Browsing by Author "Bilici, M"

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    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, A
    Purpose: 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.
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    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, A
    There 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.
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    Is lymph node ratio prognostic factor for survival in elderly patients with node positive breast cancer? The Anatolian Society of Medical Oncology
    Inal, 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, A
    Several 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.
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    Validity and Reliability of Nine Types Temperament Scale
    Yilmaz, ED; Gençer, AG; Aydemir, Ö; Yilmaz, A; Kesebir, S; Ünal, Ö; Örek, A; Bilici, M
    The aim of this study is to develop a scale compatible with the Nine Types Temperament Model (NTTM), which did not have any prior measurement tools to scientifically prove its reliability and validity. NTTM is created by re-evaluating the Enneagram System a system that defines nine personality types- used for analyzing and comprehending ego mechanisms. Nine Types Temperament Scale (NTTS) which is a self-rated instrument composed of 91 items with three-point Likert type was developed from this model and applied to 990 participants. Confirmatory factor analyses were carried out in order to evaluate whether the scale fits to the model related to the temperament model. In exploratory factor analyses of the scale eigen values of nine factors vary between 8.089 and 1.661, and represent 39.04% of the total variance. In confirmatory analyses of the scale CFI value is 0.88, GFI value is 0.84, IFI value is 0.88 and RMSEA value is 0.05. Test-retest reliability of the scale was evaluated with 46 participants. Cronbach alpha value of the whole scale is 0.75, while Cronbach alpha values for every temperament type were calculated as 0.77, 0.79, 0.68, 0.71, 0.80, 0.74, 0.71, 0.83 and 0.77 respectively. Concurrent validity was performed with Cloninger's TCI (Temperament and Character Inventory) and Akiskal's TEMPS-A (Temperament Evaluation of Memphis, Pisa, Paris and San Diego Autoquestionnaire Version). The types of NTTM showed significant correlations with TCI and TEMPS-A. Results of the study support that NTTS is a reliable and valid scale.
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    Prognostic factors of patients who received chemotherapy after cranial irradiation for non-small cell lung cancer with brain metastases: A retrospective analysis of multicenter study (Anatolian Society of Medical Oncology)
    Inal, A; Kodaz, H; Odabas, H; Duran, AO; Seker, MM; Inanc, M; Elkiran, ET; Gunaydin, Y; Menekse, S; Topcu, TO; Urakci, Z; Tastekin, D; Bilici, M; Cihan, S; Geredeli, C; Sezer, E; Uncu, D; Arpaci, E; Ozturk, B; Bal, O; Uysal, M; Tanriverdi, O; Gumus, M; Ustaalioglu, BBO; Suner, A; Cokmert, S; Hacibekiroglu, I; Aydin, K; Isikdogan, A
    Purpose: Almost half of all patients diagnosed with non-small cell lung cancer (NSCLC) have distant metastases at presentation. One-third of patients with NSCLC will have brain metastases. Without effective treatment, the median survival is only 1 month. However, it is difficult to treat brain metastases with systemic chemotherapy since the agents have difficulty crossing the blood-brain barrier. Therefore, it is important to estimate the patient's survival prognosis. The aim of this study was to analyze prognostic factors for survival in Turkish patients who received chemotherapy after cranial irradiation for NSCLC with brain metastases. Methods: We retrospectively reviewed 698 patients with brain metastases resulting from NSCLC. Ten potential prognostic variables were chosen for analysis. Univariate and multivariate analyses were conducted to identify prognostic factors associated with overall survival (OS). Results: Among the 10 variables for univariate analysis, six were identified to have prognostic significance; these included sex, smoking history, histology, number of brain metastases, extracranial metastases, and neurosurgical resection. Multivariate analysis by the Cox proportional hazard model showed that a smoking history, extracranial metastases, and neurosurgical resection were independent negative prognostic factors for OS. Conclusion: Smoking history, extracranial metastases, and neurosurgical resection were considered independent negative prognostic factors for OS. These findings may facilitate pretreatment prediction of survival and can be used for selecting patients for more appropriate treatment options.
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    Identification of the molecular etiology in rare congenital hemolytic anemias using next-generation sequencing with exome-based copy number variant analysis
    Isik, E; Aydinok, Y; Albayrak, C; Durmus, B; Karakas, Z; Orhan, MF; Sarper, N; Aydin, S; Unal, S; Oymak, Y; Karadas, N; Turedi, A; Albayrak, D; Tayfun, F; Tugcu, D; Karaman, S; Tobu, M; Unal, E; Ozcan, A; Unal, S; Aksu, T; Unuvar, A; Bilici, M; Azik, F; Ay, Y; Gelen, SA; Zengin, E; Albudak, E; Eker, I; Karakaya, T; Cogulu, O; Ozkinay, F; Atik, T
    ObjectivesIn congenital hemolytic anemias (CHA), it is not always possible to determine the specific diagnosis by evaluating clinical findings and conventional laboratory tests. The aim of this study is to evaluate the utility of next-generation sequencing (NGS) and clinical-exome-based copy number variant (CNV) analysis in patients with CHA.MethodsOne hundred and forty-three CHA cases from 115 unrelated families referred for molecular analysis were enrolled in the study. Molecular analysis was performed using two different clinical exome panels in 130 patients, and whole-exome sequencing in nine patients. Exome-based CNV calling was incorporated into the traditional single-nucleotide variant and small insertion/deletion analysis pipeline for NGS data in 92 cases. In four patients from the same family, the PK Gypsy variant was investigated using long-range polymerase chain reaction.ResultsMolecular diagnosis was established in 86% of the study group. The most frequently mutated genes were SPTB (31.7%) and PKLR (28.5%). CNV analysis of 92 cases revealed that three patients had different sizes of large deletions in the SPTB and six patients had a deletion in the PKLR.ConclusionsIn this study, NGS provided a high molecular diagnostic rate in cases with rare CHA. Analysis of the CNVs contributed to the diagnostic success.