Browsing by Author "Can, Orcun"

Now showing 1 - 7 of 7

Adrenocortical Carcinoma: Single Center Experience
(2020) Seçmeler, Şaban; Can, Orcun; Yasar, Nurgul; Geredeli, Caglayan; Demir, Cumhur; Sakin, Abdullah; Cihan, Sener
Objective: The prevalence of adrenocortical carcinoma (ACC) is approximately 0.02% of all cancers, and the annual incidence is approximately 1-2 per million population. ACC is more aggressive, and the prognosis of ACC is poorer in adults than that in pediatric patients. We aimed to investigate the clinicopathological characteristics and factors affecting overall survival (OS) in patients with ACC who were followed-up and treated in our hospital.Methods: The patients, who were treated and followed up in the oncology clinic between 2006 and 2018, were included in the study. The patients who were diagnosed with ACC in the pathologic evaluation were included.Results: A total of 10 patients, five men (50%) and five women (50%), were included in the study. The mean age was 42.4 years (range=18-67). Six patients (60%) were stage 3, and four patients (40%) were stage 4. Eight patients (80%) underwent surgery. The release of glucocorticoid and/or androgen was detected in six patients (60%). Recurrence developed in six patients (100%), and seven patients (70%) died during the follow-up. The median OS was 13 months in patients with stage 3 disease, and the median OS was eight months in patients with stage IV disease (Log-rank p=0.177). The eastern cooperative oncology group performance status (ECOG PS) and performing of surgery were detected as the most significant factors affecting OS (Log-rank p=0.01, Log-rank p=0.02).Conclusion: The significant factors for OS were found to be surgery and ECOG PS in our study.
The Effect of Body Mass Index on Location of Recurrence and Survival in Early-Stage Colorectal Cancer
(Wolters Kluwer Medknow Publications, 2020) Sakin, Abdullah; Samanci, Nilay Sengul; Secmeler, Saban; Arici, Serdar; Can, Orcun; Yasar, Nurgul; Cihan, Sener
Introduction: Obesity has become one of the major public health problems in many countries. Controversial results were reported in publications on the relationship between obesity and mortality in patients diagnosed with colorectal cancer (CRC) and that receive curative treatment. In this study, we evaluated the effects of body mass index (BMI) on the location of recurrence and disease-free survival (DFS) in patients with early-stage CRC. Materials and Methods: Patients that were followed up and treated in the Department of Medical Oncology between 1999 and 2016 were retrospectively included in the study. Patients with operated Stage I, II, and III CRC were included in the study. Patients were divided into three groups based on their BMI (kg/m2) of below 25, between 25 and 30, and above 30. Results: A total of 950 patients, of which 527 (55.5%) were male and 423 (44.5%) were female, were included in the study. The median age of the patients was 56 years. Of the patients, 408 (42.4%) had BMI of <25, 370 (38.9%) had BMI between 25 and 30, and 172 (18.2%) had BMI of 30. Local recurrence rate was significantly higher in the group with BMI >= 30 compared to the other groups (P <0.01). When compared with DFS, there was a statistically significant difference between groups with BMI of <25 and >= 30 (P = 0.02) and that difference was more evidently observed in Stage III (P = 0.02). There was no statistically significant difference of overall survival in the BMI groups (P = 0.87). In multivariate analysis, the BMI >= 30 (hazard ratio [HR], 1.49, 95% confidence interval [CI], 1.02-2.17), rectal tumor (HR, 1.70, 95% CI, 1.15-2.51), Stage III (HR, 3.91, 95% CI, 1.86-8.25), number of positive lymph nodes (HR, 1.05, 95% CI, 1.03-1.07), and R1 resection (HR, 3.47, 95% CI, 1.71-7.05) were identified as independent risk factors negatively affecting DFS. Conclusion: In this study, we observed that the high BMI increased the risk of recurrence, especially in Stage III CRC patients, and that the recurrence frequently occurred locally.
