Browsing by Subject "overall survival"
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Item Clinical and prognostic features of plasmacytomas: A multicenter study of Turkish Oncology Group-Sarcoma Working Party(2008) Kilciksiz S.; Celik O.K.; Pak Y.; Demiral A.N.; Pehlivan M.; Orhan O.; Tokatli F.; Agaoglu F.; Zincircioglu B.; Atasoy B.M.; Ozseker N.; Yersal O.; Niang U.; Haydaroglu A.To identify the outcomes of prognostic factors of solitary plasmacytoma mainly treated with local radiotherapy (RT). The data were collected from 80 patients with solitary plasmacytoma (SP). Forty patients (50.0%) received radiotherapy (RT) alone while 38 of them (47.5%) were treated with surgery (S) and RT. The median radiation dose was 46 Gy (range 30-64). The median follow up was 2.41 years (range 0.33-12.33). Ten-year overall survival (OS) and local relapse-free survival (LRFS) were 73% and 94%, respectively. The median progression-free survival (PFS) and multiple myeloma-free survival (MMFS) were 3.5 years and 4.8 years, respectively. On multivariate analyses, the favorable factors were radiotherapy dose of >50 Gy and RT + S for PFS and younger age for MMFS. For the patients with medullary plasmacytoma, the favorable factor was younger age for MMFS. RT at ≥50 Gy and RT + S may be favorable prognostic factors on PFS. Younger patients, especially with head-neck lesion and without pre-RT macroscopic tumor, seem to have the best outcome when treated with RT ± S. Progression to MM remains as the main problem especially for older patients. © 2008 Wiley-Liss, Inc.Item Postoperative Radiotherapy in the Management of Resected Non-Small-Cell Lung Carcinoma: 10 Years' Experience in a Single Institute(2010) Karakoyun-Celik O.; Yalman D.; Bolukbasi Y.; Cakan A.; Cok G.; Ozkok S.Purpose: This study reports the long term outcomes of postoperative radiotherapy in patients with resection for non-small-cell lung cancer (NSCLC). Methods and Materials: A total of 98 patients with resected NSCLC who received postoperative radiotherapy (PORT) between January 1994 and December 2004 were retrospectively analyzed. The most frequently performed surgical procedure was lobectomy (59 patients), followed by pneumonectomy (25), wedge resection (8), and bilobectomy (6). Postoperative radiotherapy was delivered as an adjuvant treatment in 71 patients, after a wedge resection in 8 patients, and after an R1 resection in 19 patients. The PORT was administered using a Co-60 source in 86 patients and 6-MV photons in 12 patients. A Kaplan-Meier estimate of overall survival, locoregional control, and distant metastasis-free survival were calculated. Results: Stages included I (n =13), II (n = 50), IIIA (n = 29), and IIIB (n = 6). After a median follow-up of 52 months median survival was 61 months. The 5-year overall survival, locoregional control, and distant metastasis-free survival rates for the whole group were 50%, 78%, and 55% respectively. The RT dose, Karnofsky performance status, age, lateralization of the tumor, and pneumonectomy were independent prognostic factors for OAS; anemia and the number of involved lymph nodes were independent prognostic factors for LC. Conclusions: Doses of PORT of greater than 54 Gy were associated with higher death rate in patients with left-sided tumor, which may indicate a risk of radiation-induced cardiac mortality. © 2010 Elsevier Inc.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 Cutaneous Squamous Cell Carcinoma of the Head and Neck: Management of the Parotid and Neck(2012) Yilmaz M.; Eskiizmir G.; Friedman O.Although the metastatic rate of cutaneous squamous cell carcinoma (SCC) is low, detailed examination for the presence of micro- and macrometastasis of lymph nodes is crucial in avoiding the devastating outcomes and in planning appropriate treatment. Cutaneous SCC of the head and neck can spread to parotid lymph nodes, cervical lymph nodes, or both, depending on the location of the primary tumor. Therefore, clinical and radiologic evaluation of the parotid and neck should be performed in patients with cutaneous SCC. Optimal treatment of metastatic cutaneous SCC of the head and neck should consist of complete surgical resection with adjuvant radiotherapy. © 2012 Elsevier Inc.