Browsing by Author "Avci T."

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    Nationwide prospective audit for the evaluation of appendicitis risk prediction models in adults: Right iliac fossa treatment (RIFT) - Turkey
    (Oxford University Press, 2024) Yalcinkaya A.; Yalcinkaya A.; Balci B.; Keskin C.; Erkan I.; Yildiz A.; Kamer E.; Leventoglu S.; Caglikulekci M.; Zarbaliyev E.; Sevmis M.; Ulgen Y.; Altinel Y.; Meric S.; Akbas A.; Hacim N.A.; Vartanoglu Aktokmanyan T.; Aktimur Y.E.; Calikoglu F.; Gullu H.F.; Durma A.G.; Acar S.; Ciftci E.; Balik E.; Kulle C.B.; Ozata I.H.; Tufekci T.; Tatar C.; Sevinc M.M.; Sevik H.; Ertürk C.; Kiraz I.N.; Ozben V.; Aytac E.; Aliyeva Z.; Mutlu A.U.; Tanal M.; Celayir M.F.; Bozkurt E.; Yetkin S.G.; Ergin E.; Attaallah W.; Uprak T.K.; Omak A.; Simsek O.; Bozkurt M.A.; Kara Y.; Bozdag E.; Yirgin H.; Ozcan A.; Okkabaz N.; Ozdenkaya Y.; Haksal M.C.; Pekuz C.K.; Duru S.; Sivrikoz E.; Ozdemir Y.; Tan N.; Yarbug Karayali F.; Taghiyeva A.; Tirnova I.; Erenler Bayraktar I.; Bayraktar O.; Emsal E.Z.; Dalkilic M.I.; Yesiltas M.; Tok H.; Karakas D.O.; Pusane A.; Demirer A.I.; Sahin H.B.; Gok A.F.K.; Bozkurt H.A.; Yildirim M.; Uzunyolcu G.; Yanar H.T.; Ergun S.; Kutluk F.; Uludag S.S.; Zengin A.K.; Ozcelik M.F.; Sanli A.N.; Altuntas Y.E.; Memisoglu E.; Sari R.; Akdogan O.; Kucuk H.F.; Ozkan O.F.; Ulgur H.S.; Kirkan E.F.; Yuksekdag S.; Rencuzogullari A.; Aktas M.K.; Aba M.; Demirel A.O.; Eray I.C.; Aydogan B.; Cetinkunar S.; Yener K.; Sozutek A.; Irkorucu O.; Bayrak M.; Altintas Y.; Alabaz O.; Atasever A.; Erdogrul G.; Kupeli A.H.; Muhammedoglu B.; Kokdas S.; Kaya M.; Uysal E.; Yildirim A.C.; Zeren S.; Ekici M.F.; Algin M.C.; Kucuk G.O.; Eraslan H.; Aybar E.; Polat S.; Ceylan A.; Isik O.; Kural S.; Aktas A.; Bakar B.; Uzunoglu M.Y.; Gulcu B.; Ozturk E.; Devay A.O.; Taspinar E.; Balcin O.; Aksoy F.; Garip G.; Yalkin O.; Iflazoglu N.; Yigit D.; Kaya R.B.; Ugur M.; Kilic E.; Dedemoglu A.; Arslan R.E.; Temiz M.; Aydin C.; Demirli Atici S.; Kaya T.; Ozturk S.; Calik B.; Kilinc G.; Acar T.; Acar N.; Cengiz F.; Ureyen O.; Tan S.; Ilhan E.; Turk Y.; Durak A.T.; Yilmaz M.; Mercan M.; Atci R.; Sokmen S.; Bisgin T.; Egeli T.; Yildirim Y.; Safak T.; Celik K.; Yilmaz E.M.; Kirnap M.; Demirkiran A.E.; Sekerci U.U.; Karacan E.; Bilgic E.; Ozmen M.M.; Guldogan C.E.; Gundogdu E.; Moran M.; Erol T.; Dincer H.A.; Kirimtay B.; Yilmaz S.; Cennet O.; Yildiz A.; Sahin C.; Akyol C.; Koc M.A.; Ersoz S.; Turhan A.; Konca C.; Tezcaner T.; Erkent M.; Aydin O.; Avci T.; Altiner S.; Osmanov I.; Emral A.C.; Cetinkaya G.; Lapsekili E.; Sakca M.; Cimen S.; Ozen D.; Kozan E.B.; Dogan L.; Haberal E.; Kayhan O.; Aksel B.; Karabacak H.; Azili C.; Yazici F.; Apaydin M.; Kaya I.O.; Cetinkaya E.; Akin T.; Gunes G.; Turap H.; Aslan D.; Demirbag A.E.; Bolukbasi B.; Karaca B.E.; Ozturk E.; Ozeller E.; Kayacan G.S.; Borcek A.O.; Ece I.; Yormaz S.; Colak B.; Calisir A.; Sahin M.; Arslan K.; Hasirci I.; Ulutas M.E.; Metin S.H.; Gultekin F.A.; Ozkan Z.; Ilhan O.; Gundogdu T.; Liman R.K.; Kanat B.H.; Aydin A.; Sungurtekin U.; Ozgen U.; Aykota M.R.; Altintoprak F.; Gonullu E.; Cakmak G.; Dulger U.C.; Mantoglu B.; Demir H.; Akin E.; Eroz E.; Nazli O.; Dere O.; Dadasoglu M.A.; Kara E.; Tutcu S.; Solak I.; Gencer I.; Dalkiran A.; Sevinc