Browsing by Author "Dogan, Mutlu"

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Factors Affecting Survival in Retroperitoneal Sarcomas Treated With Upfront Surgery: a Real-World Study by Turkish Oncology Group
(Akad Doktorlar Yayinevi, 2021) Akagunduz, Baran; Telli, Tugba Akin; Yildirim, Hasan Cagri; Goksu, Sema Sezgin; Demir, Nazan; Hafizoglu, Emre; Dogan, Mutlu
Retroperitoneal sarcomas (RPS) account for approximately 15% of all soft tissue sarcomas (STS) and encompass a heterogeneous group of tumors with limited multimodality treatment options. Surgical resection with negative margins remains the standard primary treatment for patients with localized RPS. In this multicenter study, we aimed to demonstrate the real-world data on factors affecting survival in RPS treated with upfront surgery. We included a total of 197 patients who underwent curative-intent resection of a primary non-metastatic RPS between 2000-2020 at ten experienced medical oncology departments in Turkey. The median follow-up was 33 months. The median age of patients was 53 years, 57.4% of patients were female. Univariate analysis revealed that; tumor size, grade, necrosis, resection margin status, were factors affecting recurrence-free survival (RFS) (p= 0.002, p= 0.044, p= 0,024, p= 0.003 respectively). Age, tumor size, stage, resection margin status were factors affecting overall survival (OS) (p= 0.038, p= 0.001, p= 0.032, p< 0.001, respectively). In multivariate analysis, tumor size and resection margin status were independent factors affecting RFS and OS (all p-values < 0.05). Our study demonstrated that tumor size, and resection margin status were the main factors affecting survival in resected RFS. In comparison, adjuvant chemotherapy (CT), radiotherapy (RT), or multimodality treatment did not show OS and RFS advantages. We believe that advances in the molecular characterization of these tumors might help clinicians to detect the best candidates for adjuvant therapies in RPS.
Prognostic Factors of Perioperative Flot Regimen in Operable Gastric and Gastroesophageal Junction Tumors: Real-Life Data (Turkish Oncology Group)
(Tubitak Scientific & Technological Research Council Turkey, 2022) Erol, Cihan; Sakin, Abdullah; Basoglu, Tugba; Ozden, Ercan; Cabuk, Devrim; Dogan, Mutlu; Sendur, Mehmet Ali Nahit
Background/aim: Perioperative FLOT regimen is a standard of care in locally advanced operable gastric and GEJ adenocarcinoma. We aimed to determine the efficacy, prognostic factors of perioperative FLOT chemotherapy in real-life gastric and GEJ tumors. Materials and methods: The data of patients who were treated with perioperative FLOT chemotherapy were retrospectively analyzed from 34 different oncology centers in Turkey. Baseline clinical and demographic characteristics, pretreatment laboratory values, histological and molecular characteristics were recorded. Results: A total of 441 patients were included in the study. The median of age our study population was 60 years. The majority of patients with radiological staging were cT3-4N(+) (89.9%, n = 338). After median 13.5 months (IQR: 8.5-20.5) follow-up, the median overall survival was NR (95% CI, NR to NR), and median disease free survival was 22.9 (95% CI, 18.6 to 27.3) months. The estimated overall survival at 24 months was 62%. Complete pathological response (pCR) and near pCR was achieved in 23.8% of all patients. Patients with lower NLR or PLR have significantly longer median OS (p = 0.007 and p = 0.033, respectively), and patients with lower NLR have significantly longer median DFS (p = 0.039), but PLR level did not affect DFS (p = 0.062). The OS and DFS of patients with better ECOG performance scores and those who could receive FLOT as adjuvant chemotherapy instead of other regimens were found to be better. NLR was found to be independent prognostic factor for OS in the multivariant analysis. At least one adverse event reported in 57.6% of the patients and grade 3-4 toxicity was seen in 23.6% patients. Conclusion: Real-life perioperative FLOT regimen in operable gastric and GEJ tumors showed similar oncologic outcomes compared to clinical trials. Better performance status, receiving adjuvant chemotherapy as same regimen, low grade and low NLR and PLR improved outcomes in real-life. However, in multivariate analysis, only NLR affected OS.