Comparison of the efficacy of sunitinib and pazopanib in patients with advanced non-clear renal cell carcinoma.

Non-clear cell renal cell carcinoma (non-ccRCC) is a highly heterogeneous disease group, accounting for approximately 25% of all RCC cases. Due to its rarity and especially heterogeneity, phase III trial data is limited and treatment options generally follow those of clear cell RCC. In the literature, there exists a number of studies with sunitinib, cabozantinib, and everolimus, but data on the efficacy of pazopanib are limited. Our aim in this study was to compare the efficacy of pazopanib and sunitinib, in a multicenter retrospective cohort of non-ccRCC patients. Our study included patients diagnosed with non-ccRCC who received pazopanib or sunitinib treatment as first-line therapy from 22 tertiary hospitals. We compared the progression-free survival (PFS), overall survival (OS), and response rates of pazopanib and sunitinib treatments. Additionally, we investigated prognostic factors in non-ccRCC. PFS and response rates of sunitinib and pazopanib were found to be similar, while a numerical difference was observed in OS. Being 65 years and older, being in the intermediate or poor risk group according to the International Metastatic Renal Cell Carcinoma Database Consortium, having liver metastases, presence of a sarcomatoid component, and having de novo metastatic disease were found to be significantly associated with shorter PFS. Pazopanib treatment appears to have similar efficacy in the treatment of non-ccRCC compared to sunitinib. Though randomized controlled trials are lacking and will probably be never be available, we suggest that pazopanib could be a preferred agent like sunitinib and cabozantinib.

Pazopanib and sunitinib treatments show similar progression free survival, overall survival and objective response rate.IMDC risk group, liver metastasis, sarcomatoid component and de novo metastatic disease were determined as prognostic factors.

B2 Prognostic Index in Determining Prognosis in Metastatic Breast Cancer.

OBJECTIVE: To determine the relationship between the B2 prognostic index (B2PI) scoring method and prognosis in metastatic breast cancer, and to create a formula based on parameters that can be easily accessed in daily practice. STUDY DESIGN: Descriptive study. Place and Duration of the Study: Department of Medical Oncology, Dokuz Eylul University, Izmir, Turkiye, between May 2010 and June 2021. METHODOLOGY: The clinicopathological characteristics of the patients were compared between the groups. All female breast cancer patients over the age of 18 years with de novo metastatic and non-metastatic breast cancers who developed metastasis during follow-up, were included in the study. Those with a second solid cancer or haematological malignancy and with a life expectancy of less than 3 months were excluded from the study. Chi-square and Fisher's exact tests were used to compare categorical data between the groups. Overall survival evaluations were made using the Kaplan-Meier analysis method and Log-Rank test. Risk factors for mortality were evaluated in Cox regression analysis. In all statistical tests, p <0.05 was considered statistically significant. RESULTS: There were 176 patients in this study, out of which 111 (63.1%) were de novo metastatic. When the effect of B2PI risk groups on overall survival in intrinsic subtypes was analysed, significant differences were found in the overall survival of B2PI risk groups in all subtypes except HER2+ ER- (HER2 overexpression subtype). According to the B2PI scoring system, the median overall survival was higher for both low-risk and moderate-risk patients compared to those in the high-risk category. CONCLUSION: For metastatic breast cancer patients, the B2PI can be used to determine prognosis and develop treatment strategies, as it is a clinical decision-making tool based on parameters that are easily accessible in daily practice. KEY WORDS: Metastatic breast cancer, B2 prognostic index, Prognosis, Survival.

Does immunohistochemical marker conversion affect the prognosis in breast cancer patients receiving neoadjuvant chemotherapy?

Biomarkers such as hormone receptors (HR) and human epidermal growth factor receptor2 (HER2) may change after neoadjuvant chemotherapy (NAC) in breast cancer patients. The aim of this study was to investigate the rates of receptor change after NAC and to evaluate the prognostic impact of change. Patients with breast cancer who received NAC were included in the study. Changes in pathological findings (ER, PR, HER-2, Ki-67, grade) before and after NAC were examined. In addition, the effect of receptor exchange on prognosis was evaluated. Kaplan Meier analysis was used for survival analyses. Study was approved by Ethics Board of Tepecik Training and Research Hospital (Decision number 2021/10-02). We confirm that all methods were performed in accordance with relevant named guidelines and regulations. The study included 203 female patients. When pathological findings before and after NAC were compared, significant regression was found in grade and Ki-67 values (p = 0.003, p < 0.001). ER change rate was 11.8%, PR change rate was 24.6% and HER-2 change rate was 12.5%. No significant correlation was found between ER, PR and HER-2 changes and prognosis. The pathological T stage after NAC being 1 or 2, no lymph nodes detected, and the tumor grade being 1 or 2 were independent variables related to survival (p: 0.002, p: 0.014, p < 0.001). In patients with breast cancer, it would be appropriate to re-evaluate the HER-2 and HR status of the surgical specimen following NAC, especially in initially negative patients. The correlation of receptor discordance with prognosis is not clear and more extensive studies are needed.