B.; Karahan O.; Damburaci N.; Sari E.; Akay T.; Calta A.F.; Ozdemir A.; Ohri N.; Ermis I.; Bozbiyik O.; Ozdemir M.; Goktepe B.; Demir B.; Kilincarslan O.; Gunduz U.R.; Olcum M.; Dincer O.I.; Cakir R.C.; Dinc B.; Sahin E.; Uludag E.; Arslan Y.; Posteki G.; Oktay A.; Tatar O.C.; Guler S.A.; Utkan N.Z.; Tayar S.; Copelci Y.; Kartal M.; Kalayci T.; Yeni M.; Buyukkasap A.C.; Vural S.; Kesicioglu T.; Aydin I.; Gulmez M.; Saracoglu C.; Topcu O.; Kurt A.; Soylu S.; Kurt B.; Serin M.; Basceken S.I.; Gundes E.; Savda M.; Balkan A.Z.A.; Yildiz M.N.; Uzunkoy A.; Karaca E.; Berkan A.; Isik A.; Yildiz Y.A.; Ergul Z.; Yasar N.F.; Badak B.; Ozen A.; Velipasaoglu M.; Ure I.
    Background: Appendicitis is the most prevalent surgical emergency. The negative appendicectomy rate and diagnostic uncertainty are important concerns. This study aimed to assess the effectiveness of current appendicitis risk prediction models in patients with acute right iliac fossa pain. Methods: A nationwide prospective observational study was conducted, including all consecutive adult patients who presented with right iliac fossa pain. Diagnostic, clinical and negative appendicectomy rate data were recorded. The Alvarado score, Appendicitis Inflammatory Response (AIR), Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) and Adult Appendicitis Score systems were calculated with collected data to classify patients into risk categories. Diagnostic value and categorization performance were evaluated, with use of risk category-based metrics including 'true positive rate' (percentage of appendicitis patients in the highest risk category), 'failure rate' (percentage of patients with appendicitis in the lowest risk category) and 'categorization resolution' (true positive rate/failure rate). Results: A total of 3358 patients from 84 centres were included. Female patients were less likely to undergo surgery than men (71.5% versus 82.5% respectively; relative risk 0.866, 95% c.i. 0.834 to 0.901, P < 0.001); with a three-fold higher negative appendicectomy rate (11.3% versus 4.1% respectively; relative risk 2.744, 95% c.i. 2.047 to 3.677, P < 0.001). Ultrasonography was utilized in 56.8% and computed tomography in 75.2% of all patients. The Adult Appendicitis Score had the best diagnostic performance for the whole population; however, only RIPASA was significant in men. All scoring systems were successful in females patients, but Adult Appendicitis Score had the highest area under the receiver operating characteristic curve value. The RIPASA and the Adult Appendicitis Score had the best categorization resolution values, complemented by their exceedingly low failure rates in both male and female patients. Alvarado and AIR had extremely high failure rates in men. Conclusion: The negative appendicectomy rate was low overall, but women had an almost three-fold higher negative appendicectomy rate despite lower likelihood to undergo surgery. The overuse of imaging tests, best exemplified by the 75.2% frequency of patients undergoing computed tomography, may lead to increased costs. Risk-scoring systems such as RIPASA and Adult Appendicitis Score appear to be superior to Alvarado and AIR. © 2024 The Author(s). Published by Oxford University Press on behalf of BJS Foundation Ltd.