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 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 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 Group(Humana Press Inc., 2014) Tanriverdi O.; Cokmert S.; Oktay E.; Pilanci K.N.; Menekse S.; Kocar M.; Sen C.A.; Avci N.; Akman T.; Ordu C.; Goksel G.; Meydan N.Non-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. © 2014, Springer Science+Business Media New York.Item Immunolocalization of ERK1/2 and p-AKT in normal endometrium, endometrial hyperplasia, and early and advanced stage endometrioid endometrial adenocancer and their prognostic significance in malignant group(Elsevier Ireland Ltd, 2014) Gungorduk K.; Ertas I.E.; Sahbaz A.; Ozvural S.; Sarica Y.; Ozdemir A.; Sayhan S.; Gokcu M.; Yilmaz B.; Sanci M.; Inan S.; Harma M.; Yildirim Y.Objective: To analyze the expression patterns of extracellular signal-regulated kinase (ERK1/2) and phosphorylated (p)-AKT in the tissues of non-pathologic endometrium, endometrial hyperplasia, and early and advanced stage endometrioid endometrial adenocancer using indirect immunohistochemistry, and also to investigate the effect of ERK1/2 and p-AKT expression patterns on prognosis in endometrioid adenocancer. Study design: Immunolocalization of ERK1/2 and p-AKT was examined in six different types of endometrial tissues: proliferative endometrium (PE; n = 10, 11.2%), secretuar endometrium (SE; n = 10, 11.2%), simple hyperplasia (SH; n = 15, 16.9%), complex hyperplasia (CH; n = 3, 3.4%) and atypical complex hyperplasia (ACH; n = 10, 11.2%), which were obtained from endometrial biopsies, curettage materials, and hysterectomy specimens and classified as the benign group; and both early stage endometrioid (n = 21, 23.6%) and advanced stage endometrioid adenocancer (AC; n = 20, 22.5%), which were obtained from complete surgical staging materials and classified as the malignant group. All specimens were fixed in 10% formalin and processed using routine paraffin protocols. Immunostaining intensities were evaluated as negative or weak (assigned as low expression) and moderate or strong (assigned as high expression). Results: In the malignant group, 23 of 41 patients (56.1%) had high ERK1/2 and p-AKT expression, whereas only three of 48 patients in the benign group (6.3%) had high ERK1/2 and p-AKT expression (P < 0.0001 and P < 0.0001, respectively). p-AKT expression was significantly higher in women with positive lymph nodes (OR 9.0; 95% CI: 1.2-100.0; P = 0.03). Higher expression of p-AKT was significantly associated with poor progression-free survival (PFS) and overall survival (OS). In contrast, ERK1/2 expression was not associated with PFS or OS.Conclusions ERK1/2 and p-AKT can be useful in the differential diagnosis of benign vs. malignant endometrial lesions, as well as early vs. advanced stage endometrioid endometrial adenocancer. Additionally, higher p-AKT expression could be used as a marker of poor prognosis in the management of patients with endometrioid endometrial adenocancer. © 2014 Elsevier Ireland Ltd. All rights reserved.Item The effect of FcγRIIIA gene polymorphism on the treatment of diffuse large B-cell non-hodgkin lymphoma: A multicenter prospective observational study; [FcgRIIIA gen polimorfizminin diffüz büyük b hücreli non-hodgkin lenfoma tedavisine etkisi: Çok merkezli prospektif gözlemsel Çalışma](Turkish Society of Hematology, 2015) Büyükkurt N.; Özcan M.A.; Ergene Ü.; Payzın B.; Tunalı S.; Demirkan F.; Özsan H.; Pişkin Ö.; Ündar B.Objective: The curative treatment approach for diffuse large B-cell lymphoma (DLBCL) is controversial even in the rituximab (R) era. The