Search Results (64)

Objectives: Lung cancer remains as the most common cause of cancer-related death. The possible relationships between inflammatory markers and lung cancer prognosis have yet to be clarified. In this study, we aimed to assess and compare various inflammatory markers and prognostic tests for their role in predicting mortality in patients with lung cancer who were admitted to the intensive care unit. Methods: A total of 229 patients diagnosed with small cell or non-small cell lung cancer who attended follow-up after treatment were included. The predictive performance of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), systemic immune-inflammation index (SII), modified Glasgow prognostic score (mGPS), Prognostic nutritional index (PNI), APACHE II score, and MPM II-Admission (Mortality Probability Models II-0) were assessed in terms of mortality status. We also performed multivariable logistic regression to determine whether any of these parameters were independently associated with mortality. Results: We included 229 patients into our study; the mean age was 66.17 ± 11.89 years. Among these, 135 (58.95%) patients died and 94 (41.05%) patients were discharged. When we evaluated the performance of the prognostic scores in predicting mortality, we found mGPS, MPM II-Admission, and APACHE II scores had the highest sensitivity, and MPM II-Admission, PNI, and APACHE II scores had the highest specificity. Multivariable regression revealed that PNI was the only inflammation-related parameter that was independently associated with mortality. Conclusions: PNI, APACHE-II, and MPM II-Admission may be used as easily accessible tests for mortality estimation in lung cancer patients admitted to the ICU. Full article

Background/Objectives: Upfront surgery (UFS) remains the standard treatment for patients with resectable pancreatic ductal adenocarcinoma (PDAC). We aimed to investigate the prognostic factors for survival after UFS in patients with resectable PDAC and to develop a prognostic prediction model. Methods: This multicenter, retrospective study included 603 patients who underwent UFS for resectable PDAC between January 2013 and December 2017. Univariate and multivariate analyses were performed to identify prognostic factors for overall survival (OS). We constructed a prognostic prediction model for OS after UFS. An internal validation was performed to evaluate the discriminative performance of the model. Results: The 1-, 3-, and 5-year OS rates were 83.7%, 48.2%, and 37.5%, respectively. The Cox proportional hazards model showed that tumor size > 2 cm (hazard ratio [HR] 1.50, p = 0.001); tumor contact with the portal and superior mesenteric veins of ≤180° (HR 1.47, p = 0.003); carbohydrate antigen 19-9 levels of 40 to 500 U/mL (HR 1.59, p = 0.002) and ≥500 U/mL (HR 2.16, p < 0.001); and a modified Glasgow Prognostic Score of two (HR 1.56, p = 0.038) were predictors associated with OS. The prognostic prediction model for 5-year OS demonstrated an area under the curve of 0.68. The calibration plots indicate a concordance index of 0.63. Conclusions: We identified the preoperative prognostic factors for OS and developed a prognostic prediction model to estimate OS in patients undergoing UFS for resectable PDAC. Our model may be useful and internally validated for predicting OS. Full article

Trauma is a major cause of morbidity and mortality in dogs and cats. While prognostic tools are well-established in human medicine, few guidelines exist in veterinary trauma care. The Animal Trauma Triage (ATT) score and modified Glasgow Coma Scale (mGCS) are used to assess illness severity, but their clinical utility in veterinary patients remains undervalued. This study aimed to evaluate the prognostic value of ATT and mGCS scores and their association with organ dysfunction and survival in polytraumatized veterinary patients. We hypothesized that multi-organ failure (MOF) is more prevalent in non-survivors and correlates with higher ATT and lower mGCS scores. A prospective observational study was conducted for 30 patients (20 dogs and 10 cats) admitted to two veterinary hospitals. Clinical data, trauma scores, and outcomes were collected and analyzed. The overall survival rate was 83.3%; blunt trauma accounted for 80% of cases. Non-survivors (n = 5) had higher respiratory rates at admission (p = 0.01). The ATT score accurately predicted all fatalities, while the mGCS score showed limited prognostic value. MOF was the leading cause of death in 60% of non-survivors. ATT appears to be a more reliable tool for outcome prediction, enabling improved triage, resource allocation, and early intervention in veterinary trauma cases. Full article

