Browsing by Author "Izmirli, Mustafa"

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Adjuvant Treatment Results and Prognostic Factors in Patients With Stage I-Iii Operated Breast Cancer
(Kare Publ, 2006) Izmirli, Mustafa; Donmez Yilmaz, Binnur; Alan, Omur; Yalciner, Mehmet; Berberoglu, Elif; Unsal, Mustafa
OBJECTIVES We evaluated the adjuvant treatment results and prognostic factors in patients with breast cancer. METHODS A total of 197 stage I-III breast cancer patients (mean age 51; range 18 to 80 years) treated and followed up by Okmeydam Training Hospital, Department of Radiation Oncology in 1995 were evaluated retrospectively. RESULTS The 41.1% of patients were premenopausal and the remaining were postmenopausal. Invasive ductal carcinoma was encountered as the most frequent (85.8%) histopathologic type of tumor and most frequent (%49.7) stage was IIB. Modified radical mastectomy was performed on 65% of patients. In adjuvant treatment, cyclophosphamide-methotrexate-fluorouracil combinations and anthracycline containing combinations were given to 46.7% and 23.4% of patients respectively. In addition, endocrine therapy and radiotherapy was carried out on the 75.6% and 69.0% of patients. Local recurrences was occurred in a rate of 13.2% and distant metastases were observed in a rate of 26.4% and 7.1% of patients had both local recurrences and distant metastases. The 60.9% of patients were disease free and 1% with local recurrences also they were followed-up for a median time of 89 months (4-108). The overall survival rate and disease free survival rates for 5 and 8 years were as follows; 68%, 61%, 66%, and 60% respectively. With one variable analysis increased number of involved axillary lymph nodes, tumor size and stage gave rise to reduced overall survival rate and disease free survival rate. With multiple variable analysis, number of involved axillary lymph nodes (p=0.001) and tumor size (p=0.001) had significant effect on overall survival rate and disease free survival rate. CONCLUSION The tumor size and number of involved axillary lymph nodes were found to be statistically significant prognostic factors in breast cancer patients in our study.
Analysis of Factors Associated With Survival in Advanced Stage Gastric Adenocarcinoma
(Kare Publ, 2005) Alici, Suleyman; Kaya, Serap; Izmirli, Mustafa; Tuncer, Ilyas; Dogan, Ekrem; Ozbek, Hanefi; Sayarlioglu, Hayriye
In this study, 138 patients with high grade gastric adenocarcinoma who were admitted to Yuzuncu Yil University, Medical School, Department of Medical Oncology between September 1999 and April 2002 were retrospectively evaluated in terms of the effects of clinicopathological parameters and treatment approaches on survival by single and multiple variable analyses. Patients histopathologically diagnosed as gastric adenocarcinomas with stage IV M0 (without distant organ metastasis) or stage IV M1 (with distant organ metastasis) were included in the study. Mean age of the patients was 61.1 (34-84), 64.6% male and 35.5% female. The ratio of patients with a performance score of 2-3 was 55%. The BMI was below 20 in 53.6% of the patients. According to histological grading, 41.9% of patients had indifferentiated adenocarcinoma, mucinous cell adenocarcinoma or signet ring cell adenocarcinoma. 84% of patients were clinically at stage IV M1. The percentage of patients with tumor localized upper 1/3 of stomach was 60.8%. While 19.6% of patients had received surgical treatment, 47% of the patients had received chemotherapy as adjuvant or paliative purposes. The percentage of the patients who responded to the therapy (complete response + partial response + stable response) was 39% and the percentage of patients who had progression was 7.2%. Overall median survival time was 3.1 months and three years survival rate was 8%. At single variable analysis, BMI, clinical stage, surgery, type of surgery and serum level of albumin were significant prognostic factors related to overall median survival time. Gender, clinical stage, surgery, type of surgery, hemoglobine concentration and serum level of albumin were found to be significant prognostic factors related to survival without progression (p<0.05). The factors found to be significant related to overall survival rate in single variable analysis were reevaluated in multiple variable analysis. No surgical treatment, paliative surgery (compared to radical surgery), BMI below 20 were found to be the statistically significant poor prognostic factors related to survival. The factors found to be significant related to survival without progression in single variable analysis were evaluated in multiple variable analysis and no surgical treatment (compared to surgery), male gender (compared to female) were found to be statistically significant poor prognostic parameters. In terms of both overall survival and survival without progression, whether performing surgery or not was statistically most significant independent prognostic factor. In conclusion, no surgical treatment, paliative surgery instead of radical surgery, and BMI below 20 on first admission were determined as poor prognostic factors related to survival in patients with high grade gastric adenocarcinoma.
