Browsing by Author "Demirci U."
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Item Is lymph node ratio prognostic factor for survival in elderly patients with node positive breast cancer?: The Anatolian society of medical oncology(2013) Inal A.; Akman T.; Yaman S.; Ozturk S.C.; Geredeli C.; Bilici M.; Inanc M.; Harputoglu H.; Demirci U.; Suner A.; Cinkir H.Y.; Alici S.; Colak D.; Sonmez O.U.; Goksel G.; Dogu G.G.; Engin H.; Unal O.U.; Tamozlu T.; Buyukberber S.; Boruban C.M.; 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): patholo^c tumor size (T), No. oppositive 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 T, 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 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)(2013) Inal A.; Akman T.; Yaman S.; Demir Ozturk S.; Geredeli C.; Bilici M.; Inanc M.; Harputoglu H.; Demirci U.; Balakan O.; Yesil Cinkir H.; Alici S.; Uysal Sonniez O.; Goksel G.; Gokoz Dogu G.; Umit Unal O.; Tamozlu T.; Buyukberber S.; Melih Bomban C.; 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.Item Pathologic and clinical characteristics of elderly patients with breast cancer: A retrospective analysis of a multicenter study (anatolian society of medical oncology)(International College of Surgeons, 2014) Ial A.; Akman T.; Yaman S.; Ozturk S.C.; Geredeli C.; Bilici M.; Inanc M.; Harputoglu H.; Demirci U.; Balakan O.; Cinkir H.Y.; Alici S.; Colak D.; Sonmez O.U.; Goksel G.; Dogu G.G.; Engin H.; Unal O.U.; Tamozlu T.; Buyukberber S.; Boruban C.M.; 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.Item Predictive factors for the development of brain metastases in patients with malignant melanoma: A study by the Anatolian society of medical oncology(2014) Gumusay O.; Coskun U.; Akman T.; Ekinci A.S.; Kocar M.; Erceleb O.B.; Yazici O.; Kaplan M.A.; Berk V.; Cetin B.; Taskoylu B.Y.; Yildiz A.; Goksel G.; Alacacioglu A.; Demirci U.; Algin E.; Uysal M.; Oztop I.; Oksuzoglu B.; Dane F.; Gumus M.; Buyukberber S.Background: The 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. Patients and methods: 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. Results: 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. Conclusions: Our results revealed the importance of primary tumor characteristics associated with the development of BMs. Ulceration, primary tumor thickness, anatomic site, and pathologic ≥N2 disease were found to be significant predictors of BMs development. © 2013 Springer-Verlag Berlin Heidelberg.Item Adult urological soft tissue sarcomas: A multicenter study of the anatolian society of medical oncology (ASMO)(Asian Pacific Organization for Cancer Prevention, 2015) Unal O.U.; Oztop I.; Menekse S.; Urakci Z.; Bozkurt O.; Ozcelik M.; Gunaydin Y.; Yasar N.; Yazilitas D.; Kodaz H.; Taskoylu B.Y.; Aksoy A.; Demirci U.; Araz M.; Tonyali O.; Sevinc A.; Yilmaz A.U.; Benekli M.Objective: To analyze clinicopathological characteristics, prognostic factors and survival rates of the patients with urological soft tissue sarcomas treated and followed up in Turkey. Materials and Methods: For overall survival analyses the Kaplan-Meier method was used. From medical records, nine prognostic factors on overall survival were analysed. Results: For the 53 patients (34 males, 19 females) whose charts were reviewed, the median age was 53 (range 22 to 83) years. Most frequently renal location (n=30; 56.6%) was evident and leiomyosarcoma (n=20, 37.7%) was the most frequently encountered histological type. Median survival time of all patients was 40.3 (95% CI, 14.2-66.3) months. In univariate analysis, male gender, advanced age (=50 years), metastatic stage, unresectability, grade 3, renal location were determined as worse prognostic factors. In multivariate analysis, metastatic stage, unresectability and grade 3 were determined as indicators of worse prognosis. Conclusions: Urological soft tissue sarcomas are rarely seen tumours in adults. The most important factors in survival are surgical resection, stage of the tumour at onset, grade and location of the tumour, gender and age of the patients.Item Pathological fracture in odontoid process in multiple myeloma; [Multipl miyelom tanılı hastada saptanan patolojik odontoid kırığı](Turkish Society of Hematology, 2017) Acar E.A.; Demirci U.; Pabuşçu Y.; Miskioğlu H.M.; Aydoğdu İ.[No abstract available]Item Actual reason for bone fractures in the case of a patient followed-up with the osteogenesis imperfecta: Gaucher's Disease(CIC Edizioni Internazionali s.r.l., 2017) Demirci U.; Çizmecioglu A.; Aydogdu I.Gaucher's disease (GD) is a rare disease characterized by a glucocerebroside accumulation in the reticulo-endothelial system. Patients may refer to the clinic with complaints of bone pain, hepatosplenomegaly, anemia, thrombocytopenia, growth retardation, interstitial pulmonary disease, pulmonary hypertension, and skeletal disorders. Skeletal system involvement is observed commonly in Gaucher patients and a significant cause of morbidity. Our patient was followed for several years as a glass child - osteogenesis imperfecta and he had joint deformities due to skeletal fractures. We wanted to present this case to raise awareness of GD's skeletal involvement and effects of late diagnosis.Item Treatment of inflammatory bowel disease by leukocytapheresis(Elsevier Ltd, 2017) Gerçeker E.; Yüceyar H.; Kasap E.; Demirci U.; Ekti B.C.; Aydoğdu İ.; Miskioğlu M.Studies about leukocytapheresis have emerged with the need of search for alternatives to conventional treatment in inflammatory bowel diseases (IBD). Leukocytapheresis is a novel non-pharmacologic approach for active ulcerative colitis (UC) and Crohn's disease (CD), in which leukocytes are mechanically removed from the circulatory system. Patients with active IBD treated with leukocytapheresis using a Cellsorba E column between 2012 and 2015, were enrolled in Turkey. In our experience, the results of leukocytapheresis therapy in 6 patients with CD and 20 patients with active UC were overviewed. Leukocytapheresis (10 sessions for remission induction therapy, 6 sessions for maintenance therapy) was applied to the patients with their concomitant medications. Intensive leukocytapheresis (≥4 leukocytapheresis sessions within the first 2 weeks) was used in 30% patients with active severe UC. The overall clinical remission rate in patients with UC was 80%, and the mucosal healing rate was 65%. Patients were followed for an average of 24 months. It was observed that clinical remission has continued in 65% of patients with UC. Mild relapse was observed in 3 patients with UC during follow up period. In 5 patients with CD significant clinical remission was achieved except only one patient. Surgical needs were disappeared in 3 patients with obstructive type Crohn's disease. Adverse events were seen in only 4.3% of 416 sessions. Any concomitant medications did not increase the incidence of adverse events. Our results indicate that leukocytapheresis is efficacious in improving remission rates with excellent tolerability and safety in patients with IBD. © 2017 Elsevier LtdItem Potential role of chromatin remodeling factor genes in atrophic gastritis/gastric cancer risk(AVES İbrahim KARA, 2018) Bilgiç F.; Gerçeker E.; Boyacioglu S.Ö.; Kasap E.; Demirci U.; Yildirim H.; Baykan A.R.; Yüceyar H.Background/Aims: Atrophic gastritis (AG), intestinal metaplasia (IM), and Helicobacter pylori (HP) are the risk factors for the development of gastric cancer (GC). Chromatin remodeling is one of the epigenetic mechanisms involved in the carcinogenesis of GC. The purpose of this study was to investigate the expression profiles of defined chromatin remodeling genes in gastric mucosal samples and their values as gastric carcinogenesis biomarkers. Materials and Methods: In total, 95 patients were included in the study. Patients were divided into 3 groups as: GC group (n=34), AG group (n=36), and control group (n=25). AG group was further divided into subgroups based on the presence of HP and IM in gastric mucosa. Chromatin remodeling gene expressions were analyzed using real-time PCR (RT-PCR) array in all groups. Data were evaluated using the RT-qPCR primer assay data analysis software. Results: EED, CBX3, and MTA1 were more overexpressed, whereas ARID1A, ING5, and CBX7 were more underexpressed in the AG and GC groups compared with the controls. No significant differences were observed between the AG and GC groups concerning the expression of these 6 genes, although the fold change levels of these genes in the GC group were well above than in the AG group. EED, CBX3, and MTA1 were significantly more overexpressed in HP- and IM-positive AG subgroup compared with the HP- or IM-negative AG subgroup. Conclusion: In conclusion, our results provide an evidence of epigenetic alterations in AG. Expressions of EED, CBX3, MTA1, ARID1A, ING5, and CBX7 may be considered as promising markers to be used in GC screening for patients with AG. © Copyright 2018.Item Expression profiles of histone modification genes in gastric cancer progression(Springer Netherlands, 2018) Orenay-Boyacioglu S.; Kasap E.; Gerceker E.; Yuceyar H.; Demirci U.; Bilgic F.; Korkmaz M.Gastric cancer (GC) development can be attributed to several risk factors including atrophic gastritis (AG), intestinal metaplasia (IM), and the presence of Helicobacter pylori (HP). Also, histone modification is an epigenetic mechanism that plays a pivotal role in GC carcinogenesis. In this preliminary study, we aimed to describe the expression profiles of histone modification in the AG, IM, and GC patient groups. A total of 80 patients with AG (n = 27), IM (n = 25), and GC (n = 28) with an additional 20 control subjects were included in the study. Expression profiles of three histone phosphorylation genes (PAK1, NEK6, and AURKA) and five histone deacetylation genes (HDACs 1, 2, 3, 5, and 7) were examined based on the results of Real Time qPCR method. It was observed that AURKA and HDAC2 genes were significantly overexpressed in all groups compared to the control (P < 0.05). In GC patients, overexpression of HDAC2 gene was detected in the absence of metastasis, and overexpression of AURKA, HDAC2, and NEK6 genes was detected in the presence of metastasis. When cancer involvements were compared, significant overexpression of the HDAC2 gene was noted in overall and corpus involvements (P < 0.05). In addition, overexpression of AURKA, NEK6, HDAC1, and HDAC2 genes and underexpression of HDAC5 gene were detected in the antrum involvement (P < 0.05). In conclusion, decreased expression of HDAC5 in GC is reported for the first time in this study, while supporting the existing literature in AURKA, NEK6, HDAC1, and HDAC2 up regulations during GC development. © 2018, Springer Nature B.V.Item Overexpressions of RHOA, CSNK1A1, DVL2, FZD8, and LRP5 genes enhance gastric cancer development in the presence of Helicobacter pylori(Elsevier Ltd, 2023) Demirci U.; Orenay-Boyacioglu S.; Kasap E.; Gerçeker E.; Bilgiç F.; Yüceyar H.; Yildirim H.; Baykan A.R.; Ellidokuz E.B.; Korkmaz M.Background and study aims: Intestinal metaplasia (IM), and Helicobacter pylori (HP) infection can be shown as risk factors in the development of gastric cancer (GC). WNT signaling pathway plays a critical role in carcinogenesis. However, the literature studies are limited on the significance of this pathway for the transition from IM to GC. Patients and methods: We aimed to investigate the importance of the genes of WNT signaling pathways diagnostic and prognostic markers in the presence and absence of HP in conversion from IM to GC. 104 patients, (GC group n = 35, IM group n = 45, control group n = 25) were included in this case-control study. Expression of genes in WNT signalling were searched in study groups with qRT-PCR array and qRT-PCR method. Data were analysed using PCR array data analysis software. Results: Statistically significant overexpression of RHOA, CSNK1A1, DVL2, FZD8 and LRP5 genes was detected in the GC and IM groups compared to the control group (p < 0.05). Statistically significant overexpression of RHOA, CSNK1A1, DVL2, FZD8 and LRP5 genes was observed in patients with metastatic GC compared to patients with GC without metastasis (p < 0.05). It was found that the RHOA, CSNK1A1, DVL2, FZD8 and LRP5 genes were statistically significantly over-expressed in diffuse GC patients compared to non-diffuse GC patients (p < 0.05). Statistically significant overexpression of RHOA, CSNK1A1, DVL2, FZD8 and LRP5 genes was detected in HP positive IM patients compared to HP negative IM patients (p < 0.05). Conclusion: Overexpression of RHOA, CSNK1A1, DVL2, FZD8 and LRP5 genes in IM may suggest that these genes are important markers in the development of IM and inflammation with HP. In addition, these genes are linked to tumor burden in the GC group. Consequently, we can conclude that these genes are poor prognosis biomarkers for GC and have the potential to be used as markers for future treatment monitoring. © 2023 Pan-Arab Association of GastroenterologyItem Treatment efficacy of ribociclib or palbociclib plus letrozole in hormone receptor-positive/HER2-negative metastatic breast cancer(Newlands Press Ltd, 2023) Kahraman S.; Erul E.; Seyyar M.; Gumusay O.; Bayram E.; Demirel B.C.; Acar O.; Aksoy S.; Baytemur N.K.; Sahin E.; Cabuk D.; Basaran G.; Paydas S.; Yaren A.; Guven D.C.; Erdogan A.P.; Demirci U.; Yasar A.; Bayoglu İ.V.; Hizal M.; Gulbagci B.; Paksoy N.; Davarci S.E.; Yilmaz F.; Dogan O.; Orhan S.O.; Kayikcioglu E.; Aytac A.; Keskinkilic M.; Mocan E.E.; Unal O.U.; Aydin E.; Yucel H.; Isik D.; Eren O.; Uluc B.O.; Ozcelik M.; Hacibekiroglu I.; Aydiner A.; Demir H.; Oksuzoglu B.; Cilbir E.; Cubukcu E.; Cetin B.; Oktay E.; Erol C.; Okutur S.K.; Yildirim N.; Alkan A.; Selcukbiricik F.; Aksoy A.; Karakas Y.; Ozkanli G.; Duman B.B.; Aydin D.; Dulgar O.; Er M.M.; Teker F.; Yavuzsen T.; Aykan M.B.; Inal A.; Iriagac Y.; Kalkan N.O.; Keser M.; Sakalar T.; Menekse S.; Kut E.; Bilgin B.; Karaoglanoglu M.; Sunar V.; Ozdemir O.; Turhal N.S.; Karadurmus N.; Yalcin B.; Nahit Sendur M.A.Background: Ribociclib, palbociclib and abemaciclib are currently approved CDK4/6 inhibitors along with aromatase inhibitors as the first-line standard-of-care for patients with hormone receptor-positive, HER2-negative metastatic breast cancer. Methods: The authors report retrospective real-life data for 600 patients with estrogen receptor- and/or progesterone receptor-positive and HER2-negative metastatic breast cancer who were treated with ribociclib and palbociclib in combination with letrozole. Results & conclusion: The results demonstrated that the combination of palbociclib or ribociclib with letrozole has similar progression-free survival and overall survival benefit in real life for the patient group with similar clinical features. Specifically, endocrine sensitivity may be a factor to be considered in the treatment preference. © 2023 Future Medicine Ltd.