Browsing by Author "Akman, T"
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Item Therapeutic effect of sunitinib on diabetes mellitus related ovarian injury: an experimental rat model studyErbas, O; Pala, HG; Pala, EE; Ulkumen, BA; Akman, L; Akman, T; Oltulu, F; Aktug, H; Yavasoglu, AThe aim of our study is to investigate the effect of sunitinib on diabetes mellitus related-ovarian injury and fibrosis in rat models. An experimental diabetes mellitus model was created in 16 rats, and eight rats with normal blood glucose levels were included in control group (Group-1). The diabetic rats were divided into two groups:diabetic control group (water given) - Group-2 and sunitinib treatment group - Group-3. After four weeks, bilateral oophorectomy was performed and ovaries were examined histologically. The groups were compared by Student's t-test, analysis of variance (ANOVA) and Mann Whitney's U-test. There was a significant increase in no-medication (water given) diabetic rat's ovary (Group-2) in terms of follicular degeneration, stromal degeneration, stromal fibrosis and NF-kappaB immune-expression compared with control group normal rats' ovary (Group-1) (p < 0.0001). Stromal degeneration (p = 0.04), stromal fibrosis (p = 0.01), follicular degeneration (p = 0.02), NF-kappaB immune-expression (p = 0.001) significantly decreased in sunitinib-treated diabetic rat's ovary (Group-3) when compared with no-medication (water given) diabetic rat's ovary (Group-2) (p < 0.05). When we used sunitinib in the treatment of diabetic rats, ovarian injury, fibrosis and NF-kappaB immunoexpression decreased significantly. The effects of sunitinib in rat models give hope to the improved treatment of premature ovarian failure due to diabetes mellitus in humans.Item Predictive factors for the development of brain metastases in patients with malignant melanoma: a study by the Anatolian society of medical oncologyGumusay, O; Coskun, U; Akman, T; Ekinci, AS; Kocar, M; Erceleb, ÖB; Yazici, O; Kaplan, MA; Berk, V; Cetin, B; Taskoylu, BY; Yildiz, A; Goksel, G; Alacacioglu, A; Demirci, U; Algin, E; Uysal, M; Oztop, I; Oksuzoglu, B; Dane, F; Gumus, M; Buyukberber, SThe development of brain metastases (BMs) was associated with poor prognosis in melanoma patients. Patients with BMs have a median survival of < 6 months. Melanoma is the third most common tumor to metastasize to the brain with a reported incidence of 10-40 %. Our aim was to identify factors predicting development of BMs and survival. We performed a retrospective analysis of 470 melanoma patients between 2000 and 2012. The logistic regression analyses were used to identify the clinicopathological features of primary melanoma that are predictive of BMs development and survival after a diagnosis of brain metastases. There were 52 patients (11.1 %) who developed melanoma BMs during the study period. The analysis of post-BMs with Kaplan-Meier curves has resulted in a median survival rate of 4.1 months (range 2.9-5.1 months). On logistic regression analysis site of the primary tumor on the head and neck (p = 0.002), primary tumor thickness (Breslow > 4 mm) (p = 0.008), ulceration (p = 0.007), and pathologically N2 and N3 diseases (p = 0.001) were found to be significantly associated with the development of BMs. In univariate analysis, tumor thickness and performance status had a significant influence on post-BMs survival. In multivariate analysis, these clinicopathologic factors were not remained as significant predictive factors. Our results revealed the importance of primary tumor characteristics associated with the development of BMs. Ulceration, primary tumor thickness, anatomic site, and pathologic a parts per thousand yenN2 disease were found to be significant predictors of BMs development.Item Effectiveness and safety of cabazitaxel chemotherapy for metastatic castration-resistant prostatic carcinoma on Turkish patients (The Anatolian Society of Medical Oncology)Süner, A; Aydin, D; Hacioglu, MB; Dogu, GG; Imamoglu, GI; Menekse, S; Pilanci, KN; Yazici, ÖK; Koca, D; Karaagaç, M; Akyol, M; Akman, T; Ergen, S; Avci, N; Kaçan, T; Bozkurt, O; Kefeli, U; Urakçi, Z; Araz, M; Arpaci, E; Harputlu, H; Sevinç, AOBJECTIVE: Prostate cancer is among the most common cancers in males. Prostate cancer is androgen dependent in the beginning, but as time progresses, it becomes refractory to androgen deprivation treatment. At this stage, docetaxel has been used as standard treatment for years. Cabazitaxel has become the first chemotherapeutic agent which has been shown to increase survival for patients with metastatic Castrate Resistant Prostate Cancer (mCRPC) that progresses after docetaxel. Phase 3 TROPIC study demonstrated that cabazitaxel prolongs survival. PATIENTS AND METHODS: In this study, we evaluated a total of 103 patients who took cabazitaxel chemotherapy for mCRPC diagnosis in 21 