aim of this study was to examine the FcgRIIIA gene polymorphism distribution of DLBCL patients who had been treated with R-CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) chemotherapy. Furthermore, we investigated the impact of FcgRIIIA gene polymorphism on the overall response rate (ORR) and overall survival (OS). Materials and Methods: Patients from 3 centers in the Aegean region of Turkey who had newly diagnosed CD20-positive DLBCL were enrolled in the study. The single nucleotide polymorphisms of the FcgRIIIA gene were analyzed by real time- PCR. The response to treatment was determined in the middle and at the end of the protocol. During 2 years of follow-up, the patients were clinically and radiologically evaluated for disease status every 3 months. Results: Thirty-six patients were included in the study and the distributions of F/F, V/F, and V/V types of alleles of FcgRIIIA were 25%, 50%, and 25%, respectively. Twenty-seven patients were considered as evaluable according to ORR and OS. The patients’ oRR was 87.5%, 100%, and 50% in the F/F, V/F, and V/V allele groups, respectively. We did not establish any statistically significant differences among the 3 alleles groups in respect to ORR (p=0.93). The OS within 2 years in the F/F, V/F, and V/V allele groups was 62.5%, 100%, and 100%, respectively. The OS in the F/F allele group was found to be lower than in the other 2 allele groups (p=0.01). Conclusion: The distribution of gene polymorphisms in our study group was similar to those of previous studies. While oRR was similar between the groups, our results highlight a lower OS in F/F patients compared to other allele groups of FcgRIIIA. © 2015, Turkish Society of Hematology. All rights reserved.Item Clinical characteristics, post-treatment assessment and prognostic factors affecting patient survival of patients at 65 years of age or older with hodgkin lymphoma: A retrospective multicenter study from Turkey(A. CARBONE Editore, 2015) Berber I.; Erkurt M.A.; Keklik M.; Dogu M.H.; Terzi H.; Pala C.; Sari H.I.; Sencan M.; Sivgin S.; Hacioglu S.; Altuntas F.; Aydogdu I.; Ilhan O.Introduction: During the last three decades, major advances have been made in the therapy of Hodgkin's lymphoma. However, despite these advances, Hodgkin's lymphoma has a poor prognosis in the elderly. The proportion of Hodgkin's lymphoma patients aged > 60 ranges in the different reports between 15% and 35%. This study aimed to examine clinical characteristics, treatment outcomes and prognostic factors affecting patient survival in Hodgkin's lymphoma patients aged 65 years or older. Material methods: Hodgkin's lymphoma patients at 65 years of age and older managed within last 5 years in a total of 5 centers in Turkey were retrospectively assessed. Results: The median age of a total of 32 patients was 71 (65-83) years. Elderly patients presented more frequently with B symptoms, elevated sedimentation rate, mixed cellularity histologic subtype and comorbid disease. Less frequent were bulky disease, bone marrow involvement, and the application of autologous stem cell transplantation. The nodular lymphocyte predominant subtype and lymphocyte rich subtype were not observed at all. Eastern Cooperative Oncology Group, ferritin, total protein, and histological type were significant predictors affecting survival (p<0.05). Conclusions: Hodgkin's lymphoma is a more fatal disease in 65 years of age or older, when compared to the young population. Tumor biology, older age itself, and other factors related to comorbidity probably contribute to the worse outcome of elderly patients. Further large-scale studies are needed to better investigate the factors that were significant predictors of patient survival.Item Multicenter retrospective analysis regarding the clinical manifestations and treatment results in patients with hairy cell leukemia: Twenty-four year Turkish experience in cladribine therapy(John Wiley