The Effects of Fulvestrant Treatment on Hormone Receptor-Positive Metastatic Breast Cancer
(2020) Geredeli, Çağlayan; Cihan, Sener; Arıcı, Serdar; Seçmeler, Şaban; Yasar, Nurgul; Sakin, Abdullah; Can, Orcun
Objectives: To determine fulvestrant efficacy and tolerability in Turkish patients with hormone receptor-positive metastatic breast cancer.Methods: Patients who developed metastasis while taking tamoxifen or aromatase inhibitors in the adjuvantperiod or metastatic disease at the diagnosis. Fulvestrant 500 mg was administered intramuscularly every 28days. Progression-free survival (PFS) and overall survival (OS) durations were calculated.Results: In this particular research, totally 137 patients were participated. Median PFS was 9 months (95%CI, 5.7-10.3). The 12-month PFS rate was calculated as 42%, and the 36-month PFS rate was 17%. The medianPFS was not reached in the first line use of fulvestrant in the metastatic period but 9 months and 7 months inthe second and subsequent lines respectively. Results indicated that this difference was statistically significant(p = 0.002). It was shown that patients with liver and brain metastasis had lower PFS compared patients withno liver and no brain metastasis. The estimated median OS was 38 months after fulvestrant started. The 12-month OS rate was calculated as 82.4%, and the 36-month OS rate was 50%.Conclusions: Fulvestrant contributes both PFS and OS in patients with hormone receptor-positive metastaticbreast cancer and this effect is more clear in using fulvestrant as first-line treatment.
Efficacy and Tolerability of Adjuvant Therapy in ≥70-Year Patients With T3n0m0 Colorectal Cancer: an Observational Study
(Sage Publications Ltd, 2020) Sakin, Abdullah; Yasar, Nurgul; Sahin, Suleyman; Arici, Serdar; Secmeler, Saban; Can, Orcun; Cihan, Sener
Background:This study aimed to retrospectively investigate the efficacy and tolerability of adjuvant chemotherapy in >= 70-year-old patients with stage IIA (T3N0M0) colorectal cancer. Methods Lymphovascular invasion, perineural invasion, margin positivity, dissected lymph node count of <12, and presence of perforation/obstruction were accepted as risk factors. Those patients with at least one risk factor were regarded as having high risk.Results:The study included 168 patients, among which 95 (56.5%) were male and 73 (43.5%) were female. The median age of patients was 73 years (range: 70-94). One hundred one (60.1%) patients were identified to have high risk. Eighty-one (87%) patients received 5-flourouracil+leucovorin and 12 (13%) patients received capecitabine regimens as adjuvant chemotherapy. The patients receiving capecitabine regimen had significantly higher rates of dose reduction at initiation and during the treatment. Among low-risk group, there was no statistically significant difference between patients with and without adjuvant chemotherapy in terms of disease-free survival or overall survival (p = 0.528 and p = 0.217, respectively). In high-risk group, patients receiving adjuvant chemotherapy significantly differed from those not receiving adjuvant chemotherapy in terms of median disease-free survival and overall survival (p = 0.009 and p < 0.001, respectively). While the grade, lymph node status, and adjuvant chemotherapy were identified as the most significant independent factors for disease-free survival, the most significant factors for overall survival were the age, Eastern Cooperative Oncology Group performance status, adjuvant chemotherapy, and recurrence.Conclusion:The findings of our study showed improved disease-free survival and overall survival in high-risk >= 70-year-old patients who received adjuvant chemotherapy due to T3N0M0 colorectal cancer. We believe that 5-flourouracil+leucovorin or capecitabine regimens should be recommended for these older high-risk patients who could receive adjuvant chemotherapy regardless of age.
Factors Affecting Disease-Free Survival in Operated Nonmetastatic Gastrointestinal Stromal Tumors
(Academic Press inc Elsevier Science, 2019) Sakin, Abdullah; Can, Orcun; Arici, Serdar; Yasar, Nurgul; Geredeli, Caglayan; Demir, Cumhur; Cihan, Sener
Background: Possibly originating from interstitial Cajal cells, gastrointestinal stromal tumors (GISTS) have variable biological behaviors. In this study, we aimed to examine the factors affecting the disease-free survival (DFS) in patients with GIST who underwent operation. Material and methods: The study included the patients who were followed up and treated for GIST in our oncology clinic between 2002 and 2017. The Armed Forces Institute of Pathology criteria (Miettinen risk score) were used for risk stratification of patients. Results: Seventy-four patients were included to the study, where female patients constituted 52.7%, and the median age was 56 (range: 24-83) y. Most common primary tumor location was the stomach (51.4%), followed by the small intestine (33.8%), colorectum (10.8%), and retroperitoneum (4.1%). Miettinen risk score showed 12 patients (16.7%) at very low risk, 15 patients (20.8%) at low risk, 18 patients (25%) at intermediate risk, and 27 patients (37.5%) at high risk. DFS was significantly lower in patients with small intestine involvement than in cases with stomach involvement (P = 0.004). DFS was significantly lower in patients at high risk than in patients with no high risk (P = 0.034). Small intestine localization (hazard ratio [HR], 8.98; 95% confidence interval [CI], 1.14-8.18), high-risk score (HR, 5.16; 95% CI, 1.42-12.75), c-kit positivity (HR, 0.24; 95% CI, 0.13-0.69), and adjuvant therapy (HR, 0.37; 95% CI, 0.20-0.92) were found to be the most significant factors affecting DFS. Conclusions: Our study showed negative effects of small intestine localization and high-risk category and positive effects of c-kit positivity and adjuvant therapy on DFS in patients with GIST who underwent operation. When a decision will be made in favor of adjuvant therapy, tumor localization and c-kit mutation should also be considered in addition to risk score. (C) 2019 Elsevier Inc. All rights reserved.