centers of Turkey, retrospectively. This study included patients who progressed despite docetaxel treatments, had ECOG performance score between 0-2, and used cabazitaxel treatment. Patients received cabazitaxel 25 mg/m(2) at every 3 weeks, and prednisolone 5 mg twice a day. RESULTS: Median number of cabazitaxel cures was 5.03 (range: 1-17). Cabazitaxel response evaluation detected that 34% of the patients had a partial response, 22.3% had stable disease and 32% had a progressive disease. Grade 3-4 hematological toxicities were neutropenia (28.2%), neutropenic fever (14.5%), anemia (6.7%), and thrombocytopenia (3.8%). In our study, median progression-free survival (PFS) was 7.7 months and overall survival (OS) was 10.6 months. CONCLUSIONS: This study reflects toxicity profile of Turkish patients as a Caucasian race. We suggest that cabazitaxel is a safe and effective treatment option for mCRPC patients who progress after docetaxel. Moreover, ethnicity may play important roles both in treatment response and in toxicity profile.Item Endocrine therapy alone vs chemotherapy plus endocrine therapies for the treatment of elderly patients with endocrine-responsive and node positive breast cancer: A retrospective analysis of a multicenter study (Anatolian Society of Medical Oncology)Inal, A; Akman, T; Yaman, S; Ozturk, SD; Geredeli, C; Bilici, M; Inanc, M; Harputoglu, H; Demirci, U; Balakan, O; Cinkir, HY; Alici, S; Sonmez, OU; Goksel, G; Dogu, GG; Unal, OU; Tamozlu, T; Buyukberber, S; Boruban, CM; Isikdogan, APurpose: The extra benefit of adding chemotherapy to effective endocrine therapy (ET) has not been clearly or consistently identified in patients older than 70 years with estrogen receptor (ER) positive and node positive breast cancer. The aim of this study was to evaluate the efficacy of adjuvant ET vs chemotherapy plus endocrine therapies (Chemo/ET) in such patients. Methods: In this retrospective multicenter study 191 patients >= 70 years with operated hormone receptor positive breast cancer, who were administered adjuvant ET or Chemo/ET were assessed. Results: The median patient follow-up time was 29.0 months (range 1-252). Therefore disease free survival (DFS) and overall survival (OS) analysis was limited, due to the rather short median follow-up, and only 30-month cumulative percentages are reported herein. The 30-month DFS rates were 50.0% in the ET arm and 49.0% in the Chemo/ET arm (p=0.79). The 30-month OS rates were 86% in the ET arm and 96.0% in the Chemo/ET arm (p=0.08). Cox proportional hazard model showed that only surgery was independent prognostic factor for survival (p=0.047), while tumor size showed a strong trend for statistical significance (p=0.051). Conclusion: The addition of chemotherapy to endocrine therapy in older patients has no significant impact on DFS and OS.Item The mean platelet volume may predict the development of isolated bone metastases in patients with breast cancer: a retrospective study of the Young Researchers Committee of the Turkish Oncology Group (TOG)Tanriverdi, O; Menekse, S; Teker, F; Oktay, E; Pilanci, KN; Gunaldi, M; Kocar, M; Kacan, T; Bahceci, A; Avci, N; Akman, T; Cokmert, S; Yesil-Cinkir, H; Yanmaz, MTPurpose: To determine the predictive value of the mean platelet volume (MPV) and the MPV/platelet count ratio on the development of isolated bone metastasis in patients with breast cancer. Methods: A total of 121 previously untreated female patients with isolated bone metastases from breast cancer (group 1) were included in this retrospective cohort study. The patients enrolled in this study had similar age, biological subtypes, and duration of follow-up after diagnosis. Group 1 was compared with both 71 previously untreated women with breast cancer with no metastases at all (group 2) and 39 healthy women (group 3). Demographic data, laboratory tests and histological features of all of the patients in groups 1 and 2 were recorded and the study variables from each of the three groups were compared. Results: In group 1, the cut-off value (9.2 fL) for the MPV was determined and patients were stratified into 4 subgroups. The MPV was higher in group 1 than in either group 2 or group 3. Group 1 patients had a MPV of 8.8 +/- 3.1 fL (mean 5.1, range: 6.1-15.6) and the cut-off value for MPV was 9.2fl. For patients in group 1, the MPV distribution was stratified into 4 groups as follows: group A included MPV values <6.08 fL, in group B values ranged from 6.09 to 8.46 fL, group C included values from 8.47 to 10.05 fL, and group D included patients with MPV values >10.06fL. MPV and the presence of lymphovascular invasion were found to be independent risk factors for the development of isolated bone metastases. Conclusion: We concluded that MPV can be used to predict the development of isolated bone metastases.Item Pathologic and Clinical Characteristics of Elderly