and Sons Ltd, 2015) Hacioglu S.; Bilen Y.; Eser A.; Sivgin S.; Gurkan E.; Yildirim R.; Aydogdu I.; Dogu M.H.; Yilmaz M.; Kayikci O.; Tombak A.; Kuku I.; Celebi H.; Akay M.O.; Esen R.; Korkmaz S.; Keskin A.In this multicenter retrospective analysis, we aimed to present clinical, laboratory and treatment results of 94 patients with Hairy cell leukemia diagnosed in 13 centers between 1990 and 2014. Sixty-six of the patients were males and 28 were females, with a median age of 55. Splenomegaly was present in 93.5% of cases at diagnosis. The laboratory findings that came into prominence were pancytopenia with grade 3 bone marrow fibrosis. Most of the patients with an indication for treatment were treated with cladribine as first-line treatment. Total and complete response of cladribine was 97.3% and 80.7%. The relapse rate after cladribine was 16.6%, and treatment related mortality was 2.5%. Most preferred therapy (95%) was again cladribine at second-line, and third line with CR rate of 68.4% and 66.6%, respectively. The 28-month median OS was 91.7% in all patients and 25-month median OS 96% for patients who were given cladribine as first-line therapy. In conclusion, the first multicenter retrospective Turkish study where patients with HCL were followed up for a long period has revealed demographic characteristics of patients with HCL, and confirmed that cladribine treatment might be safe and effective in a relatively large series of the Turkish study population. © 2015 John Wiley & Sons, Ltd.Item Lymphovascular space invasion and cervical stromal invasion are independent risk factors for nodal metastasis in endometrioid endometrial cancer(Blackwell Publishing, 2015) Solmaz U.; Mat E.; Dereli M.; Turan V.; Gungorduk K.; Hasdemir P.; Tosun G.; Dogan A.; Ozdemir A.; Adiyeke M.; Sanci M.Aims: The purpose of this study was to investigate the potential roles of pathological variables in the prediction of nodal metastasis in women with endometrioid endometrial cancer (EC). Materials and Methods: Women who underwent surgery for endometrioid EC between 1995 and 2012 were retrospectively reviewed. Those who underwent prior neoadjuvant chemotherapy or radiotherapy and inadequate lymphadenectomy as well as those with nonendometrioid histology, synchronous cancers, International Federation of Gynecology and Obstetrics stage IV disease, gross uterine serosal and/or gross adnexal involvement were excluded. Lymph node dissemination was defined as occurring in the following circumstances: (i) when nodal metastasis with pelvic and/or para-aortic (P/PA) lymph node dissection (LND) was performed or (ii) when there was recurrence in the P/PA lymph nodes after a negative LND or when LND was not performed. Univariate and multivariate logistic regression models were used to identify the pathological predictors of lymphatic dissemination. Results: A total of 827 women with endometrioid EC were assessed; 516 (62.4%) of whom underwent P/PA LND and 205 (24.8%) underwent P LND. Sixty-seven (13%) women in the P/PA LND group and 5 (2.4%) in the P LND group had positive lymph nodes. Multivariate analysis confirmed cervical stromal invasion (OR 4.04, 95% CI 2.02-8.07 (P < 0.001)) and lymphovascular space invasion (LVSI) (OR 110.18, 95% CI 38.43-315.87 (P < 0.001)) as independent predictors of lymphatic dissemination. Conclusion: Cervical stromal invasion and LVSI are highly associated with LN metastasis. These markers may serve as a surrogate for nodal metastasis. © 2015 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.Item Primary central nervous system lymphoma in daily practice and the role of autologous stem cell transplantation in relapsed disease: A retrospective multicenter study(Elsevier Ltd, 2016) Erkurt M.A.; Berber I.; Tekgündüz E.; Dogu M.H.; Korkmaz S.; Demir C.; Yilmaz M.; Akay O.M.; Pala C.; Bilen Y.; Kaya E.; Sari I.; Sencan M.; Kuku I.; Altuntaş F.; Dal M.S.; Aydogdu I.We investigated the course