Background: The aim of this study is to identify people with cystic fibrosis (pwCF) at risk for future pulmonary exacerbations (PEx) based on established and unestablished markers of chronic inflammation. There is currently no universal definition of PEx in cystic fibrosis (CF), but it is commonly characterized by clinical deterioration and a drop in FEV1 ≥10% with or without elevations in systemic inflammatory markers. PEx negatively affect clinical outcomes in pwCF; therefore, predicting and preventing PEx is a crucial goal in the treatment of pwCF. Methods: We retrospectively examined pwCF ≥18 years who had ≥2 pulmonary function tests per year for a 3-year period. The first year was marked as the baseline. The follow-up period (FU) was defined as the following two-year period after baseline. PEx were defined as a need for intravenous antibiotic treatment due to clinical deterioration. Various scoring systems and ratios (neutrophil/lymphocyte (NLR), lymphocyte/monocyte (LMR), CRP, CRP/albumin, Glasgow Prognostic Score (GPS), high-sensitivity modified Glasgow Prognostic Score (hs-GPS)) were compared in pwCF with and without PEx during the FU. Logistic regression models were used to determine the best marker for predicting PEx, considering factors such as age, sex, PEx at baseline, BMI, homozygote F508del mutation, diabetes mellitus, chronic bacterial infection, and CFTR (cystic fibrosis transmembrane conductance regulator)-modulator therapy. The results are reported as odds ratios (ORs) with p-values. Results: Out of 283 pwCF, 131 were included in the study. In total, 43.5% were female, and the mean age was 34.0 years. A total of 75 pwCF (57.3%) had PEx during FU. In the multivariate analysis, the following markers at baseline were significantly associated with having a PEx during FU: CRP(log) (OR = 7.29, p = 0.01), CRP/albumin (OR = 1.08, p = 0.006), decreased LMR (OR = 0.51, p = 0.02), increased NLR (OR = 1.52, p = 0.02), and GPS of 1 vs. 0 (OR = 2.75, p = 0.04). The results indicate that the CRP/albumin ratio was the best model for predicting PEx in pwCF during the FU, outperforming other models. Conclusions: While several inflammation-based scoring systems can predict PEx in pwCF, the easily calculated CRP/albumin proved to reliably identify pwCF with an increased risk for PEx, making it a promising tool in clinical practice. Full article

Background and Objectives: Complicated left-sided colonic diverticulitis is one of the important causes of hospital admissions and emergency surgery in industrialized societies and requires serious clinical decision-making processes for patient management. This study aims to evaluate the predictive role of albumin-based nutritional indices in deciding on surgical strategy (primary anastomosis vs. Hartmann procedure) in patients treated operatively for complicated left-sided colonic diverticulitis. Materials and Methods: This retrospective single-center study included 57 patients who were operatively treated for Hinchey stage III–IV diverticulitis between 2021 and 2024. Patients were divided into two groups according to surgical method: Hartmann procedure (n = 40) and primary anastomosis (n = 17). Prognostic Nutritional Index (PNI), Hemoglobin–Albumin–Lymphocyte–Platelet Score (HALP), CRP–Albumin–Lymphocyte (CALLY) Index, and Modified Glasgow Prognostic Score (mGPS) were evaluated as albumin-based nutritional indices in the preoperative period. Predictive parameters were determined using ROC analysis and multivariate logistic regression. Results: Albumin level, PNI, HALP, and CALLY scores were found to be significantly lower in the Hartmann procedure group. Additionally, the proportion of patients with mGPS score 2 was significantly higher in the Hartmann procedure group (57.5% vs. 5.9%; p < 0.001). In the ROC analysis, the cut-off value for the CALLY index was determined as 0.45 (AUC: 0.826). In multivariate analysis, albumin < 38.5 g/L (OR: 16.53), CALLY index < 0.45 (OR: 6.40), and systemic inflammatory response syndrome (SIRS) detection (OR: 12.98) were determined as independent factors predicting the Hartmann procedure. Conclusions: A low CALLY index was found to be independent predictors for the Hartmann procedure. The CALLY index, which reflects the inflammatory response, immune capacity and nutritional status, can assist surgeons in making objective, and individualized decisions by holistically evaluating the patient’s physiological status. Multicenter prospective studies are required to confirm the clinical validity of the findings. Full article

