Browsing by Author "Sahin, Suleyman"

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Assessment of Pretreatment Albumin-Bilirubin Grade in Pancreatic Cancer Patients With Liver Metastasis
(Imprimatur Publications, 2020) Sakin, Aysegul; Sahin, Suleyman; Sakin, Abdullah; Atci, Muhammed Mustafa; Yasar, Nurgul; Arici, Serdar; Cihan, Sener
Purpose: This study aimed to assess the effect of pretreat- ment albumin-bilirubin (ALBI) score on treatment outcomes in pancreatic cancer (PC) patients with liver metastasis at the time of diagnosis treated with chemotherapy (CT) in the first-line setting. Methods: This was a retrospective study of 273 PC patients >= 18 years of age who had liver metastasis at the time of diagnosis and received CT in the first-line. ALBI score was calculated through the following formula; [(log10 bilirubin (mu mol/L)x0.66)+[albumin(g/l)x-0.0852]. Patients were strati- fied into 3 categories based on the ALBI score as follows; grade I:ALBI <=-2.60, grade II:-2.60-1.39. Results: A total of 273 patients, [180 (65.9%) men and 93 (34.1%) women], were evaluated. The median age was 60 years. ALBI grade was I in 45 (16.4%) patients, II in 156 (57.1%) patients, and III in 72 (26.5%) patients. Based on the ALBI grade, median progression-free survival (mPFS) was 9 months in grade I patients, 6 months in grade II patients, and 4 months in grade III patients (p=0.002), with median overall survival (mOS) durations of 12 months vs. 8 months vs. 5 months, respectively (p<0.001). Multivariate analysis showed that ALBI grade II (HR,1.543) or III (HR,2.260) negatively affected survival. Conclusion: A higher pretreatment ALBI grade is related to worse OS and PFS in PC patients with liver metastasis treated with a first-line CT, and therefore it can help predict the treatment outcomes in these patients.
Combination of Trastuzumab and Taxane-Containing Intensified Chemotherapy in First-Line Treatment of Her2-Positive Advanced Gastric Cancer
(Sage Publications Ltd, 2021) Gurbuz, Mustafa; Akkus, Erman; Sakin, Abdullah; Urvay, Semiha; Demiray, Atike Gokcen; Sahin, Suleyman; Cay Senler, Filiz
Purpose: Taxane-containing combinations are recommended for the first-line therapy of advanced gastric cancer. It is not known which chemotherapy regimen is the best with trastuzumab for HER2-positive patients. The aim of this study was to compare taxane-containing intensified chemotherapy versus standard chemotherapy in combination with trastuzumab in the first-line treatment of HER2-positive advanced gastric adenocarcinoma. Methods: This study is a retrospective multicenter study of the Turkish Oncology Group. A total of 130 HER2-positive patients with inoperable locally advanced, recurrent, or metastatic gastric adenocarcinoma being given chemotherapy plus trastuzumab as the first-line treatment were included from 16 different oncology centers. Trastuzumab combination with intensified chemotherapy including taxane or standard chemotherapy was compared in terms of progression-free survival (PFS), overall survival (OS), and toxicity. Results: There were 108 patients in the standard and 22 patients in the intensified chemotherapy group. PFS of the standard and intensified group were 5.6 months (95% confidence interval [CI] 4.8-6.4) and 5.3 months (95% CI 2.6-8), respectively (p = 0.70). OS of the standard and intensified group were 11.1 months (95% CI 8.3-13.9) and 15.2 months (95% CI 12.7-17.7), respectively (p = 0.03). Repeated analysis excluding patients given any previous therapy revealed similar results. The intensified group had more fever and febrile neutropenia. Conclusion: Trastuzumab combination with intensified chemotherapy provides better OS in first-line treatment of HER2-positive advanced gastric cancer. Further large-scale studies should be performed in HER2-positive patients.