Analysis of Survival Factors in Patients With Advanced-Stage Gastric Adenocarcinoma
(int Scientific information, inc, 2006) Alici, Suleyman; Kaya, Serap; Izmirli, Mustafa; Tuncer, Ilyas; Dogan, Ekrem; Ozbek, Hanefi; Sayariloglu, Hayriye
Background: Prognosis in patients with gastric cancer is determined by the tumor itself, as well as certain patient-related factors. Material/Methods: In this study, 138 patients with high-grade gastric adenocarcinoma who were admitted to our hospital between September 1999 and April 2002 were retrospectively evaluated in terms of the effects of clinicopathological parameters and treatment approaches on survival by single and multiple variable analyses. Patients histopathologically diagnosed as having gastric adenocarcinomas with stage IV M-0 (without distant organ metastasis) or stage IV M-1 (with distant organ metastasis) were included in the study. Results: Overall median survival time was 3.1 months and three-year survival rate was 8%. With single variable analysis, body mass index (BMI), clinical stage, surgery, type of surgery, and serum level of albumin were significant prognostic factors related to overall median survival time. Gender, clinical stage, surgery, type of surgery, hemoglobin concentration, and serum level of albumin were found to be significant prognostic factors related to survival without progression (p < 0.05). No surgical treatment, palliative surgery (compared with radical surgery), and BMI below 20 were found to be the statistically significant poor prognostic factors related to survival in multiple variable analysis. In terms of both overall survival and survival without progression, performing surgery or not was statistically the most significant independent prognostic factor. Conclusions: No surgical treatment, palliative surgery instead of radical surgery, and BMI below 20 on first admission were determined as poor prognostic factors related to survival in patients with high-grade gastric adenocarcinoma.
Cancer Statistics of Ssk Okmeydani Training and Research Hospitals Department of Oncology From 1999 To 2004
(Kare Publ, 2007) Izmirli, Mustafa; Altin, Suleyman; Dernek, Berna Olcum; Unsal, Mustafa
OBJECTIVES In this study, we evaluated the cancer incidence and demographic characteristics in people have social insurance after from digital registration date. Evaluation was done using 6 years data after that time. METHODS We investigated the 52.214 patients having diagnosed as cancer between 1st January 1999 and 31st December 2004. Final diagnosis was evaluated with considering he patient's age, sex, admit time, county, and stage of illness. RESULTS 28.830 patients were males (55.2%) and 23.384 were females (44.86%) an median age at the time of admission was 56 (range 098). The frequency of disease was 0.7% in 0-14 years old age group, 20.5% 15-44 years old age group, 24.3% 45-54 years old age group, 27.1% 55 to 64 years old age group, and 27.4% 65 years and older age group. The 81.7% of the cases were having with local-regional disease and the remaining 18.3% were having distant metastasized disease. The detected most frequent 10 types of cancer were as follows; lung cancer 22.1%, breast cancer 15.2%, colorectal cancer 8.6%, gastric cancer 6.0%, thyroid cancer 4.0%, non-Hodgkin lymphoma 3.7%, central nervous system cancers 3.5%, ovary cancer 2.7%, corpus uteri cancer 2.5%, and larynx cancer 2.5%. The most frequent 5 cancers only for females were breast (33.4%), colorectal (8.3%), thyroid (6.9%), ovary (6.0%), and corpus uteri cancer (5.5%), and for males lung (36.1%), colorectal (8.8%), stomach (7.2%), larynx cancer (4.1%) and non-Hodgkin lymphoma (4.0%). The number of patients showed significant increase from 1999 (7.014) to 2004 (10.823). CONCLUSION We present the statistical data for cancer patients who admitted to the SSK Okmeydani Training and Research Hospital Department of Radiation Oncology before the time of revolution from SSK to Healthy ministry. That data can give us some opinion for frequency of cancer in Marmara and west of Karadeniz region.