of 54 patients presenting with primary central nervous system lymphoma, who were treated in daily practice. The patients were treated with chemotherapy and/or radiotherapy and/or intrathecal chemotherapy. At a median follow-up period of 23 months (range 1-71), median relapse-free survival (RFS) and overall survival (OS) were not reached. Estimated 2-year RFS and OS rates were 42% and 48%, respectively. Ten relapsed PCNSL patients underwent ASCT. Complete remission rate of these patients was 40%, with 20% treatment-related mortality. Estimated 2-year RFS and OS rates were 37% and 40%, respectively. The prognosis of patients with PCNSL, who received off-study treatment, is still dismal. © 2016 Elsevier Ltd.Item Evaluation of prognostic factors in localized high-grade undifferentiated pleomorphic sarcoma: report of a multi-institutional experience of Anatolian Society of Medical Oncology(Springer Science and Business Media B.V., 2016) Ozcelik M.; Seker M.; Eraslan E.; Koca S.; Yazilitas D.; Ercelep O.; Ozaslan E.; Kaya S.; Hacibekiroglu I.; Menekse S.; Aksoy A.; Taskoylu B.Y.; Varol U.; Arpaci E.; Ciltas A.; Oksuzoglu B.; Zengin N.; Gumus M.; Aliustaoglu M.Most data on prognostic factors for patients with high-grade undifferentiated pleomorphic sarcoma (HGUPS) is obtained from analyses of soft tissue sarcomas. The purpose of this study was to evaluate the clinicopathologic features and their impact on outcomes specifically in patients diagnosed with HGUPS. In this multicenter trial, we retrospectively analyzed 112 patients who were diagnosed and treated at 12 different institutions in Turkey. We collected data concerning the patients, tumor characteristics, and treatment modalities. There were 69 males (61.6 %) and 43 females (38.4 %). Median age was 56 years (19–90). The most common anatomic site of tumor origin was the upper extremity. Pleomorphic variant was the predominant histological subtype. Median tumor size was 8.2 cm (0.6–30 cm). Tumors were mainly deeply seated (57.1 %). Fifty-seven patients (50.9 %) were stage II and the remainder were stage III at the time of diagnosis. Median follow-up was 30 months (2–160). The primary site of distant metastasis was the lung (73.5 %) and the second most common site was the liver (11.7 %). The 5-year overall survival, distant metastasis-free survival, and local recurrence-free survival rates were 56.3, 53.4, and 67.2 %, respectively. Multivariate analysis showed that Eastern Cooperative Oncology Group (ECOG) performance score of II (p = 0.033), deep tumor location (p = 0.000), and development of distant metastasis (p = 0.004) were negatively correlated with overall survival, and perioperative radiotherapy and negative microscopic margins were significant factors for local control rates (p = 0.000 for each). Deep tumor location (p = 0.003) was the only adverse factor related to distant metastasis-free survival. Deep tumor location, ECOG performance score of II, and development of distant metastasis carry a poor prognostic implication on overall survival. These will aid clinicians in predicting survival and treatment decision. © 2015, International Society of Oncology and BioMarkers (ISOBM).Item Analysis of clinical and pathological characteristics, treatment methods, survival, and prognosis of uterine papillary serous carcinoma(Wichtig Publishing Srl, 2016) Solmaz U.; Ekin A.; Mat E.; Gezer C.; Dogan A.; Biler A.; Peker N.; Hasdemir P.S.; Sanci M.Purpose: Uterine papillary serous carcinoma (UPSC) is an atypical variant of endometrial carcinoma with a poor prognosis. It is commonly associated with an increased risk of extrauterine disease. The aim of this study was to investigate clinical and pathological characteristics, therapeutic methods, and prognostic factors in women with UPSC. Methods: All patients who underwent surgery for UPSC at a single high-volume cancer center between January 1995 and December 2010 were retrospectively