Factors Predicting Response in Breast Cancer Receiving Neoadjuvant Therapy and the Role of Ki67 Labeling Index.

OBJECTIVE: To determine the predictive value of Ki67 on pathological complete response (pCR) of breast and axilla regions in breast cancer (BC) patients receiving neoadjuvant therapy (NAT). STUDY DESIGN: Descriptive study. Place and Duration of the Study: Departments of Medical Oncology, Sirnak State Hospital, Aydin State Hospital, Manisa Celal Bayar University, and Dokuz Eylul University, from November 2010 to July 2022. METHODOLOGY: PCR and various histopathological parameters were evaluated for BC patients receiving NAT. The Youden Index method was used to find the cut-off value for the Ki67 variable according to the receiver operating characteristic (ROC) curve. This value was obtained as 77.5. Breast and axillary responses were individually evaluated to assess response to NAT. Univariate and multivariate logistic regression analysis were used to predict both breast and axillary pCR. RESULTS: A total number of 280 females receiving NAT for BC were included in the study. Multivariate analysis for breast pCR to NAT showed that Ki67 index (>77.5 vs <77.5, p=0.047) was statistically significant marker. While Ki67 index was significant for breast pCR in both univariate and multivariate analyses, the same was not observed on axillary response (p=0.387). CONCLUSION: High Ki67 level was significantly associated with breast pCR in BC patients receiving NAT, but a similar effect was not observed on axillary pCR. These findings suggest that breast and axilla tissues have a biological differences in treatment responses. KEY WORDS: Axillary response, Breast cancer, Ki67 Labeling Index, Neoadjuvant therapy, pathological complete response.

The effect of low HER2 expression on treatment outcomes in metastatic hormone receptor positive breast cancer patients treated with a combination of a CDK4/6 inhibitor and endocrine therapy: A multicentric retrospective study.

BACKGROUND: CDK4/6 inhibitors combined with endocrine therapy have significantly improved treatment outcomes for metastatic hormone receptor-positive (HR+) breast cancer patients. However, the impact of low HER2 expression on treatment response and progression-free survival (PFS) remains unclear. METHODS: This multicenter retrospective study included 204 HR+ breast cancer patients treated with a combination of CDK4/6 inhibitor and endocrine therapy. HER2-zero disease was detected in 138 (68%) and HER2-low disease in 66 (32%) patients. Treatment-related characteristics and clinical outcomes were analyzed, with a median follow-up of 22 months. RESULTS: The objective response rate (ORR) was 72.7% in the HER2 low group and 66.6% in the HER2 zero group (p = 0.54). Median PFS was not significantly different between the HER2-low and HER2 zero groups (19 months vs.18 months, p = 0.89), although there was a trend toward longer PFS in the HER2-low group for first-line treatment (24 months progression-free survival rate 63% vs 49%). In recurrent disease, the median PFS was 25 months in the HER2-low group and 12 months in the HER2-zero group (p = 0.08), while in de novo metastatic disease, the median PFS was 18 months in the HER2-low group and 27 months in the HER2-zero group (p = 0.16). The order of CDK4/6 inhibitor use and the presence of visceral metastasis were identified as independent variables affecting PFS. CONCLUSION: Low HER2 expression did not significantly impact treatment response or PFS in HR+ breast cancer patients treated with a CDK4/6 inhibitor and endocrine therapy. Because of the conflicting results in the literature, further prospective studies are needed to evaluate the clinical significance of HER2 expression in HR+ breast cancer.

Asprosin, irisin, and meteorin-like protein immunoreactivity in different stages of colorectal adenocarcinoma.

