 70.6% were postmenopausal, and the majority had stage II–III disease. While TBW remained stable, significant alterations in fluid distribution and body composition were observed. ECW increased, and ICW decreased, resulting in a significant rise in the E/I ratio. LTM declined significantly, particularly during the first 3 months, whereas ATM showed a gradual increase. Volume status increased progressively over time, indicating fluid accumulation. Anthracycline exposure was associated with greater reductions in LTM, while docetaxel treatment was linked to significant increases in extracellular fluid and volume, especially during the 3–6-month interval. At 6 months, a median increase of +1100 mL in volume was observed alongside a decrease in muscle mass (−1.4 kg), consistent with a pattern of masked sarcopenia. Conclusions: Chemotherapy in breast cancer patients is associated with concurrent muscle loss and fluid redistribution, which may obscure clinically relevant changes in body composition. Bioelectrical impedance spectroscopy enables differentiation between fluid and tissue compartments and provides a more accurate assessment than conventional methods. Early recognition of these changes may facilitate timely nutritional support and appropriate fluid management strategies. Full article

Objective: Pembrolizumab monotherapy is an anti-PD-1 immunotherapy that is approved as a first-line treatment for non-small cell lung cancer (NSCLC) patients with high PD-L1 expression (≥50%). However, approximately 55% of these patients do not respond. Early identification of likely non-responders is critical to enable timely transition to alternative treatments. Materials: This study analyzed a retrospective cohort of NSCLC patients treated with first-line PD-L1 monotherapy, divided into a discovery training set (n: 97; 27 non-responders) and a preliminary test set (n: 17; 9 non-responders). Treatment response was assessed using baseline and follow-up CT scans in accordance with the response evaluation criteria in solid tumors (RECIST v1.1). Methods: Our objective was to extract deep learning (DL) features from the two groups of patients and apply transfer learning techniques to identify patients at risk of progression on pembrolizumab monotherapy. A nonparametric statistical test (Mann–Whitney U) was employed to rank the discriminative power of the 128 features from these training groups. Two types of support vector machine (SVM-RBF and SVM-Polynomial) classifiers were employed to investigate the discriminating power of the highest-ranked features as measured by F1 score and AUC values over ROC curves at the three levels of the data (slice, lesion, and patient) with and without clinical descriptors. Results: SVM-RBF performed best when trained on the 10 highest-ranked DL features and five clinical descriptors, achieving AUC of 0.742 (CI 95% 0.47–1.00), SN of 88.9%, SP of 75% and F1 score of 84.2% on preliminary test set patients, whereas an AUC of 0.902 ± 0.031, SN of 81.5%, SP of 81.4% and F1 score of 71% were observed for the discovery training set. Conclusions: Integrating CT-based DL features with clinical descriptors demonstrated balanced performance, offering a promising tool to identify patients at risk of progression on pembrolizumab monotherapy to support first-line treatment decisions in PD-L1-high NSCLC. Full article

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. Full article