reviewed. Patients who did not undergo surgical staging and those with mixed tumor histology were excluded. Univariate and multivariate regression models were used to identify the risk factors for overall survival (OS) and progression-free survival (PFS). Results: A total of 46 patients were included, the majority of whom having stage I disease (IA, 13 [28.2%] and IB, 12 [26.7%]). Stages II, III, and IV were identified in 5 (10.9%), 8 (17.4%), and 8 (17.4%) women, respectively. Optimal cytoreduction was obtained in 67.3% of patients. Recurrences developed in 8 (17.4%) patients. Multivariate analysis confirmed that lymphovascular space invasion (LVSI) (odds ratio [OR] 26.83, p = 0.003) was the only independent prognostic factor for OS, whereas LVSI and optimal cytoreduction were found to be independent prognostic factors for PFS (OR 6.91, p = 0.013 and OR 2.69, p = 0.037, respectively). The 5-year overall survival rate was 63%. Conclusions: Our study demonstrated that LVSI is the only independent prognostic factor for OS, whereas LVSI and optimal cytoreduction are independent prognostic factors for PFS in patients with UPSC. © 2016 Wichtig Publishing.Item Predictive and prognostic factors in ovarian and uterine carcinosarcomas(AVES Ibrahim Kara, 2016) Cicin İ.; Özatlı T.; Türkmen E.; Özturk T.; Özçelik M.; Çabuk D.; Gökdurnalı A.; Balvan Ö.; Yıldız Y.; Şeker M.; Özdemir N.; Yapar B.; Tanrıverdi Ö.; Günaydin Y.; Menekşe S.; Öksüzoğlu B.; Aksoy A.; Erdogan B.; Hacıoglu M.B.; Arpaci E.; Sevinç A.Background: Prognostic factors and the standard treatment approach for gynaecological carcinosarcomas have not yet been clearly defined. Although carcinosarcomas are more aggressive than pure epithelial tumours, they are treated similarly. Serous/clear cell and endometrioid components may be predictive factors for the efficacy of adjuvant chemotherapy (CT) or radiotherapy (RT) or RT in patients with uterine and ovarian carcinosarcomas. Heterologous carcinosarcomas may benefit more from adjuvant CT. Aims: We aimed to define the prognostic and predictive factors associated with treatment options in ovarian (OCS) and uterine carcinosarcoma (UCS). Study Design: Retrospective cross-sectional study Methods: We retrospectively reviewed the medical records of patients with ovarian and uterine carcinosarcoma from 2000 to 2013, and 127 women were includ ed in this study (24 ovarian and 103 uterine). Patients admitted to seventeen oncology centres in Turkey between 2000 and December 2013 with a histologically proven diagnosis of uterine carcinosarcoma with FIGO 2009 stage I-III and patients with sufficient data obtained from well-kept medical records were included in this study. Stage IV tumours were excluded. The patient records were retrospectively reviewed. Data from 104 patients were evaluated for this study. Results: Age (≥70 years) was a poor prognostic factor for UCS (p=0.036). Pelvic±para aortic lymph node dissection did not affect overall survival (OS) (p=0.35). Macroscopic residual disease was related with OS (p<0.01). The median OS was significantly longer in stage I-II patients than stage III patients (p=0.03). Adjuvant treatment improved OS (p=0.013). Adjuvant radiotherapy tended to increase the median OS (p=0.075). However, this tendency was observed in UCS (p=0.08) rather than OCS (p=0.6).Adjuvant chemotherapy had no effect on OS (p=0.15).Adjuvant radiotherapy significantly prolonged the median OS in patients with endometrioid component (p=0.034). A serous/clear cell component was a negative prognostic factor (p=0.035). Patients with serous/clear cell histology for whom adjuvant chemotherapy was applied had significantly longer OS (p=0.019), and there was no beneficial effect of adjuvant radiotherapy (p=0.4). Adjuvant chemotherapy was effective in heterologous tumours (p=0.026). In multivariate analysis, the stage and chemotherapy were prognostic factors for all patients. Age was an independent