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    Positive Lymph Node Ratio as a new prognostic score in Geriatric patients with operated gastric cancer
    (Elsevier Ltd, 2024) Acar O.; Balcik O.Y.; Urun M.; Avci T.; Sahbazlar M.; Erdogan A.P.
    Objective: The pivotal prognostic determinant for recurrence and survival in surgically treated gastric cancer (GC) patients remains the lymph node status. Despite the adoption of D2 lymph node dissection as the standard approach in recent years, its association with increased morbidity in elderly patients raises concerns. This study aims to explore the prognostic significance of the Positive Lymph Node Ratio (PLNR) score in the context of recurrence and survival among elderly patients with surgically treated GC. Material and method: A retrospective review of files about surgically treated patients with GC was conducted. The prognostic impact of the PLNR score on overall survival (OS) was assessed through Receiver Operating Characteristic (ROC) analysis. Results: The cut-off value for the PLNR, determined through ROC analysis, was identified as 0.138. This value serves as a crucial threshold, as it distinguishes patients with a higher risk of poor outcomes. Patients with a PLNR score of 0.138 or below exhibited a median OS of 111 months, whereas those with a PLNR score above 0.138 had a significantly lower median OS of 22 months (p = 0.004). Conclusion: Our findings revealed that the PLNR emerged as an independent predictor of survival and recurrence in patients undergoing GC resection.However, it's important to note that while valuable, the PLNR system has limitations. It does not encompass the T stage, a key factor in cancer staging. Therefore, it cannot be a direct substitute for the comprehensive information TNM staging provides. It should be used as a supplementary tool in predicting prognosis, particularly in elderly patients unsuitable for standard lymph node dissection. © 2024 The Authors
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    Comparison of the efficacy of sunitinib and pazopanib in patients with advanced non-clear renal cell carcinoma
    (Taylor and Francis Ltd., 2024) Yildirim H.C.; Bayram E.; Chalabiyev E.; Majidova N.; Avci T.; Güzel H.G.; Kapar C.; Uzun M.; Perkin P.; Akgül F.; Yildirim S.S.; Sali S.; Yildiz A.; Kazaz S.N.; Hendem E.; Arcagok M.; Tufan G.; Yildirim U.; Akgul O.F.; Arslan Ç.; Taban H.; Sahin E.; Caglayan M.; Esen R.; Öksüzoğlu B.; Guven D.C.; Kaplan M.A.; Araz M.; Basaran M.; Cubukcu E.; Gokmen E.; Cicin I.; Algin E.; Semiz H.S.; Tural D.; Ozturk B.; Erdogan A.P.; Sari M.; Kara O.; Erman M.
    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. © 2024 Edizioni Scientifiche per l’Informazione su Farmaci e Terapia (Italian Society of Chemotherapy).
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    Real-Life Efficacy of Palbociclib and Ribociclib in Advanced Breast Cancer
    (Multidisciplinary Digital Publishing Institute (MDPI), 2025) Avci T.; Sahbazlar M.; Ekinci F.; Erdogan A.P.