Patients With Breast Cancer: A Retrospective Analysis of a Multicenter Study (Anatolian Society of Medical Oncology)Inal, A; Akman, T; Yaman, S; Ozturk, SC; Geredeli, C; Bilici, M; Inanc, M; Harputoglu, H; Demirci, U; Balakan, O; Cinkir, HY; Alici, S; Colak, D; Sonmez, OU; Goksel, G; Dogu, GG; Engin, H; Unal, OU; Tamozlu, T; Buyukberber, S; Boruban, CM; Isikdogan, AThere is very little information about breast cancer characteristics, treatment choices, and survival among elderly patients. The purpose of this multicenter retrospective study was to examine the clinical, pathologic, and biologic characteristics of 620 breast cancer patients age 70 years or older. Between June 1991 and May 2012, 620 patients with breast cancer, recruited from 16 institutions, were enrolled in the retrospective study. Patients had smaller tumors at diagnosis; only 15% of patients had tumors larger than 5 cm. The number of patients who had no axillary lymph node involvement was 203 (32.7%). Ninety-three patients (15.0%) had metastatic disease at diagnosis. Patients were characterized by a higher fraction of pure lobular carcinomas (75.3%). The tumors of the elderly patients were also more frequently estrogen receptor (ER) positive (75.2%) and progesterone receptor (PR) positive (67.3%). The local and systemic therapies for breast cancer differed according to age. An association between age and overall survival has not been demonstrated in elderly patients with breast cancer. In conclusion, the biologic behavior of older patients with breast cancer differs from younger patients, and older patients receive different treatments.Item Is lymph node ratio prognostic factor for survival in elderly patients with node positive breast cancer? The Anatolian Society of Medical OncologyInal, A; Akman, T; Yaman, S; Ozturk, SC; Geredeli, C; Bilici, M; Inanc, M; Harputoglu, H; Demirci, U; Suner, A; Cinkir, HY; Alici, S; Colak, D; Sonmez, OU; Goksel, G; Dogu, GG; Engin, H; Unal, OU; Tamozlu, T; Buyukberber, S; Boruban, CM; Isikdogan, ASeveral studies have now demonstrated that the lymph node ratio (LNR), as a superior indicator of axillary tumor burden to the number of excised nodes. While, about the prognostic value of LNR on the the survival of elderly patients is limited. The aim of this retrospective multicenter study is to evaluate the prognostic value of lymph node ratio in elderly patients with node positive breast cancer. METHODS: Onehundredeightyfour patient with operable breast cancer, recruited from 17 institutions, were enrolled into the retrospectively study. Eleven potential prognostic variables were chosen for analysis in this study. Univariate and multivariate analyses were conducted to identify prognostic factors associated with survival. RESULT: Among the eleven variables of univariate analysis, four variables were identified to have prognostic significance for Overall survival (OS): pathologic tumor size (T), No. of positive nodes (N), LNR and estrogen receptor-positive (ER). Among the eleven variables of univariate analysis, two variables were identified to have prognostic significance for Disease-free survival (DFS): N and LNR. Multivariate analysis by Cox proportional hazard model showed that 7; LNR and ER were considered independent prognostic factors for OS. Furthermore, LNR was considered independent prognostic factors for DFS. CONCLUSION: In conclusion, the LNR was associated with the prognostic importance for DFS and OS in elderly patients who were administered adjuvant treatments.Item Prognostic significance of the baseline serum uric acid level in non-small cell lung cancer patients treated with first-line chemotherapy: a study of the Turkish Descriptive Oncological Researches GroupTanriverdi, O; Cokmert, S; Oktay, E; Pilanci, KN; Menekse, S; Kocar, M; Sen, CA; Avci, N; Akman, T; Ordu, C; Goksel, G; Meydan, NNon-small cell lung cancer (NSCLC) is one of the most common cancers. Most of the patients are inoperable at the time of diagnosis, and the prognosis is poor. Many prognostic factors have been identified in prior studies. However, it is not clear which factor is more useful. In this study, we investigated whether uric acid, the last breakdown product of purine metabolism in humans, has a prognostic significance in advanced NSCLC. A total of 384 NSCLC patients at stage IIIB/IV and who did not meet exclusion criteria were included in this retrospective cross-sectional study. The patients' serum uric acid levels before first-line chemotherapy and demographic (age, gender, smoking), clinical (performance status, weight loss, disease stage, first-line treatment regimen), laboratory (hemoglobin, lactate dehydrogenase), and histologic (histologic type, tumor grade) characteristics were recorded. First, a cut-off value was determined for serum uric acid level. Then, the patients were stratified into four groups (quartiles) based