Browsing by Author "Alici, S"

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Aggressive Non-hodgkin's Lymphoma Treated at the Institute of Oncology, Istanbul - Treatment, Outcome, and Prognostic Factors
(Lippincott Williams & Wilkins, 2002) Alici, S; Bavbek, SE; Kaytan, E; Basaran, M; Eralp, Y; Onat, H
In an unselected group of patients with aggressive non-Hodgkin's lymphoma (A-NHL) treated at our institution during a 10-year period (1989-1998), we studied the treatment outcome and influence of possible prognostic factors. Two hundred one patients with A-NHL were analyzed retrospectively with regard to personal, treatment, and disease-specific characteristics. Median age was 55 years (range: 16-87 years) and the male:female ratio was 1.5. During a median follow-up of 26 months, the overall response rate was 74% (complete response 63%, partial response 11%). The 2- and 5-year disease-free survival rates were 49 +/- 3% (mean +/- SEM) and 41 +/- 4%, respectively. In a univariate analysis, the following variables were associated with prognosis in terms of survival: patient age, clinical stage, performance status, B symptoms, erythrocyte sedimentation rate, treatment response, and histologic grade of tumor. In multivariate analyses, patient age, performance status, and treatment response emerged as independent prognostic factors for survival.
Antithyroid Antibody Levels in Patients With Breast Cancer
(Amer Assoc Clinical Chemistry, 2004) Sekeroglu, MR; Dulger, H; Alici, S; Algun, E; Noyan, T
Clinical Characteristics of Gestational Trophoblastic Disease at a Single Institute
(Tohoku Univ Medical Press, 2002) Alici, S; Eralp, Y; Saip, P; Argon, A; Basaran, M; Topuz, E; Aydiner, A
ALICI, S., ERALP, Y., SAIP, P., ARGON, A., BASARAN, M., Topuz, E. and AYDINER, A. Clinical Characteristics of Gestational Trophoblastic Disease at A Single Institute. Tohoku J. Exp. Med., 2002, 197 (2), 95-100-Gestational trophoblastic diseases (GTD) represent a group of malignancies classified as invasive mole, chorlocarcinoma, and placental-site trophoblastic tumors. The overall cure rate in the treatment of this malignant disorder now exceeds 90%. The aim of this study is retrospectively to evaluate the clinical characteristics and effectiveness of single-agent chemotherapy (CT) and combination chemotherapy according to the World Health Organization (WHO) risk groups of gestational trophoblastic diseases. Thirty one patients with GTD were treated in our institute between 1990-1998. Median age at presentation was 29 years (range 19-70 years). All patients were classified with respect to the WHO scoring system. According to this system, patients were divided into three clinical groups: low-risk nonmetastatic (low-risk group with good prognosis), low-risk metastatic, and high-risk metastatic (high risk group with poor prognosis). Eighteen patients in the nonmetastatic low-risk group with favorable prognostic factors received single agent CT (methotrexate and folinic acid), while 3 patients with metastatic low-risk and 10 patients in the metastatic high-risk group with poor prognosis received combination CT (EMA-CO). Complete response (CR) was obtained in all patients in the low risk group with good prognosis, whereas 9/13 (69%) patients in the poor prognosis group achieved CR and 4 (31%) had partial responses. This clinical classification system may be currently prefer for determining initial therapy in women with malignant gestational trophoblastic tumors. And, our report confirms that the alternating EMA/CO regimen is a well-tolerated and effective combination for the treatment of women with high-risk GTD. gestational trophoblastic diseases; EMA/CO; choriocarcinoma (C) 2002 Tohoku University Medical Press.
Coexistence of Subacute Thyroiditis and Renal Cell Carcinoma
(Canadian Medical Association, 2003) Algün, E; Alici, S; Topal, C; Ugras, S; Erkoç, R; Sakarya, ME; Özbey, N
RENAL CELL CARCINOMA IS CHARACTERIZED by varied manifestations, which include unusual metastatic sites and paraneoplastic and vascular syndromes. We describe the case of a 57-year-old man who presented with high fever, weight loss, palpitations and a tender goitre. We suggest that, in this patient, subacute thyroiditis manifested as a paraneoplastic syndrome of renal cell carcinoma.