prognostic factor for UCS. However, serous/clear cell histology and radiotherapy tended to be significant prognostic factors. Conclusion: The primary location, the histological type of sarcomatous and the epithelial component may be predictive factors for the efficacy of chemotherapy or radiotherapy in UCS and OCS. © Trakya University Faculty of Medicine.Item The effect of the gastrectomy on survival in patients with metastatic gastric cancer: A study of ASMO(Future Medicine Ltd., 2016) Yazici O.; Özdemir N.; Duran A.O.; Menekşe S.; Nahit Şendur M.A.; Karaca H.; Göksel G.; Arpaci E.; Hacibekiroʇlu I.; Bilgetekin I.; Kaçan T.; Özkan M.; Aksoy S.; Aksoy A.; Çokmert S.; Uysal M.; Elkiran E.T.; Çiçin I.; Büyükberber S.; Zengin N.Aim: To investigate the role of surgical resection of primary tumor on overall survival (OS) in advanced gastric cancer patients at the time of diagnosis. Patients & methods: The survival rates of metastatic gastric cancer patients whose gastric primary tumor was resected at time of diagnosis were compared with metastatic gastric cancer patients whose primary tumor was nonresected. Results: The median progression-free survival and OS in operated and nonoperated group were 10 versus 6, 14 versus 9 months, respectively (p < 0.001). In multivariate analysis, gastric resection of primary tumor, Eastern Cooperative Oncology Group performance status, second-line chemotherapy had a significant effect on OS (hazard ratio [HR]: 0.52 [95% CI: 0.38-0.71], HR: 0.57 [95% CI: 0.42-0.78], HR: 1.48 [1.09-2.01]; p ≤ 0.001, p = 0.001 and p = 0.012, respectively). Conclusion: Subpopulations of patients with metastatic gastric cancer might benefit from surgical removal of primary tumor. © 2016 Future Medicine Ltd.Item Efficacy and toxicity of cisplatin and capecitabine combination in the first-line treatment of patients with advanced gastric cancer: A multicenter study by the anatolian society of medical oncology; [İleri evre mide kanserli hastaların birinci basamak tedavisinde cisplatin ve kapesitabin kombinasyonunun etkinlik ve toksisitesi: Çok merkezli anadolu tıbbi onkoloji derneği çalışması](UHOD - Uluslararasi Hematoloji Onkoloji Dergisi, 2016) Ciltas A.; Buyukberber S.; Topcu T.O.; Kucukoner M.; Uyeturk U.; Cihan S.; Sendur M.A.; Budakoglu B.; Kefeli U.; Yildiz R.; Goksel G.; Berk V.; Balakan O.; Oksuzoglu B.; Uncu D.; Coskun U.; Ozdemir F.; Benekli M.Gastric cancer is an important public health problem which comprises 10% of all cancers and 12% of all cancer related deaths all over the world. Because of the differences in patient populations and treatment schemes in various studies, standard practice for advanced stage gastric cancer has not been fully established. The aim of this study was to assess the use of cisplatin and capecitabine combination regimen in real-world clinical practice. Medical records of 76 male and 37 female metastatic gastric cancer patients treated with first-line cisplatin and capecitabine combination between February 2006 and December 2009 were retrospectively analyzed in 11 centers of the Anatolian Society of Medical Oncology. Patients previously treated with chemotherapy were excluded from the analysis. The median age of the patients was 64 years (range, 28-83). Seventy-six (67.2%) patients were males and 37 (32.7%) females. Most of the patients were metastatic (n= 85, 75.2%) at the time of initial diagnosis. The most common sites for metastasis were liver (65.9%), lung (11.3%), peritoneum (23.8%) and local recurrence (15.9%) with multiple metastases in 9.7% of the patients. The mean follow-up period of all patients was 41 months (range 12-61). Overall response rates was 33.6%, while disease control rate (DCR) was 72.6 %. Median Progression-free survival was 4.7 months (95%CI 3.75- 6.49) and median overall survival was 11.1 months (95%CI 5.58- 10.98). The most common grade 3-4 adverse events were anemia (8.3%), nausea-vomiting (3.8%) and