A new 5,698-patient real-world cohort from Valladolid (Del Río-Solá et al., Adv Wound Care 2026) reports 61.8% five-year survival overall, falling to 32.1% after major amputation — and concludes the diabetic foot ulcer should be treated as a marker of advanced systemic disease, not an isolated wound. The newest entry in a fifteen-year line of evidence putting DFU mortality squarely in the cancer conversation.