Background/Objectives: The TOPAZ-1 phase III trial reported a survival benefit of using durvalumab, an anti-programmed death ligand 1 (anti-PD-L1) antibody, in combination with gemcitabine and cisplatin (GCD) treatment in patients with advanced biliary tract cancer. This retrospective study investigated the efficacy and safety of GCD treatment for advanced biliary tract cancer in real-world conditions. Methods: The study subjects were 52 patients with biliary tract cancer who received GCD therapy between January 2023 and May 2024. The observation parameters included the modified Glasgow Prognostic Score (mGPS), neutrophil–lymphocyte ratio (NLR), platelet–lymphocyte ratio (PLR), tumor markers (CEA, CA19-9), overall response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and adverse events. Results: The cohort included 36 men and 16 women, with a median age of 73.0 years. There were 36 cases of cholangiocarcinoma (distal: 10, perihilar: 19, intrahepatic: 7), 13 cases of gallbladder cancer, and 3 cases of ampullary carcinoma. The stages were locally advanced in 30 cases and metastatic in 22 cases. Biliary drainage was performed in 30 cases. There were 38 cases receiving first-line therapy and 14 cases receiving second-line or later treatments. The median values at the start of GCD therapy were ALB 3.7 g/dL, CRP 0.39 mg/dL, NLR 2.4, PLR 162.5, CEA 4.8 ng/mL, and CA19-9 255.9 U/mL. The mGPS distribution was 0:23 cases, 1:18 cases, and 2:11 cases. The treatment outcomes were ORR 25.0% (CR 2 cases, PR 11 cases), DCR 78.8% (SD 28 cases, PD 10 cases, NE 1 case), median PFS 8.6 months, and median OS 13.9 months. The PLR was suggested to be useful for predicting PFS. A decrease in CEA at six weeks after the start of treatment was a significant predictor of PFS and OS. Gallbladder cancer had a significantly poorer prognosis compared to other cancers. The immune-related adverse events included hypothyroidism in two cases, cholangitis in one case, and colitis in one case. Conclusions: The ORR, DCR, and PFS were comparable to those in the TOPAZ-1 trial. Although limited by its retrospective design and small sample size, this study suggests that GCD therapy is an effective treatment regimen for unresectable biliary tract cancer in real-world clinical practice. Full article

Background: Malnutrition and unintended weight loss are frequent in cancer patients and linked to poorer outcomes. However, data on long-term weight trajectories, particularly comparing different cancer entities, remain limited. Methods: In this retrospective, multicenter study, we analyzed 145 patients diagnosed with either head and neck cancer (HNC; n = 48) or high-grade B-cell lymphoma (HGBCL; n = 97). Body weight, C-reactive protein (CrP), albumin, and modified Glasgow Prognostic Score (mGPS) were assessed at diagnosis and at 3, 6, 9, and 12 months. Clinically relevant weight loss was defined as >5% from baseline. Survival analyses were performed for HGBCL patients. Results: Weight loss was common in both cohorts, affecting 32.2% at 3 months and persisting in 42.3% at 12 months. Nearly half of HNC patients had sustained >5% weight loss at one year, whereas HGBCL patients were more likely to regain weight, with significantly higher rates of weight gain at 6 and 12 months (p = 0.04 and p = 0.02). At baseline, HGBCL patients showed elevated CrP and lower albumin compared to HNC (both p < 0.001). Weight loss at 6 months was significantly associated with reduced overall survival in HGBCL (p < 0.01). Both Δweight at 6 months and mGPS emerged as useful prognostic indicators. Conclusions: This study reveals distinct patterns of weight change and systemic inflammation between HNC and HGBCL patients during the first year after diagnosis. These findings highlight the need for entity-specific nutritional monitoring and tailored supportive care strategies extending into survivorship. Prospective studies integrating body composition analyses are warranted to better guide long-term management. Full article