Non-Urothelial Bladder Cancers: Single Center Experience
(2019) Yasar, Nurgul; Arıcı, Serdar; Seçmeler, Şaban; Sakin, Abdullah; Demirel, Cumhur; Can, Orcun; Geredeli, Cağlayan
Objective: Bladder cancers are classified into two groups as urothelial and non-urothelial cancer (NUBC). In this study, we investigated the clinicopathological featuresand treatment responses in patients with NUBC who were diagnosed and treated in our center.Methods: The patients who were diagnosed and treated in our hospital between 2006 and 2017 were included in the study retrospectively. Patients with urothelial ormixed bladder cancers were excluded from the study.Results: A total of 16 patients with NUBC were included in the study. Six patients had squamous cell carcinoma, six patients had small cell carcinoma and four patientshad adenocarcinoma. Thirteen patients (81%) were male and three were female. Although there was no statistically significant difference between the groups in terms oflocalization of metastases (p=0.663), the most common site of metastasis was pelvic structures in squamous cell carcinoma group and multiple distant organ metastasiswere observed in small cell carcinoma group. The median survival in squamous cell carcinoma, adenocarcinoma, and small cell carcinoma was 11±5.3, 12±10, and2±1.8 months, respectively (logrank p=0.329).Conclusion: There are no large prospective randomized clinical studies to guide treatment in NUBC. In the light of these results, we recommend that these patientsshould participate in prospective clinical studies.
Prognostic Significance of Primary Tumor Localization in Stage Ii and Iii Colon Cancer
(Baishideng Publishing Group inc, 2018) Sakin, Abdullah; Arici, Serdar; Secmeler, Saban; Can, Orcun; Geredeli, Caglayan; Yasar, Nurgul; Cihan, Sener
Aim To investigate the effects of tumor localization on disease free survival (DFS) and overall survival (OS) in patients with stage I -III colon cancer. METHODS This retrospective study included 942 patients with stage. and. colon cancer, which were followed up in our clinics between 1995 and 2017. The tumors from the caecum to splenic flexure were defined as right colon cancer (RCC) and those from splenic flexure to the sigmoid colon as left colon cancer (LCC). RESULTS The median age of the patients was 58 years (range: 19-94 years). Male patients constituted 54.2%. The rates of RCC and LCC were 48.4% (n = 456) and 51.6% (n = 486), respectively. During the median follow-up of 90 mo (range: 6-252 mo), 14.6% of patients developed recurrence and 9.1% of patients died. In patients with stage. and. disease with or without adjuvant therapy, DFS was similar in terms of primary tumor localization (stage.; P = 0.547 and P = 0.481, respectively; stage.; P = 0.976 and P = 0.978, respectively). In patients with stage. and. disease with or without adjuvant therapy, OS was not statistically significant with respect to primary tumor localization (stage.; P = 0.381 and P = 0.947, respectively; stage.; P = 0.378 and P = 0.904, respectively). The difference between median OS of recurrent RCC (26 +/- 6.2 mo) and LCC (34 +/- 4.(mo) cases was eight months (P = 0.092). CONCLUSION Our study showed no association of tumor localization with either DFS or OS in patients with stage. or. colon cancer managed with or without adjuvant therapy. However, post-recurrence OS appeared to be worse in RCC patients.