Colorectal Cancer in Young Patients: Characteristics and Outcome
(Tohoku Univ Medical Press, 2003) Alici, S; Aykan, NF; Sakar, B; Bulutlar, G; Kaytan, E; Topuz, E
Colorectal cancer is predominantly a disease of the elderly population, but this disease is unusual in patients 40 years of age or under, and controversy persists as to prognosis in this subset of patients. The aim of this study was to determine the clinicopathologic features and their impact on patients survival of colorectal cancer in patients aged 40 years or younger, and to compare them with those of older patients. The records of 466 patients with non-metastatic colorectal adenocarcinoma who were referred between 1991 and 1999 to the University of Istanbul, Institute of Oncology, following curative surgery were retrospectively analysed. The clinicopathologic features of 84 (18%) colorectal cancers (group A; male: female ratio 48: 36) which occurred in patients aged 40 years or younger were compared with 382 colorectal. cancers in older patients (group B; male: female ratio 194: 188). Patient gender, performance status, T stage, N stage, TNM stage, histologic grade, location of tumor, lymphatic invasion, serum levels of LDH and CEA, and survival rates were compared as prognostic factors. There was no statistically significant difference between group A and group B with respect to patient gender, performance status, T stage, N stage, TNM stage, histologic grade, location of tumor, serum levels of LDH and CEA, and survival rates of colorectal cancers. The proportion of lymphatic invasion was present in 27% of patients in group A vs. 12% in group B. With median follow-up of 69 months, the overall 5-year survival rate was 61% in group A and 56% in group B. In the univariate survival analysis according to age groups (group A and B), advanced TNM stage, location of rectal tumor, presence of lymphatic invasion, and presence of high serum LDH and CEA levels are predictors of poorer survival in young patients with colorectal. cancer. In the Cox-Regression analysis, location of tumor and TNM stage were determined as independent prognostic factors for survival. This study revealed no difference in clinicopathologic characteristics in patients with colorectal cancer aged 40 years or younger compared with those aged above 40 years. However, in patients aged 40 years or younger, distal location of tumor and advanced stage should be considered as poor prognostic factors for overall survival. (C) 2003 Tohoku University Medical Press.
Fatal Lactic Acidosis Due To Leukemic Transformation in a Patient With Non-hodgkin's Lymphoma: Case Report
(Health Communications inc, 2005) Dogan, E; Erkoc, R; Sayarlioglu, H; Alici, S; Dilek, I; Alici, O
Lactic acidosis (LA) associated with hematologic malignancies is uncommon, life-threatening, and generally occurs in adults. Its pathogenesis is poorly understood. This is a case report of LA due to leukemic transformation that occurred in a patient with non-Hodgkin's lymphoma (NHL). A 24-year-old man with NHL was admitted to the hospital with dyspnea. Venous blood gas analysis revealed metabolic acidosis (pH 7.05; HCO3 6 mEq/L; BE 22 mmol/L; anion gap 28 mEq/L); the patient had an elevated plasma lactate concentration (12 mmol/L) and low glucose concentration (38 mg/dL). There was no reason other than leukemia-such as infection, circulatory failure, or drug use-for the development of severe LA. This case report shows that in patients with NHL, leukemic transformation may give rise to LA.
Incidence of Renal Insufficiency in Cancer Patients
(Health Communications inc, 2005) Dogan, E; Izmirli, M; Ceylan, K; Erkoc, R; Sayarlioglu, H; Begenik, H; Alici, S
The frequency of chronic renal insufficiency among cancer patients is unclear. The aim of this study was to determine the frequency of impaired renal function within a population of cancer patients. One thousand two hundred seventeen patients (563 women, 654 men) with cancer underwent serum creatinine concentration and glomerular filtration rate (GFR) evaluations. The Cockcroft-Gault formula was used to estimate the GFR from the creatinine clearance (Cl-cr). Renal insufficiency was defined as a GFR <= 90 mL/min. Among this population, 72 (5.9%) demonstrated an abnormal serum creatinine concentration (>1.2 mg/dL). According to the Cockcroft-Gault formula evaluations, however, 330 (27.1%) of the patients had an estimated GFR <90 mL/min. Among these, the Cl-cr was between 60 and 89 mL/min in 241 patients (19.8%); 30 and 59 mL/min in 75 patients (6.2%); and 15 and 29 mL/min in 7 patients (0.6%); 7 patients (6%) had a Cl-cr <15 mL/min. As a result, 21.2% of patients demonstrating a normal serum creatinine level had abnormal renal function. Renal function should be evaluated in all cancer patients, regardless of their serum creatinine level, before any drug regimen is administered. The Cockcroft-Gault formula appears to be more accurate than serum creatinine concentration for diagnosing renal insufficiency in patients with cancer, but more prospective studies in this population will be necessary to confirm this finding.