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. Full article

Background/Objectives: Perimesencephalic subarachnoid hemorrhage (pmSAH) is generally considered to be a benign variant of spontaneous SAH. However, in rare cases, an underlying aneurysm may be present, altering both clinical management and prognosis. The aim of this study was to evaluate the prognostic impact of aneurysmal pathology in patients presenting with perimesencephalic hemorrhage, focusing on the occurrence of complications and functional outcomes. Methods: This single-center, retrospective study included 77 patients diagnosed with perimesencephalic hemorrhage between 2012 and 2022. Clinical and radiological data were extracted, including demographics, risk factors, complications (hydrocephalus, vasospasm, and delayed cerebral ischemia (DCI)), and outcome scores (Glasgow Outcome Scale (GOS) and modified Rankin scale (mRS) at discharge). Patients were divided into two groups based on the presence or absence of an aneurysm confirmed through digital subtraction angiography (DSA). Results: Of the 77 patients, 7 (9.1%) were found to have an aneurysm. While rates of complications such as hydrocephalus and DCI were higher in the aneurysm group, these differences did not reach statistical significance. However, patients with aneurysms had significantly worse functional outcomes, with higher mRS and lower GOS scores at discharge. Logistic regression confirmed the presence of aneurysms as an independent factor associated with poor outcomes (OR = 21.6; 95% CI: 1.00−467.3; p = 0.050), while other variables such as age, sex, and World Federation of Neurosurgical Societies (WFNS) score were not statistically significant. ROC analysis showed moderate discriminative power of aneurysm presence for poor outcomes (AUC = 0.72). Conclusions: The presence of an aneurysm, although rare in pmSAH, significantly worsens functional outcomes. These findings highlight the necessity of early and sensitive vascular diagnostics—particularly DSA—to reliably exclude aneurysms. Differentiating between aneurysmal and non-aneurysmal perimesencephalic bleeding is essential not only for clinical decision-making but also for optimizing resource allocation in neurocritical care. Full article

Background/Objectives: Acute pancreatitis (AP) remains a pressing clinical challenge, largely due to its potential to lead to life-threatening complications and increased mortality. Over the years, numerous tools have been proposed to evaluate the intensity of AP and estimate likely health outcomes. Despite their usefulness, many of these assessment models are complex and rely on a wide array of clinical inputs, making them less practical in everyday healthcare settings. In contrast, the Aggregate Systemic Inflammation Index (AISI), which is calculated using routine blood count parameters, provides a simpler and more inclusive approach to measuring systemic inflammation. This research focuses on examining how effectively AISI can be used to gauge disease severity and project clinical trajectories in individuals affected by pancreatitis. Methods: This retrospective study reviewed the medical records of 412 individuals diagnosed with acute pancreatitis, all of whom received care at the Internal Medicine Clinic of Ankara Bilkent City Hospital between 1 April 2019 and 1 September 2024. The investigation encompassed a thorough analysis of patients’ demographic characteristics, lab parameters, and clinical findings, with special attention given to inflammatory markers, including the Aggregate Systemic Inflammation Index (AISI), its revised version, the Platelet-to-Lymphocyte Ratio (PLR), the Neutrophil-to-Lymphocyte Ratio (NLR), and the Systemic Inflammatory Response Index (SIRI). Comparative analyses between groups were performed using independent sample t-tests and one-way ANOVA, complemented by Tukey’s post hoc tests where appropriate. Correlations among continuous variables were determined through Pearson’s analysis, and the prognostic accuracy of both AISI and its modified form was assessed using Receiver Operating Characteristic (ROC) curve methodology. Results: The mean age among participants was 63.47 ± 17.92 years, while the average AISI value was calculated as 1183.89 ± 1067.42. Both the original and modified versions of the AISI index showed strong positive correlations with several key clinical measures, including prolonged hospitalization, a Glasgow score of 2 or above, BISAP, Ranson scoring, the revised Atlanta classification, and APACHE II. AISI was also significantly linked to the presence of complications and overall mortality (p < 0.01). Analysis through ROC curves demonstrated that an AISI level above 236.626 effectively predicted hospital stays exceeding 10 days, with a sensitivity of 94.40% and a specificity of 91.00%. Moreover, both AISI and its modified form reliably distinguished patients who had a Ranson score of zero, with high diagnostic accuracy. Conclusions: AISI and its modified version demonstrate a strong association with both the intensity and clinical course of acute pancreatitis. Thanks to their simplicity, low cost, and broad usability in healthcare settings, these indices hold considerable promise as practical and dependable tools for assessing the severity and likely outcomes of this increasingly prevalent disease. Full article

