Browsing by Author "Sakin, A."

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The Association of Visfatin Levels With Metabolic Parameters and Inflammation in Diabetic Nephropathy
(Yuzuncu Yil Universitesi Tip Fakultesi, 2020) Sakin, A.; Sahin, S.; Behlul, A.; Sumnu, A.; Gursu, M.; Sakin, A.; Ozturk, S.
To investigate the visfatin levels at the stages of diabetic nephropathy(DNP), changes in visfatin levels according to stages of DNP, and the association of visfatin levels with other anti-inflammatory parameters including high sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), and tumor necrosis factor alpha(TNFα). Patients were divided into 4 groups based on the glomerular filtration rate (GFR) and albuminuria as follows; Group I: Albuminuria<30 mg per day and GFR>60ml/min, Group II:albuminuria 30 to 300 mg per day and GFR>60ml/min, Group III:albuminuria>300mg per day and GFR>60ml/min, and Group IV: Albuminuria>300 mg per day and GFR<60 ml/min. Of the 141 patients included in the study, 83(58.8%) were female. The mean age of patients was 55.3±8.2 years. Microalbuminuria was found to be 10.1±9.8 mg per day in group I, 89.4±68.2 mg per day in group II, 525.1±280.7 mg per day in group III, and 1034±1893 mg per day in group IV (p<0.001). When the correlation analysis was repeated separately in each group, there was a positive correlation between Visfatin and IL-6 levels in only group III (r=0.926; p<0.001). When the patients in group III and IV were combined in a single group and considered as macro-albuminuric, multivariate analysis showed that visfatin had a positive correlation with IL-6 (r=0.380, p=0.006) In this study, we could not determine any association between visfatin levels and other anti-inflammatory markers (IL-6, TNFα, and hsCRP). However, we found a close relationship between visfatin levels and IL-6 which is one of the most important markers of inflammation in diabetic patients with overt nephropathy, namely macro-albuminuric patients. © 2020, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Chemoradiotherapy Followed by Surgery Versus Observation in Esophageal Squamous Cell Carcinoma
(Zerbinis Publications, 2021) Sakin, A.; Sahin, S.; Aldemir, M.N.; Iliklerden, U.H.; Kotan, M.C.
Purpose: We aimed to examine the effect of esophagectomy after chemoradiotherapy (CRT) or non-surgical follow-up after CRT in patients with locally advanced esophageal squamous cell carcinoma (ESCC). Methods: A total of 653 patients under follow-up for locally advanced ESCC between 2010-2019 were reviewed for enrollment. Patients with no distant metastasis at the time of diagnosis who underwent esophagectomy or were taken under observation following CRT were included in the study. Overall, 127 eligible patients were included, 55 of whom were male (43.3%) and 72 female (56.7%). Results: After CRT, 59 patients (53.5%) had undergone surgery and 68 (46.5%) were taken under observation. Median disease-free survival (mDFS) was not reached in the group that underwent surgery and was 13 months in the observation group (p<0.001). Median overall survival (mOS) was significantly longer in the operated group (p=0.006). There was no statistically significant difference in DFS and OS between patients who underwent surgery and those included in the observation group after achieving clinical and pathological complete response following CRT (p=0.119, p=0.699, respectively). The multivariate analysis identified surgery and increased CRT response as the factors that affect DFS (p=0.042, p<0.001, respectively). Conclusion: In this study, surgery provided no additional benefit on survival in locally advanced ESCC patients with complete response while prolonged survival was observed in those without complete response. © 2021 Zerbinis Publications. All rights reserved.
The Effect of Cachexia on Survival in Metastatic Gastric Cancer Patients Treated With Best Supportive Care
(Yuzuncu Yil Universitesi Tip Fakultesi, 2020) Sakin, A.; Aldemir, M.N.
In this retrospective study, we aimed to investigate the effect of cachexia on survival in metastatic gastric cancer (GC) patients treated with best supportive care (BSC) using real-life data. From 2015 to 2019, metastatic GC patients who were treated with BSC were included in this study. The study enrolled 53 metastatic GC patients, 36 (67.9%) were male and 17 (32.1%) were female. The median age of the patients was 66 years. The patients were assigned into two groups, according to body mass index (BMI): BMI <18kg/m2 or BMI ≥18 kg/m2 . A total of 18 patients (33.9%) were in the BMI <18kg/m2 group and 35 patients (66.1%) were in the BMI ≥18 kg/m2 group. There was a statistically significant difference between the two BMI groups with a median overall survival (mOS) of 1 month in the BMI <18kg/m2 group and 3 months in the BMI ≥18 kg/m2 group (p<0.001). In the multivariate analyses, age (hazard ratio [HR], 0.97), chronic obstructive pulmonary (HR, 6.53), BMI <18kg/m2 (HR, 2.31), liver metastasis (HR, 3.53), and peritoneum metastasis (HR, 2.31) were associated with OS. In this study, we found that presence of cachexia at the time of diagnosis in metastatic GC patients treated with BSC was associated with shorter survival in comparison to non-cachectic patients. © 2020, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
The Effect of Different Treatment Modalities on Survival in Elderly Patients With Locally Advanced Non-Small Cell Lung Cancer
(Taylor & Francis Ltd, 2021) Sakin, A.; Sahin, S.; Atci, M. M.; Sakin, A.; Yasar, N.; Geredeli, C.; Cihan, S.