Malignant Pheochromocytoma With Peritonitis Carcinomatosa
(Lippincott Williams & Wilkins, 2005) Algün, E; Kösem, M; Alici, S; Harman, M; Güler, O; Kotan, E
Pheochromocytomas and functioning paragangliomas are rare tumors arising from the primitive neural crest. Approximately 10% of adrenal pheochromocytomas are malignant. Malignant pheochromocytomas usually recur in the retroperitoneum or appear as metastatic deposits in bone, lung, or liver. Here, we report a 51-year-old woman with malignant pheochromocytoma with a peritoneal metastasis, which is a very unusual metastatic site. She was referred to the hospital with headache, abdominal pain, and ileus. A right adrenal mass was surgically removed in May 1997. Pathologic examination revealed pheochromocytoma and capsular with adjacent muscle invasion. During the next 3 years, the patient remained well. The disease recurred in 2001, with hypertensive episodes and peritonitis carcinomatosa. Further investigation revealed no other metastatic sites. Peritoneal metastasis is very rare in malignant pheochromocytoma and generally is attributed to direct peritoneal seeding during surgery.
Oral Etoposide (Vp16) in Platinum-Resistant Epithelial Ovarian Cancer (Eoc)
(Lippincott Williams & Wilkins, 2003) Alici, S; Saip, P; Eralp, YI; Aydiner, A; Topuz, E
This phase II study evaluates the efficacy and toxicity of a prolonged schedule second-line and third-line treatment of oral VP16 in patients with measurable advanced ovarian cancer resistant to, or relapsed following, platinum-based chemotherapy. Twenty-two eligible women with progressive or relapsed ovarian cancer resistant to platinum-based therapy were included in this study. All the patients had received more than one prior treatment, and had evidence of disease progression within 6 months of the previous chemotherapy. Eleven patients had received more than two different chemotherapy regimens. Fifteen patients had received consolidation therapy with intraperitoneal cisplatin after an initial treatment course with six cycles of a platinum-based combination regimen. All patients with measurable disease observed in abdominal computed tomography scans were given oral VP16 at a daily dose of 50 mg/m(2) for 14 consecutive days with 4 weekly intervals. Among 22 assessable patients, there were one complete response (CR) and three partial responses (PR), so the objective response rate, which is the addition of CR and PR rates, was 18%. Seven patients (32%) had stable disease. Median duration of response and stable disease was 2.5 months (range: 1-10 months). Overall median survival was 11 months from study entry (range: 3-36 months). Toxicity for most patients was mild, but a few severe myelotoxicities occurred, and there were no treatment-related deaths. According to World Health Organization toxicity criteria grade III/IV thrombocytopenia was seen in 4 of 22 patients, grade III/IV neutropenia in 6 of 22 patients, and grade III anemia was observed in 3 of 22 patients. Non-hematologic toxicity was mild, and mucositis was the most frequently observed nonhematologic toxicity. Oral etoposide has considerable activity with a tolerable toxicity profile for the treatment of platinum-resistant epithelial ovarian cancer.