diarrhea (1.8%). In terms of efficacy, toxicity and convenience, cisplatin and capecitabine combination is effective and well tolerated in Turkish patients with advanced gastric cancer, and could be one of the standard regimens for the first-line treatment in this cohort. © 2016, UHOD - Uluslararasi Hematoloji Onkoloji Dergisi. All rights reserved.Item Comparison of survival with somatostatin analog and chemotherapy and prognostic factors for treatment in 165 advanced neuroendocrine tumor patients with Ki-67 20% or less(Lippincott Williams and Wilkins, 2016) Özaslan E.; Karaca H.; Koca S.; Sevinc A.; Hacioglu B.; Özkan M.; Özcelik M.; Duran A.O.; Hacibekiroglu I.; Yildiz Y.; Tanriverdi O.; Menekse S.; Aksoy A.; Bozkurt O.; Urvay S.; Uysal M.; Demir H.; Ciltas A.; Dane F.The objectives of this study were to compare progression-free survival (PFS) with somatostatin analog (SSA) versus chemotherapy (CTx) in first-line therapy and to determine the patient group in which these treatments were more effective in neuroendocrine tumors (NETs) with a Ki-67 index of 20% or less. Patients who received SSA or CTx and had unresectable locally advanced and metastatic NETs with a Ki-67 index of 20% or less were retrospectively selected from 13 centers in the Turkish database between 2000 and 2015. One hundred and sixty-five patients were enrolled. The median age was 56 years and the male-to-female ratio was 1.09. Seventy-four (45%) patients were of grade 1 NET and 91 (55%) were of grade 2. SSA was given to 104 patients, whereas 61 were treated with CTx. The objective response rate after SSA was 15.4%; another 73.1% had stable disease. The objective response rate after CTx was 36.1%, and 40.9% had stable disease (P=0.008). The median PFS in SSA patients was 21 months (95% confidence interval: 12.4-29.6), and 8 months for CTx (95% confidence interval: 5.5-10.6) (P<0.001). There was no significant difference between PFS of receiving SSA and CTx in pancreatic neuroendocrine tumor (PNET) patients; however, the PFS of receiving SSA was longer in non-PNET patients (P<0.001). SSA was better treatment in advanced NET patients with a Ki-67 index of less than 5%, having a primary resected and a performance status of 0 (P<0.05). SSA may be preferred over CTx in advanced NET patients with low-to-intermediate grade. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.Item Evaluation of treatment outcomes of triple-negative breast cancer(Medknow Publications, 2016) Cinkaya A.; Akin M.; Sengul A.Purpose: Breast cancer is the most common cancer in women. Treatment responses are variable depending on tumor morphological characteristics, clinical characteristics, and hormonal receptor levels. In current medical practice, estrogen receptor (ER), progesterone receptor (PGR), and human epidermal growth factor receptor 2 (HER2) levels have been identified as important prognostic factors; they can change prognosis and treatment modalities. In this study, the prognostic factors of patients with triple-negative breast cancer (TNBC) were examined retrospectively. Materials and Methods: Some 110 cases with negative prognostic and predictive proteins (ER, PGR, and HER2) were included in this study. Median follow-up was 56 months. Recurrences, overall survival, and prognostic factors were evaluated. Results: We revealed in our triple-negative series that nodal status, tumor size, whole breast radiation doses, and type of surgery are the most useful prognostic markers. Conclusion: Triple-negative breast cancers, especially basal-like subtypes, have bad prognoses. They have high histopathological grades and high risk of invasion. This group can make early metastases and expected survival is usually short. We need to focus on new treatment strategy modalities on this group, and pretreatment values of different prognostic markers are well-identified, such as androgen receptors, basal cytokeratin expression, and BRCA gene status.