The Comparison of Flot Vs. Mdcf Regimens in Neoadjuvant Setting for Locally-Advanced Gastric Cancer
(2023) Urun, Muslih; Sahin, Suleyman; Ürün, Yonca Yılmaz; Sakin, Abdullah
Objectives: To compare the pathological tumor response and survival of mDCF (modified docetaxel+cisplatin+5- flourosil) vs. FLOT (5-flourosil+oxaliplatin+dosataxel) regimens in the neoadjuvant setting for patients with locally- advanced gastric adenocarcinoma. Methods: A total of 72 patients, 44 males and 28 females, who were diagnosed with locally-advanced gastric adeno- carcinoma and treated with neoadjuvant chemotherapy were included. Postoperative pathological tumor response, disease free survival (DFS) and overall survival (OS) were compared between the two treatment groups (FLOT and mDCF group). Results: Median DFS was 19.0 months in the FLOT arm (long rank p=0.218), while median DFS could not be reached in the mDCF arm. Rate of DFS in 6, 12,18 and 24 months were 95,4%, 80,9%, 63% and 42% in FLOT group, respectively. In mDCF group, rate of DFS in 6, 12, 18 and 24 months were 100%, 88%, 71,2% and 62,2%, respectively. Median OS was not reached in both groups (long rank p=0.514). There was no significant difference between the treatment regimens (mDCF and FLOT) in terms of response to the treatment, DFS, and OS. Conclusion: Since no significant difference was observed between the regimens in terms of treatment response and survival, we think that cisplatin can be preferred instead of oxaliplatin as a part of neoadjuvant treatment regimen in elderly patients with diabetic neuropathy or high risk of neuropathy.
The Effect of Body Mass Index on Treatment Outcomes in Patients With Metastatic Non-Small Cell Lung Cancer Treated With Platinum-Based Therapy
(Routledge Journals, Taylor & Francis Ltd, 2021) Sakin, Aysegul; Sahin, Suleyman; Mustafa Atci, Muhammed; Yasar, Nurgul; Demir, Cumhur; Geredeli, Caglayan; Cihan, Sener
To investigate the effect of body mass index(BMI) on treatment outcomes and side-effect profile in metastatic non-small cell lung cancer(NSCLC) patients receiving platinum-based chemotherapy(ChT) in the first-line setting. This was a retrospective analysis of 233 NSCLC patients who were treated and followed up from 2008 through 2018. NSCLC patients who had metastatic disease at the time of diagnosis and were treated with platinum-based ChT in the first-line setting were included. The patients were divided into 2 groups based on the BMI as follows; BMI < 25 kg/m(2)and BMI >= 25 kg/m(2). This retrospective analysis enrolled 233 patients, 35 (15.0%) of whom were female. The BMI in 132 patients (56.2%) was < 25 kg/m(2). The median age was 58 years (range, 21-90). Median progression-free survival(PFS) was 7 mo, in the patients with BMI >= 25 kg/m(2)compared to 5.0 mo, in those with BMI < 25 kg/m(2)(p = 0.032), with corresponding median overall survival(OS) durations of 12 vs. 9 mo, (p = 0.003). In multivariate analysis, ECOG PS 2, grade III histology, and brain or bone metastasis negatively affected OS, whereas BMI >= 25 kg/m(2)positively affected OS. A high BMI prior to therapy in patients with NSCLC treated with platinum-based ChT in the first-line setting was associated with more favorable PFS and OS.
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.
The Evaluation of Efficacy and Tolerability of Gemcitabine Vs. Capecitabine Therapy in the Second-Line Setting for Metastatic Pancreatic Cancer Patients With Poor Performance Status
(2019) Yasar, Nurgul; Sakin, Abdullah; Cihan, Şener; Geredeli, Caglayan; Atcı, Muhammed Mustafa; Sahin, Suleyman; Demir, Cumhur
Aim: The aim of this study was to evaluate the efficacy and tolerability of single-agent gemcitabine vs.capecitabine therapy in the second-line setting for metastatic Pancreatic Cancer (mPC) patients withpoor performance status.Material and methods: A total of 48 patients with mPC, who were followed and treated in oncologycenter between 2012 and 2017, were included. After a failure of first-line therapy, patients with an ECOGPS 2 treated with capecitabine or gemcitabine monotherapy in the secondline setting were retrospectively analyzed.Results: Of the 48 patients, 26(54.2%) were males and 22(45.8%) were females. The median age of thepatients was 62 years(range, 31-82). Treatment regimens in the first-line setting were as follows;gemcitabine+cisplatin in 24(50%) patients, gemcitabine+nub-paclitaxel in 4(8.3%) patients, FOLFIRINOXin 8(16.7%) patients, FOLFOX in 8(16.7%) patients, and gemcitabine+oxaliplatine in 4(8.3%) patients. Afterprogression on first-line therapy, 29(60.5%) patients were treated with capecitabine in the second-linesetting, while 19(39.5%) patients were given gemcitabine. Median progression-free survival was found tobe 4 months(95% CI,1.9-6.0) in patients receiving capecitabine compared to 2 months(95% CI, 0.5-3.4) inthose treated with gemcitabine (p¼0.271). Median overall survival was 6.0 months(95% CI, 2.0-9.9) inpatients receiving capecitabine therapy versus 5.0 months (95% CI, 1.0-8.9) in those treated with gemcitabine monotherapy (p¼0.353).Conclusions: Optimal second-line treatment for mPC has not yet been established. In the present study,capecitabine monotherapy was compared to gemcitabine and it was found that they both had similarefficacy in the second-line treatment for mPC patients who were not eligible for combination chemotherapy regimen.