Objective: The benign nature of perimesencephalic subarachnoid hemorrhage (pmSAH) can be challenged by the occurrence of complications. Given the limited prognostic value of established clinical parameters for the development of complications in patients with pmSAH, this study evaluates the potential of volumetric hemorrhage quantification for risk assessment and the evaluation of the clinical outcome. Material and Methods: In this retrospective single-center study, we analyzed all consecutive patients diagnosed with pmSAH between 2010 and 2023 at a tertiary care academic medical center in Germany. The volumetric quantification of the hemorrhage in cm³ was performed using non-contrast CT imaging. The occurrence of clinical complications, including hydrocephalus, vasospasm, and delayed cerebral ischemia (DCI), were assessed. Clinical outcomes were determined by the Glasgow Outcome Scale (GOS) at discharge. Multivariable logistic regression models were used to assess the correlation between quantified hemorrhage volumes and the occurrence of complications and clinical outcomes (GOS) controlled for other variables such as age, sex, cardiovascular risk factors, clinical symptoms, and the modified Fisher scale. Results: A total of 82 patients (58.5% male, 54.8 ± 12.1 years) were enrolled. The median World Federation of Neurosurgical Societies (WFNS) score for all patients at admission was 1.0 (IQR 1.0–1.0). During the clinical course, hydrocephalus occurred in 29%, vasospasm in 14.6%, and DCI in 8.5% of all patients. Hemorrhage volume quantification was found to be the strongest independent predictor for hydrocephalus (OR 1.28; 95% CI 1.02–1.61; p = 0.032) and vasospasm (OR 1.25; 95% CI 1.07–1.46; p = 0.007) and showed a high predictive accuracy in ROC analyses (AUC = 0.77 and 0.76, respectively). Conversely, neither clinical parameters nor the modified Fisher scale were associated with these complications. A higher hemorrhage volume was also significantly correlated with a worse functional outcome (GOS; β = –0.07, CI: −0.12–−0.02, p = 0.021). Conclusions: In patients with pmSAH, the volumetric quantification of hemorrhage may be an adequate prognostic parameter regarding the occurrence of hydrocephalus and vasospasm. In addition, the quantitative assessment of hemorrhage volumes was strongly associated with clinical outcomes in these patients. Despite the generally benign nature of pmSAH, this imaging biomarker could improve individualized clinical management strategies and inform about the risk for the occurrence of complications. Full article

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. Full article

Background: Sepsis is a critical condition characterized by severe immune dysregulation, ranking among the leading causes of morbidity and mortality in intensive care and internal medicine units. Nutritional status plays a pivotal role in modulating these responses, as when inadequate it can compromise immune defenses, the body’s ability to handle stress and inflammation, and the clinical course. Malnutrition is frequently observed in septic patients and is strongly associated with worse clinical outcomes, including increased mortality, prolonged hospital stays, and greater complication rates. In this context, nutritional scoring systems have emerged as valuable tools to evaluate patients’ nutritional status and predict clinical trajectories. Objectives: Given the absence of a direct comparison of their performance in an internal medicine setting, this study aimed to assess the effectiveness of various nutritional scores as predictive tools for clinical outcomes in septic patients, emphasizing their application within the field of internal medicine. Methods and Results: A retrospective analysis was conducted on 143 patients diagnosed with sepsis or septic shock who were admitted to an internal medicine unit. Key variables included clinical and laboratory parameters, comorbidities, and nutritional scores at the time of diagnosis. The modified Glasgow Prognostic Score (mGPS), the Prognostic Nutritional Index (PNI), the Controlling Nutritional Status (CONUT) score, the modified Nutrition Risk in Critically Ill (mNUTRIC) score, and the blood urea nitrogen-to-albumin ratio (BAR) were evaluated in forecasting mortality and clinical outcomes in patients with sepsis. Among them, the mNUTRIC score emerged as the strongest independent predictor of in-hospital mortality, with a good performance and a reasonable threshold for risk stratification. Conclusions: The study highlights the mNUTRIC score’s practicality and reliability in assessing nutritional and inflammatory risks in septic patients, particularly in non-ICU settings. These findings suggest its potential utility in guiding nutritional interventions and improving clinical outcomes, emphasizing the importance of integrating nutritional assessment into sepsis management. Full article