on their serum uric acid levels. Descriptive statistics, univariate and multivariate analyses, and survival analyses were used. Majority of the patients were males, smokers and metastatic at time of diagnosis and had history of weight loss and adenocarcinoma upon pathological examination. The serum uric acid levels of all patients were determined as 4.9 +/- 2.9 (range 1.9-11.3). The patients were stratified according to quartiles of serum uric acid concentration with cutoff values defined as <3.08 mg/dL (lowest quartile, Group 1), 3.09-5.91 mg/dL (Group 2), 5.92-7.48 mg/dL (Group 3), and >7.49 mg/dL (highest quartile, Group 4). Among the patients who had serum uric acid levels over 7.49, it was observed that those who also had squamous cell carcinoma had a greater rate of brain metastasis, a shorter time lapse until brain metastasis, and lower overall survival rate. It can be assumed that NSCLC patients who had histologically shown squamous cell carcinoma display brain metastasis and poor prognosis. It can be recommended to repeat this study with larger patient series including immunohistochemical, molecular, and wider laboratory investigations.Item The effects of sunitinib on endometriosisPala, HG; Erbas, O; Pala, EE; Ulkumen, BA; Akman, L; Akman, T; Oltulu, F; Yavasoglu, AThe aim of the present study was to evaluate the effect of sunitinib on endometriotic implants and adhesions in a rat endometriosis model. An experimental endometriosis model was created in 21 rats. These rats were randomly divided into three groups: Group 1 (control group, 7 rats) was given no medication; Group 2 (sunitinib group, 7 rats) was given 3 mg/kg per day of oral sunitinib; and Group 3 (danazol group, 7 rats) was given 7.2 mg/kg per day of oral danazol. The volume of endometriotic implants was calculated. The extent and severity of adhesions were evaluated. The groups were compared by the Student's t-test, analysis of variance (ANOVA) and the Mann-Whitney U test. There was no statistically significant difference in the mean volume of endometriotic implants before medication between three groups. The volume of implants and extent, severity, total score of adhesions were significantly decreased after medication in Group 2 and Group 3. We noted that the volume of the endometriotic implants and adhesion formation were decreased both after sunitinib and danazol treatment. As a result, sunitinib seems to be effective for endometriotic peritoneal lesions. The effects of sunitinib in rat models give hope for improving the treatment of human endometriosis and prevention of pain symptoms.Item The clinical and pathological features of 133 colorectal cancer patients with brain metastasis: a multicenter retrospective analysis of the Gastrointestinal Tumors Working Committee of the Turkish Oncology Group (TOG)Tanriverdi, O; Kaytan-Saglam, E; Ulger, S; Bayoglu, IV; Turker, I; Ozturk-Topcu, T; Cokmert, S; Turhal, S; Oktay, E; Karabulut, B; Kilic, D; Kucukzeybek, Y; Oksuzoglu, B; Meydan, N; Kaya, V; Akman, T; Ibis, K; Saynak, M; Sen, CA; Uysal-Sonmez, O; Pilanci, KN; Demir, G; Saglam, S; Kocar, M; Menekse, S; Goksel, G; Yapar-Taskoylu, B; Yaren, A; Uyeturk, U; Avci, N; Denizli, B; Ilis-Temiz, EBrain metastasis in colorectal cancer is highly rare. In the present study, we aimed to determine the frequency of brain metastasis in colorectal cancer patients and to establish prognostic characteristics of colorectal cancer patients with brain metastasis. In this cross-sectional study, the medical files of colorectal cancer patients with brain metastases who were definitely diagnosed by histopathologically were retrospectively reviewed. Brain metastasis was detected in 2.7 % (n = 133) of 4,864 colorectal cancer patients. The majority of cases were male (53 %), older than 65 years (59 %), with rectum cancer (56 %), a poorly differentiated tumor (70 %); had adenocarcinoma histology (97 %), and metachronous metastasis (86 %); received chemotherapy at least once for metastatic disease before brain metastasis developed (72 %), had progression with lung metastasis before (51 %), and 26 % (n = 31) of patients with extracranial disease at time the diagnosis of brain metastasis had both lung and bone metastases. The mean follow-up duration was 51 months (range 5-92), and the mean survival was 25.8 months (95 % CI 20.4-29.3). Overall survival rates were 81 % in the first year, 42.3 % in the third year, and 15.7 % in the fifth year. In multiple variable analysis, the most important independent risk factor for overall survival was determined as the presence of lung metastasis (HR 1.43, 95 % CI 1.27-4.14; P = 0.012). Brain metastasis develops late in the period of colorectal cancer and prognosis in these patients is poor. However, early screening of brain metastases in patients with lung metastasis may improve survival outcomes with new treatment modalities.