Factors Affecting Survival and Treatment Efficacy in Breast Cancer Patients With Bone Marrow Metastasis
(Wiley-hindawi, 2020) Sakin, Abdullah; Sakalar, Teoman; Sahin, Suleyman; Yasar, Nurgul; Demir, Cumhur; Geredeli, Caglayan; Cihan, Sener
Factors Affecting Survival in Esophageal Squamous Cell Carcinoma: Single-Center Experience
(Kare Publ, 2020) Sakin, Abdullah; Urun, Yonca Yilmaz; Sahin, Suleyman; Atici, Muhammed Mustafa; Arici, Serdar; Geredeli, Caglayan; Cihan, Sener
OBJECTIVE: Squamous cell esophageal cancer (ESCC) is a highly fatal malignancy. This study aims to investigate the factors affecting survival in patients with metastatic and non-metastatic ESCC. METHODS: Between 2008 and 2016, 107 patients with ESCC who were followed up in an oncology clinic were included in the analysis. Patients were grouped based on the stage of disease as clinical-stage II to IV. RESULTS: Of the 107 patients, 55 (55.1%) of them were male and 52 (48.6%) of them were female. The mean age was 60.8 years. Based on the clinical-stage, 28 (26.2%) patients had stage II disease, 33 (30.8%) had stage III disease, and 46 (43.0%) had stage IV disease. Twenty-nine (27.1%) patients with the non-metastatic disease underwent surgery following neoadjuvant chemoradiotherapy (CRT), while 29 (27.1%) patients received definitive CRT. Twenty-six (56.5%) patients with metastatic disease received chemotherapy (CT). While median overall survival (mOS) could not be reached in patients who underwent surgery following neoadjuvant CRT, mOS for patients receiving definitive CRT versus patients treated with surgery alone-was 22.0 months and 24.0 months, respectively (p=0.008). In the metastatic stage, mOS was 8.0 months for the patients treated with a first-line CT and 3.0 months for patients receiving best supportive care (p<0.001). In multivariate analysis, factors predicting survival in patients with the non-metastatic disease were ECOG PS 3-4 (Hazard ratio [HR], 6.13), undergoing surgery (HR, 0.22), clinical-stage III disease (HR, 3.19), and presence of recurrence (HR, 24.12). For patients with metastatic disease, ECOG PS 3-4 (HR, 3.31), grade-III histology (HR, 3.39), liver metastasis (HR, 2.53), and receiving CT (HR, 0.15) were the factors associated with survival in multivariate analysis. CONCLUSION: In our study, surgery and early clinical-stage increased survival, whereas experiencing recurrence adversely affected survival in non-metastatic ESCC. In the metastatic stage, ECOG PS 3-4, grade-3 histology and liver metastasis adversely affected survival, while receiving CT significantly improved survival.
Factors Affecting Survival in Operated Esophageal Squamous Cell Carcinoma
(Springer, 2022) Akgul, Nida; Sakin, Abdullah; Sahin, Suleyman; Aldemir, Mehmet Naci; Aytekin, Aydin; Alay, Murat; Kotan, Mehmet Cetin
Purpose Esophageal squamous cell carcinoma (ESCC) is an extremely fatal and relatively rare gastrointestinal system malignancy. This study aimed to investigate the factors affecting survival in operated patients with ESCC. Materials and Methods We included 110 patients (38 [34.5%] male; 72 [65.5%] female) aged >= 18 (median age, 54 [26-77]) years who were operated without any signs of metastases and followed up at Van Yuzuncu Yil University Dursun Odabasi Medical Center between 2004 and 2019. Results Initially, 39 (35.5%) patients were clinical lymph node-positive and 71 (64.5%) patients were negative. Thirty-five (31.8%) patients underwent surgery after neoadjuvant chemoradiotherapy (nCRT), and 75 (%68.2) patients underwent direct surgery without nCRT. Five-year overall survival (OS) was 84.4% and 59.2% in patients who underwent surgery after nCRT and in those who underwent direct surgery, respectively. Median OS was significantly longer in patients who underwent surgery after nCRT (p = 0.003). There was a statistically significant difference in OS in patients who underwent surgery after nCRT depending on tumor response (p = 0.04). In multivariate analysis, advanced pathologic stage (p = 0.002) adversely affected survival, whereas nCRT administration (p = 0.031) positively affected OS. Conclusion We suggest that nCRT should be administrated before surgery, especially in locally advanced ESCCs. In addition, we believe that nCRT response can be used as a good parameter for survival. These results, however, should be supported by prospective studies.
Factors Affecting Survival in Operated Gastric Cancer
(Elsevier Sci Ltd, 2023) Sakin, Aysegul; Sahin, Suleyman; Sakin, Abdullah; Aldemir, Mehmet Naci; Sakoglu, Nevin; Bayram, Irfan; Kotan, Mehmet Cetin
In this study, our aim was to determine the possible effects of Helicobacter pylori (HP), chronic atrophic gastritis (CAG), and gastrointestinal metaplasia (GIM) on survival in operated bowel type gastric cancer patients (INTGC). Among 548 patients, 347(63.3%) were male. The median age was 57 years. Disease-free survival (DFS) and overall survival (OS) were significantly shorter in patients with GIM than those in patients without GIM (log rank, P = 0.003 and log rank P = 0.003, respectively). Multivariate analysis showed that presence of GIM (HR, 2.1) was found to be an independent factor of worse DFS. In our study, stage pIII patients with GIM had significantly shorter DFS and OS than those without GIM (log rank p = 0.008 and log rank p = 0.001, respectively). However, in subgroup analysis of patients with GIM, there was no significant DFS and OS difference between patients with stage pI and pII disease (log rank p = 0.999, log rank p = 0.184 vs. log rank p = 0.409, log rank p = 0.281, respectively).
Factors Affecting Survival in Operated Pancreatic Cancer: Does Tumor Localization Have a Significant Effect on Treatment Outcomes
(Kare Publ, 2020) Sakin, Abdullah; Sahin, Suleyman; Sakin, Aysegtil; Atci, Muhammed Mustafa; Arici, Serdar; Yasar, Nurgul; Cihan, Sener
OBJECTIVE: This study aims to investigate the factors affecting survival in operated pancreatic ductal adenocarcinoma (PDAC) and the possible prognostic effect of primary tumor localization on treatment outcomes. METHODS: In this study, 98 patients with curatively-operated PDAC, who were followed up and treated for the years 2008 through 2018, were enrolled. Metastatic and locally advanced stages and patients under 18 years of age were excluded from this study. Patients were divided into two groups based on the primary tumor localization as *head or *body/tail. RESULTS: Sixty-seven (68.3%) patients were male and 31 (31.7%) were female, with a median age of 62 years (range, 35-82 years). The numbers of patients with a primary tumor located in *head vs.*body/tail were 74 (75.4%) vs. 24 (24.6%), respectively. Patients with a primary tumor located in *head vs.*body/tail; median disease-free survival was 16.0 months vs. 13 months (p=0.972), respectively, with corresponding median overall survival was 25 months vs. 33 months (p=0.698). The level of carcinoembryonic antigen(CEA) at diagnosis (Hazard ratio[HR], 1.09 95%CI, 1.01-1.18), stage III disease (HR, 2.09 95%CI, 1.16-4.35), and receiving adjuvant treatment (HR, 0.20 95%CI, 0.09-4.34) were the independent predictors of survival. CONCLUSION: Our study revealed that high levels of CEA at diagnosis and stage III disease adversely affected the survival in non-metastatic PDAC patients, while receiving adjuvant therapy had a positive effect on survival. The findings suggest that primary tumor localization did not affect survival in operated PC patients. The results on this issue are still inconsistent and under debate in the literature.
Factors Affecting Survival in Patients With Isolated Liver-Metastatic Colorectal Cancer Treated With Local Ablative or Surgical Treatments for Liver Metastasis
(Imprimatur Publications, 2019) Sakin, Abdullah; Sahin, Suleyman; Atci, Muhammed Mustafa; Yasar, Nurgul; Geredeli, Caglayan; Aribal, Serkan; Cihan, Sener
Purpose: Local treatments for isolated synchronous or metachronous liver metastases in colorectal cancer (CRC) have been shown to improve overall survival (OS). The aim of this study was to investigate the factors affecting OS in CRC patients with isolated liver metastasis in whom the primary tumor and corresponding liver metastasis were treated with curative intent using local ablative or surgical methods. Methods: A total of 47 CRC patients presenting with an initial or subsequent isolated liver metastasis, who were treated with local surgical or ablative treatment for liver metastasis with curative intent, were enrolled in this study between 2007 and 2017. The possible factors affecting OS were analyzed. Results: Out of the 47 patients, 35 (74.5%) were male. The median age was 61 (25-80) years. Thirty-four (72.3%) patients underwent liver metastasectomy, while 13 (27.7%) patients were treated with non-surgical local ablative therapies (NSLAT) for liver metastasis. Median OS (mOS) could not be reached in patients who underwent metastasectomy at the time of diagnosis compared to 55 months in those undergoing metastasectomy following a chemotherapy period (p=0.03). Patients treated with NSLAT had a mOS of 60 months compared to "not reached'' in those who underwent liver metastasectomy (p=0.45). mOS was higher in patients with pT4 stage vs.
The Impact of Tumor Regression Grade on Long-Term Survival in Locally Advanced Rectal Cancer Treated With Preoperative Chemoradiotherapy
(Sage Publications Ltd, 2020) Sakin, Abdullah; Sahin, Suleyman; Sengul Samanci, Nilay; Yasar, Nurgul; Demir, Cumhur; Geredeli, Caglayan; Cihan, Sener
Purpose The aim of this study is to investigate the prognostic effect of tumor regression grade (TRG) on long-term survival in locally advanced rectal cancer treated with preoperative chemoradiotherapy. Methods Medical records of 182 patients with locally advanced rectal cancer, who were treated with preoperative chemoradiotherapy followed by surgery between 2002 and 2016, were retrospectively reviewed. TRG was classified into five categories based on the pathological response as follows - TRG1: no viable cancer cell, TRG2: single cancer cell or small groups of cancer cells, TRG3: residual tumor outgrown by fibrosis, TRG4: residual tumor outgrowing fibrosis, TRG5: diffuse residual tumor without regression. TRG1, (TRG2+TRG3), and (TRG4+TRG5) were grouped as complete response, intermediate response, and no response, respectively. Results Of the 182 patients with locally advanced rectal cancer, 112 (61.5%) were male. The mean age was 54.4 (range, 25-87) years. The total number of patients in complete response, intermediate response, and no response group was 24 (13.2%), 105 (57.7%), and 53 (29.1%), respectively. The corresponding five-year relapse-free survival and overall survival rates were 79.8%-92.3%, 74.7%-79.4%, and 55.7%-55.8%, respectively (p < 0.05 for relapse-free survival, p < 0.05 for overall survival). According to ypTNM stage, there was no significant difference in relapse-free survival among TRG groups in ypStage I and II patients (p > 0.05). In ypStage III patients, relapse-free survival was 62 months in no response group vs. not reached in intermediate response group (p < 0.05). According to the ypTNM, there was no significant difference in overall survival among TRG groups in ypStage I, II, and III patients (p > 0.05). In the multivariate analysis, pathological complete response was found to be an independent variable for relapse-free survival and overall survival (hazard ratio (95% confidence interval), 0.34 (0.17-6.77), 0.39 (0.18-0.83), respectively). Conclusion This study showed that patients with pathological complete response to preoperative chemoradiotherapy had longer relapse-free survival and overall survival rates than those with residual disease.
Mean Platelet Volume and Platelet Distribution Width Correlates With Prognosis of Early Colon Cancer
(Imprimatur Publications, 2020) Sakin, Aysegul; Sahin, Suleyman; Sakin, Abdullah; Karatas, Fatih; Samanci, Nilay Sengul; Yasar, Nurgul; Cihan, Sener
Purpose: Several platelet indices have been linked to prognosis of various cancers, including metastatic colorectal cancer. The aim of this study was to investigate the prognostic effect of mean platelet volume (MPV) and platelet distribution width (PDW) in early colon cancer (CC) patients. Methods: This retrospective study included early CC patients who were followed up and treated between 2005 and 2017. Relapse free survival (RFS) and overall survival (OS) were determined with respect to several demographic and clinical characteristics of patients, including MPV and PDW. The cut-off value was determined as >8.5 fL for MPV (sensitivity: 67.1%, specificity 54.5%) and <= 16% for PDW (sensitivity: 66.7%, specificity: 60.0%). Results: The study included 394 patients, 53.3% of which were male. Stage I, II, and III patients constituted 8.9%, 46.4%, and 44.7% of the study population, respectively. Among all patients, RFS and OS were significantly longer in patients with MPV <= 8.5 fL and PDW>16 fL (p <0.001 and p=0.011 for MPV, respectively; and p<0.001 and p=0.026 for PDW, respectively). In patients with stage III disease, those with MPV <= 8.5 fL had significantly longer RFS and OS compared to those with MPV >8.5 fL (p<0.001 and p=0.001, respectively). On the other hand, those with PDW>16% had significantly longer RFS than that in those with PDW <= 16 fL, among stage III patients (p<0.001). In multivariate analysis, stage, perineural invasion, lymphovascular invasion, adjuvant treatment, CEA, CA19-9, PDW, and MPV were found the most significant factors affecting RFS. Conclusion: Our study suggests that elevated MPV and decreased PDW appear to be unfavorable prognostic factors in early CC, especially in patients with stage III disease. Considering the wide availability and accessibility of these indices, it is reasonable to designate further larger prospective studies to clarify and verify their potential roles in early CC.
The Predictive Value of Baseline Volumetric Pet/Ct Parameters on Treatment Response and Prognosis in Locally Advanced Rectal Cancer Treated With Neoadjuvant Chemoradiotherapy
(Springer, 2022) Sakin, Abdullah; Sahin, Suleyman; Karyagar, Sevda Saglampinar; Karyagar, Savas; Atci, Mustafa; Akboru, Mustafa Halil; Cihan, Sener
Purpose To investigate the prognostic effects of baseline volumetric PET/CT parameters including the maximum standard uptake value (SUVmax), metabolic tumor volume (MTV), and tumor lesion glycolysis (TLG) on treatment response and prognosis in locally advanced rectal cancer (LARC) treated with neoadjuvant chemoradiotherapy (NACRT). Methods Between 2015 and 2018, 51 patients with LARC treated with NACRT followed by surgery were included in this retrospective study. Patients were divided into 2 groups by tumor regression grade (TRG) as follows: group I = TRG 1 (no detectable cancer cells) + TRG 2 (single cells and/or small groups of cancer cells) and group II = TRG3 (residual tumor outgrown by fibrosis) + TRG 4 (remarkable fibrosis outgrown by tumor cells) + TRG 5 (no fibrosis with extensive residual cancer). Results Of the 51 patients, 34 (66.7%) were male. The median age was 55 (range, 37-78) years. According to TRG status, 14 (27.4%) patients were in group I and 37 (72.6%) patients were in group II. The area under the curve (95% CI) was 0.749 (0.593-0.905) in the ROC curve plotted for MTV. The cut-off value for MTV was 12, with 70% sensitivity and 65% specificity. MTV was >= 12 in 32 (62.8%) patients. MTV and TLG values were significantly different between groups I and II, whereas there was no significant difference between the groups in terms of SUVmax values (p = 0.006, p = 0.033, and p = 0.673, respectively). The disease-free survival was not reached in patients with MTV < 12 vs. 20 months in those with MTV >= 12 (p = 0.323). In multivariate analysis, MTV (OR, 95% Cl, 5.00 [1.17-21.383]) was found to be the factor that affected pathological complete response. Conclusion In LARC treated with NACRT, MTV prior to treatment can help predict the response to treatment.
The Prognostic Effect of Pretreatment 18f-Fdg Pet/Ct Metabolic Parameters in Locally Advanced Esophageal Squamous Cell Carcinoma Treated With Definitive Chemoradiotherapy
(Elsevier Sci Ltd, 2022) Sakin, Abdullah; Ozcelik, Mahsun; Sahin, Suleyman; Aydemir, Ozan; Aldemir, Mehmet Naci; Iliklerden, Umit Haluk; Kotan, Mehmet Cetin
Introduction: In this study, we aimed to examine the relation between pre-treatment 18F-FDG PET/CT metabolic parameters [(including the maximum standard uptake value (SUVmax), metabolic tumor volume (MTV), and tumor lesion glycolysis (TLG)] and treatment response and survival in locally-advanced Esophageal Squamous Cell Cancer (ESCC) treated with definitive chemoradiotherapy (dCRT). Methods: A total 76 patients with locally-advanced ESCC who received dCRT between June 2015 and December 2019 were included in this retrospective study. Patients were divided into two groups as complete response (CR) or non-complete response (Non-CR) according to response to treatment. AUC was obtained as 0.749 (p < 0.001) in the ROC curve drawn by MTV for the CR. The MTV value was <= 12 cm(3), with 72.1% sensitivity and 73.0% specificity. Results: Of the 76 patients, 38 (50%) were male and 38 (50%) were female. The median age was 62 (39-84) years. The treatment response in 35 (46%) patients was CR. MTV value was > 12cm3 in 41(54%) patients. Median follow-up time was 14.5 months. In patients with MTV > 12cm3, median progression-free survival(mPFS) and median overall survival(mOS) were 9 months and 11 months, respectively, whereas mPFS and OS could not be reached in those with MTV & LE;12 cm3 (p < 0.001 and p < 0.001, respectively). In patients with non-CR, mPFS and mOS were 8 months and 9 months, respectively, whereas mPFS and OS could not be reached in patients with CR (p < 0.001 and p < 0.001, respectively). In multivariate analysis, age (odds ratio [OR], 1.07), ECOG PS (OR, 11.1), and MTV (OR, 4.73) were found to be the factors affecting treatment response. Conclusion: In our study, treatment response and MTV were found to be the factors associated with survival in patients treated with dCRT, showing the pre-treatment MTV value as a predictor of treatment response.
Prognostic Impact of Blood Transfusion in Patients With Metastatic Non-Small Cell Lung Cancer Receiving Chemotherapy
(Elsevier Ireland Ltd, 2019) Sakin, Abdullah; Sahin, Suleyman; Yasar, Nurgul; Demir, Cumhur; Arici, Serdar; Geredeli, Caglayan; Cihan, Sener
Purpose: To investigate the prognostic effects of Allogeneic Blood Transfusion (ABT) in patients with metastatic Non-Small Cell Lung Cancer (NSCLC) receiving Chemotherapy (CT) in the first-line treatment, comparing untransfused patients to those receiving blood transfusion during treatment period or before treatment period. Methods: This was a retrospective study of 433 patients with metastatic NSCLC receiving CT in the first-line treatment. Patients were categorized into 3 groups according to the transfusion strategy as follows; group-U (Untransfused patients, n = 303), group-B(patients receiving transfusion Before treatment period, n = 43), and group-D(patients receiving transfusion During treatment period, n = 87). Results: There were 433 patients in the analysis, consisting of 388 (89.6%) males, with a median age of 60 years (range, 21-92). The median Overall Survival(mOS) according to the ABT was 14 months for group-U, 9 months for group-B, and 7 months for group-D (p < 0.001). In subgroup analysis, patients with squamous cell carcinoma subtype, mOS was 11 months for group-U, 12 months for group-B, and 9 month for group-D (p = 0.074) The corresponding mOS durations for adenocarcinoma subtype were 21 months, 7 months, and 6 months (p < 0.001). Performing ABT during treatment period was found to be a negative independent factor related to OS (HR 1.50 for progression-free survival, 95% CI 1.15-1.97, HR 1.36 for OS, 95% CI 1.04-1.80). Conclusion: Our results demonstrated that ABT was significantly associated with earlier progression and shorter survival in patients with metastatic NSCLC, especially in adenocarcinoma histology, hence suggesting that transfusion strategy in this group should remain limited, and its benefit should outweigh the risk of progression.
Prognostic Significance of Neutrophil-To Ratio in Esophageal Squamous Cell Carcinoma
(Kare Publ, 2021) Sakin, Aysegul; Alay, Murat; Sahin, Suleyman; Aydemir, Ozan; Aldemir, Mehmet Naci; Sakin, Abdullah; Kotan, Cetin
OBJECTIVE: The purpose of the study was to assess the effect of neutrophil-to-lymphocyte ratio (NLR) on recurrence and survival in patients with Esophageal Squamous Cell Carcinoma (ESCC) undergoing surgery. METHODS: This was a retrospective analysis of the 80 resectable ESCC patients who underwent surgery at Yuzuncu Yil University Faculty of Medicine between 2008 and 2018. Receiver operator characteristics curve of NLR was plotted for disease-free survival (DFS). The area under the curve of NLR was 0.692 (p=0.008) with 65.2% sensitivity and 2.8 with 69.5% specificity. Patients were divided into two groups based on the NLR as follows: NLR <2.8 and NLR >= 2.8. RESULTS: Among 80 ESCC patients, 54 (65.5%) were female. The median age was 55 years (range, 26-77). The NLR was <2.8 in 47 (58.7%) patients. Median DFS was 55 months in patients with NLR >= 2.8, whereas it was not reached in those with NLR <2.8 (p=0.008), with corresponding overall survival (OS) durations of 71 months and not reached (p=0.027). Eastern Cooperative Oncology Group performance score 2, presence of obstruction at diagnosis, lower 1/3 esophageal localization, neoadjuvant treatment, and NLR >= 2.8 were found to be the factors related to survival. CONCLUSION: The present study demonstrated that high pre-treatment NLR was associated with worse DFS and OS in patients with resectable esophageal cancer. We believe that pre-treatment NLR may help guide predicting treatment outcomes in non-metastatic resectable ESCC patients.
The Prognostic Value of Postoperative Lymph Node Ratio in Gastric Adenocarcinoma Patients Treated With Neoadjuvant Chemotherapy
(Springernature, 2021) Sakin, Abdullah; Atci, Muhammed M.; Aldemir, Mehmet Naci; Akagunduz, Baran; Sahin, Suleyman; Arici, Serdar; Cihan, Sener
Objective In this study, we aimed to investigate the prognostic value of postoperative lymph node ratio (LNR) in locally advanced gastric cancer (GC) patients receiving neoadjuvant chemotherapy (NACT). Methods LNR was calculated as the ratio of positive LNs to the total LNs removed. The receiver operating characteristic (ROC) curve was plotted to estimate the cut-off value of LNR for recurrence. The area under the curve of LNR was 0.714 (95% CI: 0.604-0.825, p<0.001) with 60% sensitivity and >0.255 with 76% specificity. Patients were grouped as group I (<= 0.255) and group II (>0.255). Results In this study, 157 GC patients were included (39.5% female and 60.5% male). Of the patients, 97 (61.8%) were in group I and 60 (38.2%) were in group II. Disease-free survival (DFS) was not reached in group I, and it was 16 months in group II (p<0.001). Overall survival (OS) was 58 months in group I and 28 months in group II (p>0.001). In multivariate analysis, lymphovascular invasion, neoadjuvant response, adjuvant treatment, and LNR were found to be the factors associated with DFS and OS (p<0.05). Conclusion In our study, it was observed that LNR can predict survival rates better than LN staging.
Red Blood Cell Distribution Width as a Possible Predictor of Diagnosis and Survival in Gastric Cancer
(2020) Sakin, Ayşegül; Kotan, Çetin; Alay, Murat; Sahin, Suleyman; Sakin, Abdullah; Aytekin, Aydın; Esen, Ramazan
Objectives: To compare the preoperative Red Cell Distribution Width (RDW) value in curatively-operated gastric cancer(GC) patients without receiving neoadjuvant chemotherapy (NACT) vs. control group, with the aim of investigating itspreoperative prognostic effect.Methods: Receiver Operator Characteristics (ROC) curve of RDW value was plotted for DFS. The area under curve (AUC)of the RDW was 0.714 with 73.5% sensitivity and >5.5 with 71.1% specificity. Patients were divided into 2 groups as RDW≤15.5 and RDW >15.5.Results: The study included 330 GC patients (37.7% female and 62.3% male) and 330 healthy controls (63.9% maleand 36.1% female). ROC curves were used to confirm the predictive role of preoperative RDW value in predicting thepresence of GC. For GC, the AUC of RDW was 0.665 with 61.3% sensitivity and 14.1 with 64% specificity. There was apositive correlation between disease stage and RDW in GC patients (Rho=0.338, p<0.001). Five-year DFS was 81.1% inthe low-RDW group and 61.9% in the high-RDW group (p=0.001). Similarly, Corresponding 5-year overall survival (OS)rates were 74.4% and 57.7 (p=0.001). In multivariate analysis, male gender, stage III disease, high CEA, and RDW ≥15.5were the factors associated with worse DFS, whereas adjuvant therapy (p=0.036) prolonged DFS significantly.Conclusion: In our study, preoperative RDW was found to be both predictive and prognostic for GC.