OBJECTIVE: In this study, we aimed to investigate the immunoreactivity of asprosin, irisin, and meteorin-like protein (METRNL) in different stages of colorectal adenocarcinoma, which is the most common malignancy of the gastrointestinal tract. MATERIALS AND METHODS: Overall, 60 patients with colorectal adenocarcinoma, including 20 well (Group 1), moderately (Group 2), and poorly differentiated (Group 3) cases, respectively, and 20 with normal colonic mucosa, were examined using light microscopy for immunohistochemical staining of asprosin, METRNL, and irisin. RESULTS: Compared with the control group, a significant increase in irisin and asprosin immunoreactivity was found in the grade 1 and 2 colorectal adenocarcinoma groups. Moreover, compared with the grade 1 and 2 groups, this immunoreactivity was significantly decreased in the grade 3 colorectal adenocarcinoma group. Although there was no significant difference in METRNL immunoreactivity between the grade 1 and control groups, a statistically significant increase in this immunoreactivity was found in the grade 2 group. In contrast, METRNL immunoreactivity was significantly decreased in the grade 3 group compared with the grade 2 group. CONCLUSION: We found that in early-stage colorectal adenocarcinoma there was an increase in the immunoreactivity of asprosin and irisin, but in the advanced stage there was a decrease in immunoreactivity. Although METRNL immunoreactivity did not change in the control and grade 1 groups, it was found to increase significantly in the grade 2 group and decrease in the grade 3 group.

Turkish HPB Surgery Association consensus report on hepatic cystic Echinococcosis (HCE).

Objectives: Cystic Echinococcosis (CE) is one of the important problems of the Eurasian region. We aimed to prepare a consensus report in order to update the treatment approaches of this disease. This study was conducted by Turkish HPB Surgery Association. Material and Methods: This study was conducted with the modified Delphi model. For this purpose, we conducted a three-stage consensus-building approach. Results: Six topics, including diagnosis, medical treatment, percutaneous treatment, surgical treatment, management of complications and posttreatment follow-up and recurrences in HCE were discussed. Conclusion: The expert panel made recommendations for every topic.

Selvester Score May Be a Predictor of ICD Therapies in Patients with Non-Ischemic Dilated Cardiomyopathy

ABSTRACT Introduction: The benefit of implantable cardioverter-defibrillator (ICD) in patients with non-ischemic dilated cardiomyopathy (DCM) is still an issue under discussion. Studies examining the relationship between ventricular scar tissue and ICD shock with cardiac magnetic resonance (CMR) are promising. CMR studies have shown that ventricular scar tissue size and Selvester score show a correlation. In the light of this information, this study aimed to investigate the potential relationship between Selvester score and ICD therapies. Methods: The study included 48 patients who had undergone ICD implantation with a diagnosis of DCM and who had undergone routine 6-month ICD control in outpatient clinic controls between December 2018 and October 2019. Selvester score and other data were compared between patients who received ICD therapy (n=10) and those who did not (n=38). Results: Selvester score (P<0.001) was higher in ICD therapy group. Positive correlation was found between ICD shock therapy and Selvester score (P=0.002, r=0.843). Selvester score was detected as an independent predictor for ICD therapy after multiple linear regression analysis (P=0.004). Receiver operating characteristic curve analysis showed that Selvester score (P<0.001) was a significant predictor of ICD therapy. Selvester score cutoff points of 5 for were calculated to estimate ICD therapy, with a sensitivity of 100% and specifity of 81%. Conclusion: In our study, it was found that a high Selvester score may be a predictor for ICD therapies in patients with DCM. As an inexpensive and non-invasive method, Selvester score can help in the decision-making in these patients.

Is CRP/Albumin Ratio (CAR) a New Parameter to be Added to Risk Stratification Systems in Metastatic Renal Cell Carcinoma Patients?