Purpose: The aim of this study is to investigate the effect of treatment modalities on survival among unoperat ed and locally-advanced non-small cell lung cancer (NSCLC) patients aged 70 years and older, representing real-life data. Methods: From 2005 through 2017, medical records of 2259 patients with lung cancer from Okmeydani Training and Research Hospital-Istanbul/Turkey were reviewed retrospectively. Patients with locally advanced NSCLC >= 70 years of age who did not undergo surgery for lung cancer were reviewed. In total, 130 patients were eligible for the final analysis. Patients were stratified into four groups as: chemotherapy (CT), concurrent chemoradiotherapy (cCRT), sequential chemoradiotherapy (sCRT), and radiotherapy (RT) only. Results: Of the 130 patients included in the analysis; CT, cCRT, sCRT, and RT only were applied to 25(19.2%), 30(23.1%), 31(23.8%), and 44(33.8%) patients, retrospectively. Twelve (9.2%) patients were female. Median age was 72 years (range, 70-88). Sixty (46.2%) patients had stage IIIA disease and 70(53.8%) patients had stage IIIB disease. Median progression-free survival(mPFS) in patients treated with CT, cCRT, sCRT, and RT were 8.0, 15, 10, and 9.0 months, respectively(p = 0.07). Corresponding median overall survival (mOS) were 10, 33, 20, and 15 months (p = 0.04). In multivariate analysis, stage IIIB disease [hazard ratio (HR), 2.8], ECOG-PS 2(HR, 2.10), and ECOG-PS 3-4(HR, 5.13) were found to be the negative factors affecting survival, while cCRT (HR, 0.45) and sCRT (HR, 0.50) were the independent factors associated with better survival. Conclusion: This study showed that the use of combined treatment modality was associated with better survival in elderly patients with locally advanced NSCLC, with the greatest survival observed in patients treated with cCRT. We therefore suggest that cCRT, when feasible, should be strongly considered in locally advanced NSCLC patients 70 years and over. (c) 2019 Sociedade Portuguesa de Pneumologia. Published by Elsevier Espana, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/bync-nd/4.0/).
The Effect of Obesity on Response To Neoadjuvant Therapy in Locally Advanced Gastric Cancer
(Asian Pacific Organization for Cancer Prevention, 2020) Sakin, A.; Sahin, S.; Sakin, A.; Aldemir, M.N.; Bayram, I.; Kotan, C.
Introduction: The effect of obesity on response to neoadjuvant chemotherapy (NACT) remains unknown. We aimed to investigate the effect of obesity on response to NACT and survival in locally-advanced gastric cancer (GC). Methods: From 2010 to 2019, 142 GC patients with clinical stage III disease who underwent curative surgery after NACT were enrolled. Patients were divided into 3 groups according to body mass index (BMI) as follows; BMI < 25 kg/m2, BMI = 25-30 kg/m2, and BMI > 30 kg/m2. The Mandard tumor regression grading system was used for tumor regression grade (TRG). Results: Of the 142 GC patients, 45(31.7%) were female. The median age was 58 years. BMI was < 25 kg/m2 in 60 (42.3%) patients, 25-30 kg/m2 in 44 (31%) patients, and > 30kg/m2 in 38 (26.8%) patients. The numbers of patients with TRGI-II, TRGIII, and TRGIV-V were 35 (24.6%), 44 (31%), and 63 (44.4%), respectively. There was no statistically significant difference among BMI groups in terms of disease-free survival (DFS) and overall survival (OS) (p = 0.919 and p = 0.398, respectively). According to TRG groups; mDFS was 46 months in TRG I-II, 28 months in TRG III, and 18 months in TRG IV-V (p<0.001). In multivariate analysis, presence of perineural invasion and lymphovascular invasion were the factors affecting TRG. Conclusion: In our study, we found that pre-treatment obesity did not affect the TRG in clinical stage III GC patients. However, a better TRG status was associated with improved survival. © 2020 Asian Pacific Organization for Cancer Prevention.
Effect of Pretreatment Platelet Parameters on Survival in Limited Disease Small Cell Lung Cancer
(Asian Pacific Organization for Cancer Prevention, 2019) Sakin, A.; Yasar, N.; Arici, S.; Demir, C.; