Browsing by Author "Geredeli C."
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Item Gemcitabine Alone versus combination of Gemcitabine and Cisplatin for the Treatment of Patients with Locally Advanced and/or Metastatic Pancreatic Carcinoma: A Retrospective Analysis of multicenter study(SAP - Slovak Academic Press, spol. s.r.o., 2012) Inal A.; Kos F.T.; Algin E.; Yildiz R.; Dikiltas M.; Unek I.T.; Colak D.; Elkiran E.T.; Helvaci K.; Geredeli C.; Dane F.; Balakan O.; Kaplan M.A.; Durnali A.G.; Harputoglu H.; Goksel G.; Ozdemir N.; Buyukberber S.; Gumus M.; Kucukoner M.; Ozkan M.; Uncu D.; Benekli M.; Isikdogan A.The majority of patients with pancreatic cancer is of advanced disease. Several randomized Phase II and III trials suggest that the combination of gemcitabine and cisplatin (GemCis) response rates were higher than Gemcitabine (Gem) alone, however the trials were not enough powered to indicate a statistically significant prolongation of survival in patients with advanced pancreatic adenocarcinoma. The aim of this retrospective multicenter study is to evaluated the efficiency of Gem alone versus GemCis in patients with locally advanced and/or metastatic pancreatic adenocarcinoma. A total of 406 patients, from fourteen centers were evaluated retrospectively. All patients received Gem or GemCis as first-line treatment between September 2005 to March 2011. Primary end of this study were to evaluate the toxicity, clinical response rate, progression-free survival (PFS) and overall survival (OS) between the arms. There were 156 patients (M: 98, F: 58) in Gem arm and 250 patients (M: 175, F: 75) in the combination arm. Gemcitabin arm patients older than the combination arm (median 63 vs 57.5, p=0.001). In patients with the combination arm had a higher dose reduction (25.2% vs 11.3%, p=0.001) and dose delay (34% vs 16.8%, p=0.001). Among patients with the combination and Gemcitabin arm gender, diabetes mellitus, performance status, cholestasis, grade, stage did not have a statistically difference (p>0.05). Clinical response rate to the combination arm was higher than the Gem arm (69.0% vs 49.7%, p=0.001). PFS was more favorable in the GemCis arm than Gem alone, but the difference did not attain statistical significance (8.9 vs 6.0, p=0.08). OS was not significantly superior in the GemCis arm (12.0 vs 10.2, p>0.05). Grade III-IV hematologic and nonhematologic toxicity were higher in the combination arm. PFS was more favorable in the GemCis arm than Gem alone, but the difference did not attain statistical significance. OS was not significantly superior in the GemCis arm.Item Prognostic factors in patients with advanced pancreatic cancer treated with gemcitabine alone or gemcitabine plus cisplatin: Retrospective analysis of a multicenter study(2012) Inal A.; Kos F.T.; Algin E.; Yildiz R.; Berk V.; Tugba Unek I.; Colak D.; Kucukoner M.; Tamer Elkiran E.; Helvaci K.; Geredeli C.; Dane F.; Balakan O.; Ali Kaplan M.; Gok Durnali A.; Harputoglu H.; Goksel G.; Ozdemir N.; Buyukberber S.; Gumus M.; Ozkan M.; Benekli M.; Isikdogan A.Purpose: The majority of patients with pancreatic cancer present with advanced disease. Systemic chemotherapy for patients with pancreatic cancer has limited impact on overall survival (OS). Patients eligible for chemotherapy should be selected carefully. The aim of this study was to analyse prognostic factors for OS in advanced pancreatic cancer patients treated with first-line palliative chemotherapy with gemcitabine alone or gemcitabine plus cisplatin. Methods: We retrospectively reviewed 343 locally advanced or metastatic pancreatic cancer patients who were treated with gemcitabine or gemcitabine plus cisplatin as first-line chemotherapy between December 2000 and June 2011. Fifteen potential prognostic variables were chosen for analysis. Univariate and multivariate analyses were conducted to identify prognostic factors associated with OS. Univariate and multivariate statistical methods were used to determine prognostic factors. Results: Among the 15 variables of univariate analysis, 6 were identified to have prognostic significance: stage (p<0.001), cholestasis (p=0.02), weight loss, prior pancreatectomy, serum CEA level (p<0.001) and serum CA19-9 level (p<0.001). In addition, age, chemotherapy and liver metastasis were of borderline significance (p=0.06). Multivariate analysis (Cox proportional hazard model) included the 6 significant prognostic factors ofunivariate analysis and showed that stage was independent prognostic factor for OS, as were weight loss, and serum CEA level. Conclusion: Stage, weight loss, and serum CEA level were identified as important prognostic factors for OS in advanced pancreatic cancer patients. These findings may also facilitate pretreatment prediction of OS and can be used for selecting patients for treatment. © 2012 Zerbinis Medical Publications.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 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)(Wolters Kluwer Medknow Publications, 2018) Inal A.; Kodaz H.; Odabas H.; Duran A.; Seker M.; Inanc M.; Elkiran E.; Gunaydin Y.; Menekse S.; Topcu T.; 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.; Oven Ustaalioglu B.; 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. © 2017 Journal of Cancer Research and Therapeutics | Published by Wolters Kluwer - Medknow.Item Is eribulin treatment prognostic factor in patients with metastatic breast cancer treated with this drug? Retrospective analysis of a multicentre study(Zerbinis Publications, 2019) Oruc Z.; Kaplan M.A.; Geredeli C.; Sari N.Y.; Ozaslan E.; Aytekin A.; Elkiran E.T.; Koca S.; Dogan M.; Turan N.; Yuce O.; Sevinc A.; Ercelep O.; Isikdogan A.Purpose: This study aimed to analyze prognostic factors for survival and the reliability and the effectiveness of eribulin therapy in metastatic breast cancer (MBC) patients. Methods: A total of 80 patients treated with eribulin in 12 medical oncology centers in Turkey between 2013-2017 were retrospectively evaluated. Sixteen potential prognostic variables were assessed for analysis. Results: The patients had received a median of 5 prior chemotherapy regimens and a median of 3 eribulin cycles for MBC. Median progression-free survival (PFS) was 5.5 months (95% Cl: 4.1-7.8) and median overall survival (OS) was 11 months (95 % Cl: 6-15). Multivariate analysis showed that eribulin treatment line was shown to have independent prognostic significance for PFS. PFS difference was demostrated in patients who received 3 chemotherapy lines for advanced disease compared to those who had more than 3 chemotherapy lines [median PFS; 3 lines: 8.6 months (6.2-11) and >3 lines: 4.6 months (3.7-4.6) p=0.00]. The clinical benefit rate (CBR) was 52.5 and 35% in patients treated with three lines and with >3 previous chemotherapeutic regimens. Most common toxicities were neutropenia (62.5%), fatigue (52.5%), alopecia (50%) and nausea (37.5%). Conclusions: Eribulin treatment line was identified as in-depedent prognostic factor for PFS in MBC patients. © 2019 Zerbinis Publications. All rights reserved.Item Is eribulin treatment prognostic factor in patients with metastatic breast cancer treated with this drug? Retrospective analysis of a multicentre study(Zerbinis Publications, 2020) Oruc Z.; Kaplan M.A.; Geredeli C.; Sari N.Y.; Ozaslan E.; Aytekin A.; Elkiran E.T.; Koca S.; Dogan M.; Turan N.; Yuce O.; Sevinc A.; Ercelep O.; Isikdogan A.Purpose: This study aimed to analyze prognostic factors for survival and the reliability and the effectiveness of eribulin therapy in metastatic breast cancer (MBC) patients. Methods: A total of 80 patients treated with eribulin in 12 medical oncology centers in Turkey between 2013-2017 were retrospectively evaluated. Sixteen potential prognostic variables were assessed for analysis. Results: The patients had received a median of 5 prior chemotherapy regimens and a median of 3 eribulin cycles for MBC. Median progression-free survival (PFS) was 5.5 months (95% Cl: 4.1-7.8) and median overall survival (OS) was 11 months (95 % Cl: 6-15). Multivariate analysis showed that eribulin treatment line was shown to have independent prognostic significance for PFS. PFS difference was demostrated in patients who received 3 chemotherapy lines for advanced disease compared to those who had more than 3 chemotherapy lines [median PFS; 3 lines: 8.6 months (6.2-11) and >3 lines: 4.6 months (3.7-4.6) p=0.00]. The clinical benefit rate (CBR) was 52.5 and 35% in patients treated with three lines and with >3 previous chemotherapeutic regimens. Most common toxicities were neutropenia (62.5%), fatigue (52.5%), alopecia (50%) and nausea (37.5%). Conclusions: Eribulin treatment line was identified as indepedent prognostic factor for PFS in MBC patients. © 2020 Zerbinis Publications. All rights reserved.