    Background: Clinical trials in metastatic hormone receptor-positive (HR+) human epidermal growth factor receptor-2 (HER2)-negative patients have shown that cyclin-dependent kinase 4/6 (CDK 4/6) inhibitors both increase response rates and provide survival benefits. The efficacy of these therapies needs to be supported by real-life data. In this study, we aimed to evaluate treatment response, survival and affecting factors in patients with HR+/HER2− metastatic breast cancer (MBC) who were followed up with CDK 4/6 inhibitors in our center. Materials and methods: A retrospective analysis of 120 patients with HR+/HER2− MBC treated with ribociclib or palbociclib in combination with letrozole or fulvestrant was performed. Results: Median progression-free survival (mPFS) was 24 months in the general population, 27 months in the ribociclib arm and 20 months in the palbociclib arm, with no significant difference in progression-free survival (PFS) in both arms (p = 0.25). The mPFS was longer in the ribociclib + letrozole arm compared to palbociclib + letrozole (27 vs. 20 months, respectively). PFS was also longer in patients receiving ribociclib + fulvestrant compared to palbociclib + fulvestrant but not statistically significant (33 vs. 21 months, respectively). Median overall survival (mOS) was not reached, but 3-year overall survival (OS) was statistically significantly longer in the ribociclib arm (87% vs. 55.5%, respectively, p = 0.03). Conclusion: Palbociclib and ribociclib are first-line treatment options for metastatic HR+/HER2− disease and have similar efficacy. In our study, while the mPFS was not statistically significant in both arms, the 3-year OS rate was higher in the ribociclib arm and statistically significant. Our findings were confirmed in randomized studies comparing both agents head-to-head. © 2025 by the authors.
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    Efficacy of first-line CDK 4-6 inhibitors in premenopausal patients with metastatic breast cancer and the effect of dose reduction due to treatment-related neutropenia on efficacy: a Turkish Oncology Group (TOG) study
    (Taylor and Francis Ltd., 2025) Yildirim H.C.; Kapar C.; Koksal B.; Seyyar M.; Sanci P.C.; Guliyev M.; Perkin P.; Buyukkor M.; Yaslikaya S.; Majidova N.; Keskinkilic M.; Ozaskin D.; Avci T.; Gunes T.K.; Arcagok M.; Topal A.; Keskin G.S.Y.; Kavgaci G.; Yildirim N.; Celayir O.M.; Avci N.; Aslan F.; Alkan A.; Erciyestepe M.; Cengiz M.; Pehlivan M.; Gulmez A.; Beypinar I.; Basoglu Tuylu T.; Kayikcioglu E.; Chalabiyev E.; Turhal S.; Guzel H.G.; Ayas E.; Sahbazlar M.; Dulgar O.; Demir H.; Yavuzsen T.; Bayoglu V.; Kivrak Salim D.; Ozturk B.; Ozdemir F.; Kara O.; Oksuzoglu B.; Bal O.; Demirci N.S.; Yilmaz M.; Cabuk D.; Aksoy S.
    The only phase 3 study on the effectiveness of CDK 4-6 inhibitors in first-line treatment in premenopausal patients with hormone receptor (HR) positive, HER2 negative metastatic breast cancer is the MONALEESA-7 study, and data on the effectiveness of palbociclib is limited. Data are also limited regarding the effectiveness of CDK 4-6 inhibitors in patients whose dose was reduced due to neutropenia, the most common side effect of CDK 4-6 inhibitors. In our study, we aimed to evaluate the effectiveness of palbociclib and ribociclib in first-line treatment in patients with premenopausal metastatic breast cancer and the effect of dose reduction due to neutropenia on progression-free survival. Our study is a multicenter, retrospective study, and factors affecting progression-free survival (PFS) were examined in patients diagnosed with metastatic premenopausal breast cancer from 29 different centers and receiving combination therapy containing palbociclib or ribociclib in the metastatic stage. 319 patients were included in the study. The mPFS for patients treated with palbociclib was 26.83 months, and for those receiving ribociclib, the mPFS was 29.86 months (p = 0.924). mPFS was 32.00 months in patients who received a reduced dose, and mPFS was 25.96 months in patients who could take the initial dose, and there was no statistical difference (p = 0.238). Liver metastasis, using a fulvestrant together with a CDK 4-6 inhibitor, ECOG PS 1 was found to be a negative prognostic factor. No new adverse events were observed. In our study, we found PFS over 27 months in patients diagnosed with premenopausal breast cancer with CDK 4-6 inhibitors used in first-line treatment, similar to post-menopausal patients. We did not detect any difference between the effectiveness of the two CDK 4-6 inhibitors, and we showed that there was no decrease in the effectiveness of the CDK 4-6 inhibitor in patients whose dose was reduced due to neutropenia. © 2024 Edizioni Scientifiche per l'Informazione su Farmaci e Terapia (Italian Society of Chemotherapy).