Primary Malignant Fibrous Histiocytoma Presenting as an Intussusception: Report of the Small Intestine of a Case
(Springer, 2002) Kotan, C; Kosem, M; Alici, S; Ilhan, M; Tuncer, I; Harman, M
Malignant fibrous histiocytoma occurs most commonly in the extremities and trunk, but rarely in the visceral organs. Malignant fibrous histiocytoma of the small intestine is an extremely rare condition. To our knowledge, only ten cases of primary tumors involving the small intestine have been described up to now. Among them only one case has been reported to lead to intussusception. This case report documents the appearance of a storiform-pleomorphic type primary malignant fibrous histiocytoma of the ileum, which led to intussusception, in a 58-year-old man with a 3-month history of dyspepsia, weight loss, general fatigue, and nonspecific abdominal pain. The patient was well with no sign of disease at 8 months after surgery. The clinical and pathologic characteristics of malignant fibrous histiocytoma of the small intestine as found in the literature are also reviewed.
Prognostic Factors in Localized Aggressive Non-hodgkin's Lymphoma
(Lippincott Williams & Wilkins, 2003) Alici, S; Bavbek, SE; Kaytan, E; Eralp, Y; Onat, H
To identify the prognostic factors that specifically predict survival rates of patients with localized aggressive non-Hodgkin's lymphoma (NHL), a retrospective study including 118 patients with clinical stage I and 11 NHL treated at the Institute of oncology, Istanbul University between 1989 and 1998 was conducted. Patients were treated either with radiotherapy alone, radiotherapy and adjuvant chemotherapy, or chemotherapy (with or without adjuvant radiotherapy). The 5-year disease-free survival (DFS) and overall survival rates were calculated, and univariate and multivariate analyses were performed to identify the significance of various prognostic factors such as gender, age, performance status, stage (1 versus II), B symptoms, extranodal involvement, gastrointestinal tract disease, erythrocyte sedimentation rate, bulky disease, histologic grade, serum lactate dehydrogenase level, serum beta(2)-microglobulin level, serum albumin level, treatment regimen, remission status, and the International Prognostic Index risk groups, which may have an influence on the outcome of patients with NHL. The overall 5-year survival rate was 52% with a median follow-up of 30 months. The complete response rate was 68%, and the 5-year DFS of complete responders was 70%. Cox multivariate regression analysis showed that incomplete response, low serum albumin, bulky disease (>10 cm), and high grade histology were the pretreatment factors associated with shorter survival. When remission status was included in the model, the attainment of a complete response was the major determinant of long-term survival; however, low albumin level was still a significant adverse predictor for survival in multivariate analysis. These factors need to be evaluated for analyzing the outcome of treatment and to identify better therapeutic strategies.
Prognostic Features and Outcome in Patients With Agressive Non-hodgkin's Lymphoma Who Do Not Achieve a Complete Response To First-Line Regimens
(Amer Soc Clinical oncology, 2005) Alici, S; Bavbek, S; Basaran, M; Onat, H
Serum Levels of Leptin and Proinflammatory Cytokines in Patients With Gastrointestinal Cancer
(Blackwell Publishing Ltd, 2004) Dülger, H; Alici, S; Sekeroglu, MR; Erkog, R; Özbek, H; Noyan, T; Yavuz, M
The aim was to investigate the serum levels of leptin, TNFalpha, IL-1 beta, IL-6, insulin, and growth hormone in patients with upper gastrointestinal cancer and cachexia. A total of 39 patients with various advanced stage (stage IV) gastrointestinal malignancies were enrolled. These cancer patients were divided into two groups according to the presence or absence of cachexia. Fifteen healthy adults were recruited as the control group. Body mass index (BMI; kg/m(2)) was calculated. Serum leptin, turnout necrosis factor (TNF)-alpha interleukin (IL)-1 beta, interleukin (IL)-6, growth hormone, insulin, glucose, triglyceride, total protein, albumin, erythrocyte sedimentation rate, and CRP were measured. In both cancer groups (cachectic and non-cachectic) body mass index and serum leptin levels were lower than controls (p < 0.001). Serum IL-1 beta, IL-6, and growth hormone levels were higher in both cachectic and non-cachectic groups than those of controls (p < 0.05). Serum TNF-alpha level in non-cachectic group was also significantly higher than in control group (p < 0.01). There is no significant difference between three groups in terms of insulin resistance as assessed by HOMA index. Our results showed that some proinflammatory cytokine levels were increased and leptin level was decreased due to upper gastrointestinal cancers. Increased cytokine levels may lead to decreased food intake and caused a weight loss. (C) 2004 Blackwell Ptiblishing Ltd.