OBJECTIVE: To evaluate the effect of pretreatment C-reactive protein (CRP)/Albumin ratio (CAR) on prognosis and its association with IMDC (International metastatic renal cell carcinoma database consortium) risk score and overall survival (OS) in metastatic renal cell carcinoma (mRCC) patients. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Department of Medical Oncology, Dokuz Eylul University, Izmir, Turkey, between 2007 and 2020. METHODOLOGY: Clinico-pathological and treatment-related data of mRCC patients were retrospectively evaluated and included in the study. CAR was used as a prognostic inflammatory score. CAR threshold value for OS has been obtained by ROC analysis. The prognostic value of CAR was tested using Kaplan-Meier and Cox-regression models. IMDC-CAR model was created by adding CAR to IMDC risk stratification. RESULTS: OS was 91 months in patients with CAR below the threshold value of 0.072 (<0.072), while OS was 51 months in patients with CAR of 0.072 and above (p=0.005). According to IMDC risk stratification, intermediate and poor risk groups showed similar survival times (p>0.05). However, when CAR was added to the IMDC risk score in the intermediate group, it was divided into 3 subgroups with different prognoses (p=0.02). CONCLUSION: CAR is an independent predictor of OS in mRCC patients. In this study, it has been demonstrated that more accurate prognosis prediction could be made by adding CAR to IMDC indicators in the intermediate risk group, which constitutes a highly heterogeneous group according to IMDC risk stratification. KEY WORDS: Renal cell cancer, Albumin, C-reactive protein, IMDC, Prognosis.

The effect of hyperandrogenism and obesity on mindfulness and metacognition in adolescents with polycystic ovary syndrome.

The aim of this study was to determine whether serum androgen levels have an effect on mindfulness and metacognition in adolescents with polycystic ovary syndrome (PCOS). Adolescents diagnosed with PCOS were asked to answer a questionnaire that included socio-demographic information and two scales: the Mindful Attention Awareness Scale (MAAS) and the Metacognition Scale Child and Adolescent form (MCQ-C). The patients were divided into two groups, the hyperandrogenism group and the non-hyperandrogenism group, according to serum androgen levels. The scores of MAAS and MCQ-C were compared between the groups. The study sample consisted of 70 adolescents. Of these, 44 had hyperandrogenism according to a blood test. No statistically significant difference was found in MAAS scores between the hyperandrogenism and the non-hyperandrogenism groups (p = 0.79). However, the level of mindfulness was found to be lower in participants with a higher modified Ferriman-Gallwey score (mFGS) (r = 0.26, p = 0.02). Mindfulness levels were also lower for obese patients with PCOS compared to non-obese patients with PCOS (p = 0.02). Cognitive monitoring (MCQ-C-CM), one of the MCQ-C sub-scales, was significantly higher in the non-hyperandrogenism group (p = 0.03), and similarly, a positive correlation was detected between higher androgen levels and the positive meta-worry (MCQ-C-PM) sub-scale of the MCQ-C (for total testosterone; r = 0.348, p = 0.03, and for androstenedione; r = 0.35, p = 0.03). High serum androgen levels in PCOS had no effect on mindfulness, but as the modified Ferriman Gallwey score increased, mindfulness levels decreased. For the sub-scales of MCQ-C,MCQ-C-CM, and MCQ-C-PM, the scores increased as androgen levels increased. In line with the results of the present study, evaluating mindfulness in PCOS patients with increased hair growth and metacognition in PCOS patients with serum hyperandrogenism may contribute well-being in adulthood by reducing the psychological burden caused by the disease.

Is the tumor-stroma ratio a prognostic factor in gallbladder cancer?

OBJECTIVE: This study aimed to examine the prognostic effect of the tumor-stroma ratio, which has been shown to have prognostic value in various cancers, in patients with gallbladder cancer who have undergone curative resection. METHODS: The records of gallbladder cancer patients who underwent surgical treatment in our clinic between December 2005 and March 2021 were analyzed retrospectively. The hematoxylin and eosin-stained sections representing the tumors were evaluated under light microscopy to determine tumor-stroma ratio, and based on the results, <50% was defined as the stroma-rich and ≥50% as the stroma-poor groups. RESULTS: A total of 28 patients, including 20 females and 8 males, with a mean age of 64.6 years, were included in this study. Stroma-poor and stroma-rich tumors were detected in 15 and 13 patients, respectively. There was no statistically significant relationship identified between tumor-stroma ratio and advanced age, gender, serum levels of carbohydrate antigen 19-9 and carcinoembryonic antigen, incidental or nonincidental diagnosis, jaundice, adjacent organ or structure resection, tumor location, grades 1-2 or 3, T1/T2 or T3/T4, N0 or N1/N2, M stage, American Joint Committee on Cancer stage, lymphovascular invasion, and perineural invasion. The stroma-poor and stroma-rich groups had a 5-year survival rate of 30% and 19.2% and a median overall survival of 25.7 and 15.1 months, respectively, with no statistically significant difference between the groups (p=0.526). CONCLUSIONS: A low tumor-stroma ratio tended to be a poor prognostic factor in gallbladder cancer, although not to a statistically significant degree. This can be considered one of the preliminary studies, as further studies involving larger groups are needed.