Catalase, Carbonic Anhydrase and Other Biochemical Parameters in Esophageal Cancers in Turkey
(Asian Pacific Organization Cancer Prevention, 2010) Demir, Halit; Akkus, Zeynel Abidin; Cebi, Aysegul; Cakir, Tahir; Izmirli, Mustafa
Purpose: The main aim of our investigation is to show possible changes in antioxidant balance and selected biochemical parameters in esophageal cancers. Materials and Methods: This study was performed for the determination of levels in 25 patients diagnosed as having cancer in the Yuzuncu Yil University (Medical Oncology) and 15 healthy volunteers at same department with negative cancer signs. Results: The activity levels of catalase of sick and health groups were 33.8 +/- 4.31 (EU/gHg)(-1), 122.4 +/- 31.7 (EU/gHg)(-1), respectively. Th differance between the average levels was significant (p<0.001). CA (carbonic anhydrase) activity was 2.19 +/- 0.12 (EU/gHg)(-1), 2.46 +/- 0.32 (EU/gHg)(-1) in groups at same order with no statistical significance (p>0.05). The levels of albumin, globulin, ferritin, ALT, LDH, glucose, CRP, AST and uric acid were also determined in sick and healthy groups: 4.04 +/- 0.24, 4.04 +/- 0.43 gr/dl (p>0.05); 4.46 +/- 0.82, 3.17 +/- 0.10g/dl (p>0.05); 175.4 +/- 29.1, 260.4 +/- 15.45g/dI (p<0.001); 12.7 +/- 1.13, 19.5 +/- 1.91 ng/ml (p<0.001); 317.6 +/- 13.8, 298.0 +/- 12.1 mg/dl (p>0.05); 106.5 +/- 12.1, 89.7 +/- 2.2 (p>0.05), 5.94 +/- 1.04, 4.41 +/- 0.28 U/L (p>0.05); 19.4 +/- 1.68, 19.5 +/- 1.91 mg/dl (p>0.05); 30.0 +/- 3.24, 10.5 +/- 0.64 mg/dl (p<0.01) respectively. Conclusions: Consequently, in diagnosis of esophageal cancer, CA, CRP, uric acid and antioxidant examinations may be very important factors. Additional studies are needed to further address this important issue.
The Comparison of Brain and Lens Doses in Whole Brain Radiotherapy With Different Treatment Plannings
(Akad Doktorlar Yayinevi, 2009) Ugurluer, Gamze; Izmirli, Mustafa; Palamik, Zehra A.; Cakir, Tahir
The aim of study was to evaluate the effects ontarget volume (brain) and lens doses with different treatment plannings in patients who received whole brain radiotherapy because of brain metastases. The system tomography scans of 14 patients at 0.5 cm intervals, were transferred to three-dimensional treatment planning computer and the normal tissues and target volumes were outlined. Seven different treatment plannings were done for each patient. Plan I: Angled blocked plan; Plan II: Non-angled blocked plan; Plan III: Helmet plan; Plan IV: Blocked plan with the inferior border at the inferior orbital ridge; Plan V: Angled unblocked plan; Plan VI: Non-angled unblocked plan; Plan VII: Conventially planned non-angled unblocked plan. Brain and lens minimum, maximum and mean doses and brain V95 and D95 doses were recorded for each plan using dose-volume histograms. When the plans were compared according to the brain minimum, mean, V95 and D95 doses, it was observed that the doses in Plan VII were lower than the others (mean 1171.57 cGy, mean 3294.64 cGy, 97.48% and mean 2990.57 cGy respectively, p < 0.05). When the plans were compared according to the lens doses, the minimum, maximum and mean doses were higher in the unblocked plans (p < 0.05). It was seen that with the angling of beams five degrees to the posterior the lens doses decreased (p < 0.05). This study shows that using 3 dimensional treatment planning, brain minimum doses increases and the dose inhomogenity decreases, and lens doses decreases using customized blocks and angling of beams five degrees posteriorly.
Epidemiologic Evaluation of the Patients Admitted To Department of Medical Oncology, Yuzuncu Yil University, Medical Faculy
(Kare Publ, 2006) Alici, Suleyman; Izmirli, Mustafa; Dogan, Ekrem
OBJECTIVES In this study the aim was to evaluate the cancer incidence, tumour and patient characteristics in Lake Van region by using the registry data of Medical Oncology Department. METHODS Patients (861 males (54.4%); 723 females (45.6%) [man to female ratio was 1.19]; mean age 53; range 14 to 90 years) admitted to Department of Medical Oncology, Ytiztincti Yil University and having diagnosed as cancer (n=1584) between lth January 2001 and 31th December 2004, were evaluated retrospectively. The disease was seen most frequently (23.8%) in 51 to 60 years old age group, also 70.5% of all cases were within the age range of 41-70. The 43.6% of the cases were having local-regional and 56.4% were having metastasized disease. RESULTS When all patients considered the most frequent five types were as follows; gastric cancer 26.5%, esophagus cancer 15.8%, breast cancer 9.5%, colorectal cancer 7.6% and lung cancer 6.4%. When evaluated for gender the most frequent five cancers for women were breast (19.8%), stomach (19.6%), esophagus (19.2%), colorectal (7.3%) and over (5.5%), for men stomach (32%), esophagus (13%), lung (9.3%), colorectal (7.9%), and lymphoma (5.4%). When considered for the systems the most frequent cancer localizations were gastrointestinal system (56.6%), breast (9.5%), lung (6.4), lymphoma (5%) and urologic (4.8% ). CONCLUSION Upper gastrointestinal system tumors are more frequent in Lake Van region for both man and women. Etio-pathologic studies are needed for this difference.