Background and Objectives: There is no reliable immune scoring system that can help us predict the postoperative outcomes of colorectal cancer patients with peritoneal metastases after cytoreductive surgery. In this cohort, the aims were (1) to evaluate the postoperative morbidity, mortality and surgical oncological outcomes in colorectal cancer patients with peritoneal metastasis; (2) to compare oncological and postoperative outcomes of colon cancer patients with peritoneal metastasis and rectal cancer patients with peritoneal metastasis; and (3) to assess the prognostic value of the modified Glasgow Prognostic Score (mGPS) and the CRP–albumin ratio (CAR). Materials and Methods: A prospectively maintained database of 258 patients who underwent cytoreductive surgery for peritoneal metastases of colorectal origin between 2007 and 2024 was analyzed. According to the anatomical location of the primary tumor, two different groups were created: rectum cancer patients with peritoneal metastasis (Group A) and colon cancer patients with peritoneal metastasis (Group B). All standard clinico-pathological characteristics, operative findings, morbi-mortality results, and final oncologic outcomes were compared between Groups A and B. We evaluated whether CAR and mGPS could predict postoperative morbi-mortality and overall survival in the two groups or not. Results: No significant difference was detected between Groups A and B in terms of clinical–demographic characteristics. In both groups, the preoperative mGPS and CAR values were statistically significantly higher in those who developed postoperative high-grade complications (C-D grade III/IV) (p < 0.001) and those who died perioperatively (p = 0.001 and p = 0.002). Conclusions: In multivariate Cox analysis, the CAR was found to be an independent prognostic factor for overall survival in this cohort. CAR and mGPS predicted high-grade complications and postoperative mortality in both groups. Full article

Background: Previously, we proposed that the immune-modified Glasgow Prognostic Score (imGPS), which adds the lymphocyte count to the mGPS, is helpful as a prognostic marker for patients with head and neck squamous cell carcinoma. In this study, we investigated the imGPS as a marker for the therapeutic effect of pembrolizumab in treating recurrent and metastatic head and neck cancer (RMHNC). Methods: This study included RMHNC patients who were treated with pembrolizumab from December 2019 to April 2024. ALB, CRP, lymphocyte counts, neutrophil-to-lymphocyte ratios (NLRs), mGPSs, and imGPSs were extracted as biomarkers, and the response rate and prognosis were analyzed for each. Results: A total of 54 patients were enrolled. Lymphocyte counts were correlated with the overall response rates (ORRs) (p = 0.0082). Although the mGPS did not show significant differences in ORRs, imGPSs revealed a significant difference (p = 0.013). CRP, ALB, and lymphocyte counts were correlated with overall survival (OS) and/or progression-free survival (PFS). NLRs, mGPSs, and imGPSs were also correlated with OS and/or PFS, with imGPSs showing the greatest area under the curve (OS; AUC = 0.795, PFS; AUC = 0.754). Conclusions: This study demonstrates that the imGPS is an excellent predictive marker for the therapeutic effect and prognosis of pembrolizumab for RMHNC. The imGPS can be employed with daily blood tests, highlighting the potential to forecast the impact of the ICI with high reliability. Full article