Is the tumor-stroma ratio a prognostic factor in gallbladder cancer?

SUMMARY OBJECTIVE: This study aimed to examine the prognostic effect of the tumor-stroma ratio, which has been shown to have prognostic value in various cancers, in patients with gallbladder cancer who have undergone curative resection. METHODS: The records of gallbladder cancer patients who underwent surgical treatment in our clinic between December 2005 and March 2021 were analyzed retrospectively. The hematoxylin and eosin-stained sections representing the tumors were evaluated under light microscopy to determine tumor-stroma ratio, and based on the results, <50% was defined as the stroma-rich and ≥50% as the stroma-poor groups. RESULTS: A total of 28 patients, including 20 females and 8 males, with a mean age of 64.6 years, were included in this study. Stroma-poor and stroma-rich tumors were detected in 15 and 13 patients, respectively. There was no statistically significant relationship identified between tumor-stroma ratio and advanced age, gender, serum levels of carbohydrate antigen 19-9 and carcinoembryonic antigen, incidental or nonincidental diagnosis, jaundice, adjacent organ or structure resection, tumor location, grades 1-2 or 3, T1/T2 or T3/T4, N0 or N1/N2, M stage, American Joint Committee on Cancer stage, lymphovascular invasion, and perineural invasion. The stroma-poor and stroma-rich groups had a 5-year survival rate of 30% and 19.2% and a median overall survival of 25.7 and 15.1 months, respectively, with no statistically significant difference between the groups (p=0.526). CONCLUSIONS: A low tumor-stroma ratio tended to be a poor prognostic factor in gallbladder cancer, although not to a statistically significant degree. This can be considered one of the preliminary studies, as further studies involving larger groups are needed.

Selvester Score May Be a Predictor of ICD Therapies in Patients with Non-Ischemic Dilated Cardiomyopathy.

INTRODUCTION: The benefit of implantable cardioverter-defibrillator (ICD) in patients with non-ischemic dilated cardiomyopathy (DCM) is still an issue under discussion. Studies examining the relationship between ventricular scar tissue and ICD shock with cardiac magnetic resonance (CMR) are promising. CMR studies have shown that ventricular scar tissue size and Selvester score show a correlation. In the light of this information, this study aimed to investigate the potential relationship between Selvester score and ICD therapies. METHODS: The study included 48 patients who had undergone ICD implantation with a diagnosis of DCM and who had undergone routine 6-month ICD control in outpatient clinic controls between December 2018 and October 2019. Selvester score and other data were compared between patients who received ICD therapy (n=10) and those who did not (n=38). RESULTS: Selvester score (P<0.001) was higher in ICD therapy group. Positive correlation was found between ICD shock therapy and Selvester score (P=0.002, r=0.843). Selvester score was detected as an independent predictor for ICD therapy after multiple linear regression analysis (P=0.004). Receiver operating characteristic curve analysis showed that Selvester score (P<0.001) was a significant predictor of ICD therapy. Selvester score cutoff points of 5 for were calculated to estimate ICD therapy, with a sensitivity of 100% and specifity of 81%. CONCLUSION: In our study, it was found that a high Selvester score may be a predictor for ICD therapies in patients with DCM. As an inexpensive and non-invasive method, Selvester score can help in the decision-making in these patients.

Long-term results and prognostic factors after surgical treatment for gallbladder cancer.

Objectives: Gallbladder cancer is relatively rare and traditionally regarded as having poor prognosis. There is controversy about the effects of clinicopathological features and different surgical techniques on prognosis. The aim of this study was to investigate the effects of clinicopathological characteristics of the patients with surgically treated gallbladder cancer on long-term survival. Material and Methods: We retrospectively analyzed the database of gallbladder cancer patients treated at our clinic between January 2003 and March 2021. Results: Of 101 evaluated cases, 37 were inoperable. Twelve patients were determined unresectable based on surgical findings. Resection with curative intent was performed in 52 patients. The one-, three-, five-, and 10-year survival rates were 68.9%, 51.9%, 43.6%, and 43.6%, respectively. Median survival was 36.6 months. On univariate analysis, poor prognostic factors were determined as advanced age; high carbohydrate antigen 19-9 and carcinoembryonic antigen levels; non-incidental diagnosis; intraoperative incidental diagnosis; jaundice; adjacent organ/structure resection; grade 3 tumors; lymphovascular invasion; and high T, N1 or N2, M1, and high AJCC stages. Sex, IVb/V segmentectomy instead of wedge resection, perineural invasion, tumor location, number of resected lymph nodes, and extended lymphadenectomy did not significantly affect overall survival. On multivariate analysis, only high AJCC stages, grade 3 tumors, high carcinoembryonic antigen levels, and advanced age were independent predictors of poor prognosis. Conclusion: Treatment planning and clinical decision-making for gallbladder cancer requires individualized prognostic assessment along with standard anatomical staging and other confirmed prognostic factors.

The impact of the level of anxiety and temperament in asymptomatic or mildly symptomatic patients requesting implant removal surgery after tibia intramedullary nailing.

BACKROUND: Implant removal (IR) surgery is one of the most frequent procedures in orthopedic practice. Many of the IR surgeries result from patient request rather than a medical necessity. The purpose of the study was to investigate the association between the level of anxiety, type of temperament and psychopathological status, and the willingness to receive IR surgery in asymptomatic or mildly symptomatic patients. We also aimed to compare pre- and postoperative pain scores and document the complication rates after IR surgery. METHODS: The patients who received tibia intramedullary nailing after tibia diaphyseal fracture with a minimum of 18 months follow-up were included in the study. A total of 246 asymptomatic or mildly symptomatic patients were evaluated, and all patients received detailed oral and written information about the risks of IR surgery. The patients who wished to receive IR surgery were called Group 1 (N = 104), and the patients who did not wish to have surgery were called Group 2 (N = 146). All patients were referred to a psychologist to complete the Beck anxiety inventory (BAI), Symptom checklist-90-R (SCL-R-90), and the Temperament Evaluation of Memphis, Pisa, and San Diego Autoquestionnaire (TEMPS-A). RESULTS: The mean age of the patients was 32.31 ± 9.56. One hundred thirteen (45.9%) of the patients were male, and 133 were female (54%). Mean BAI and SCL-90-R were higher in Group 1 than Group 2 (P = 0.001). Anxious and irritable temperament was higher in Group 1 (P = 0.045 and P = 0.035 respectively), and non-dominant and hyperthymic temperament was higher in Group 2 (P = 0.02 and P = 0.04 respectively). CONCLUSIONS: The level of anxiety and type of temperament is associated with the willingness to receive implant removal surgery in asymptomatic or mildly symptomatic patients. Measures to reduce anxiety levels may reduce the rate of unnecessary implant removal surgeries, associated patient care costs, and potential complications.

Preoperative cardiac risk factors associated with in-hospital mortality in elderly patients without heart failure undergoing hip fracture surgery: a single-centre study.

INTRODUCTION: In the present study, our aim was to ascertain the preoperative cardiac risk factors related to the in-hospital mortality in the elderly patients (aged over 65 years) who required preoperative cardiology consultation for hip fracture surgery. MATERIAL AND METHODS: The present study was a retrospective, single-centre study, which enrolled consecutive elderly patients without heart failure scheduled for hip fracture surgery in our institution. In all patients, an anesthesiologist performed a detailed preoperative evaluation and decided the need for the cardiac consultation. Patients underwent preoperative cardiac evaluation by a trained cardiologist using the algorithms proposed in the recent preoperative guidelines. The in-hospital mortality was the main outcome of the study. RESULTS: In total, 277 elderly patients undergoing hip fracture surgery were enrolled in this analysis. The overall in-hospital mortality rate was 12.1% (n=30 cases). In a multivariate analysis, we found that insulin dependency, cancer, urea, presence of atrial fibrillation (AF) (OR: 3.906; 95% CI 1.470 to 10.381; p=0.006) and pulmonary artery systolic pressure (PASP) (OR: 1.057; 95% CI 1.016 to 1.100; p=0.006) were the predictors of in-hospital mortality. The receiver operating characteristic curve analysis revealed that the optimal value of PASP in predicting the in-hospital mortality was 35 mm Hg (area under the curve=0.71; 95% CI 0.60 to 0.81, p<0.001) with sensitivity of 87.7% and specificity of 59.5%. CONCLUSION: The present research found that the preoperative cardiac risk factors, namely AF and PASP, might be associated with increased in-hospital mortality in elderly patients without heart failure undergoing hip fracture surgery.