Expression of Cd44s in Advanced Stage Esophageal Squamous Cell Carcinomas and Other Clinicopathological Prognostic Factors
(Akad Doktorlar Yayinevi, 2009) Izmirli, Mustafa; Bayram, Irfan; Senol, Serkan; Ilhan, Mahmut
CD44s is an adhesion molecule which is a member of the cell adhesion molecules family hyaladherins. CD44s has some effects including tumor-endothel interaction, cell motility and migration, cell adhesion and tumor invasion, tumor progression, and metastasing. In this study, we aimed to evaluate the CD44s expression and some other prognostic factors in patients with esophageal squamous cell carcinoma. Between 1999 and 2004, pathological specimens of 35 patients were examined by the Yuzuncu Yil University (YYU) Medical Faculty, Pathology Department and other clinical and laboratory findings were collected from Oncology Department patient files. CD44s staining was positive in 32 patients and negative in 3. The intensity of stained CD44s was positive in 30 and negative in 5 patients. Thirteen patients were well-differentiated, 18 were mid-differentiated, and 4 were poorly differentiated. Inflamatuary reactions were observed in 23 cases. The median survival was 5.3 months and the one year, two year and five year survival rates were 34.2%, 8.6% and 2.9% respectively. Treatment modality, clinical stage and tumour size at the diagnosis time was significant at univariate analysis and only treatment modality was significant in multivariate analysis. Very high CD44s expression was observed in sq cell osephageal cancer patients. CD44s may be an important marker in prognosis. Treatment modality was found as an independent factor on prognosis of osephageal cancer.
Prognostic Factors and Cox-2 Expression in Advanced Stage Esophageal Squamous Cell Carcinoma
(Springer, 2006) Alici, Suleyman; Ugras, Serdar; Bayram, Irfan; Izmirli, Mustafa
Cyclooxygenase-2 (COX-2) is overexpressed in various types of human malignancies, including squamous cell carcinomas of the esophagus, but its clinicopathologic role in esophageal squamous cell carcinoma (ESCC) remains unclear. The aim of this study was to analyze expression of COX-2 in ESCC and to correlate this expression with clinicopathologic parameters and survival. From 1999 to 2003, endoscopic tissue samples from 110 patients with ESCC were collected for analysis. COX-2 expression was examined through immunohistochemical staining. Clinicopathologic data were analyzed to verify significance. COX-2 expression was detected in 50 of 110 ESCC specimens (45%). COX-2 expression was negative to weak in 73% (COX-2 low) and moderate to strong in 27% (COX-2 high) of tumors. Statistical differences between COX-2 high and COX-2 low were found according to status of the stage (stage IVM1a/IVM1b) (P=.001): cancer antigen (CA) 19-9 (normal/high) (P=.011), CA 12-5 (normal/high) (P=.011), and CA 15-3 (normal/high) (P=.035). Survival was significantly reduced among patients with high COX-2 expression (median overall survival, 3 mo) when compared with the COX-2 low group (median overall survival, 6 mo) (P=.0001). In the univariate analysis, age, body mass index, stage, COX-2, lactate dehydrogenase, CA 12-5, and CA 15-3 were significant factors for survival. With the use of COX regression analysis, only stage (P=.000), COX-2 (P=.000), lactate dehydrogenase (P=.023), and CA 15-3 (P=.002) were independent prognostic factors. Results showed that in patients with ESCC, COX-2 overexpression was significantly correlated with visceral metastases (IVM1b). COX-2 overexpression is an unfavorable prognostic factor in ESCC.
The Results of Palliative Intensive Hypofractionated Radiotherapy From Patients Having Brain Metastases With Unknown Primary Tumour
(Kare Publ, 2006) Izmirli, Mustafa; Altin, Sulayman; Buyukpolat, M. Yakup; Adatepe, M. Ferhan; Unsal, Mustafa
OBJECTIVES We retrospectively examined the results of hypofractionated radiotherapy from 24 patients having brain metastases with unknown primary. METHODS Radiotherapy was administered to 24 patients (20 males (83.4%), 4 females (16.6%), age range 24-75 years) as 10 Gy fraction doses with 10 days intervals for a total of 30 Gy tumour dose in 3 fractions. Antiedema treatment was given to all patients. Karnofsky performance status was 70 for one patient and below 70 for the rest of the patients. Multiple metastases were present in 79.2% of the patients, in 20.8% of the patients there was single lesion and histophatologic diagnosis was present only for this group. 50% of the patients had hemiplegia, 45.8% had hemiparesia, 4.2 % had quadriplegia and 6 patients (25%) had other additional pathologies. Treatment was started at the day of admission for 13 patients. RESULTS The total and partial reliefs in neurological symptoms were seen in 8.3% and 37.5% of patients, respectively. Median survival from diagnosis of brain lesions was 2.87 months. The six months, 1 and 2 years survival rates were 33.3%, 8.33%, and 8.33%, respectively. The prognosis of patients with brain metastases is poor and have similar survival rates from the other poor performance patients (KPS<70). CONCLUSION As a conclusion, short course hypofractionated radiotherapy might be adviced to the patients with poor prognosis.
A Retrospective Analysis of Prognostic Factors and Treatment Results of Gastric Adenocarcinomas Treated With Postoperative Chemoradiotherapy
(Kare Publ, 2014) Izmirli, Mustafa; Kilic, Kubra; Yilmazer, Gokhan; Nart, Maruf
OBJECTIVES This retrospective study aimed to evaluate effects of various factors on survival in patients living in the basin of Lake Van who were diagnosed with gastric cancer, and given postoperative chemoradiotherapy (CRT). METHODS One hundred and four patients with gastric adenocarcinoma w ho received adjuvant CRT were evaluated retrospectively. RESULTS The median overall survival time was 28.30 months, and 3-year and 5-year median survival rates were 47.6% and 33.6%, respectively. The median disease-free survival, however, was 23.97 months, and 3-year and 5-year disease-free survival rates were 38.1% and 26.2%, respectively. Regarding with the evaluation of various prognostic factors, the number of involved lymph nodes (LN) and positive surgical margins for overall survival; the performance status for disease-free survival; and the rate of LN involvement along with the number of chemotherapy treatments >= 3 for both disease-free survival and overall survival were determined statistically significant via univariate analysis. In multivariate analysis, positive surgical margins, the number of involved LNs and the rate of LN involvement were defined statistically significant for overall survival, whereas no parameter was determined statistically significant for disease-free survival. CONCLUSION An improvement in overall survival and disease-free survival has been achieved with the treatment of adjuvant CRT in patients with gastric cancers.
Rheumatoid Arthritis and Pulmonary Carcinoid Tumor
(Modestum Ltd, 2005) Sayarlioglu, Mehmet; Izmirli, Mustafa; Uzun, Kursat; Alici, Suleyman; Erkoc, Reha
A 40-yearold woman was admitted with a history of elbow, wrist, knee pain and prolonged morning stiffness. Rheumatoid arthritis (RA) diagnosed before five years, had been treated with non-steroidal anti-inflammatory agents and low dose corticosteroid. On hospital admission, routine chest x-ray showed a 4x4 cm solitary mass in the right pulmonary. A diagnostic thoracotomy was performed. The histological examination showed a typical carcinoid tumor. This is the third carcinoid tumor case reported to be associated with RA.
Whole Brain Radiotherapy Results of Patients With Brain Metastases and Investigation of Their Prognostic Factors
(Kare Publ, 2014) Yilmazer, Gokhan; Nart, Maruf; Izmirli, Mustafa; Yavuz, Alpaslan; Can, Alper
OBJECTIVES To assess the survival ratios of patients with brain metastasis after whole brain radiotherapy according to recursive partitioning analysis (RPA) classification and other prognostic factors. METHODS Whole brain radiotherapy results and prognostic factors of 62 patients with brain metastasis were studied retrospectively. RESULTS The median survival rate in our study was 6.9 months. Single variation analysis demonstrated statistically significant survival results independently in female patients, with Karnofsky performance scale value of 70 and over, patients with controlled primary disease, RPA class I, and diagnosed with breast cancer (p<0.05). The results obtained from multi-variation analysis demonstrated statistically significant survival results among female patients, patients with an age of 65 years old and below as well as patients with solitary metastasis and who had undergone surgery (p<0.05). CONCLUSION Prognostic factors of patients must be considered in the treatment of brain metastases by selecting the most suitable process through radiosurgical, surgical resection, and/or whole brain radiotherapy.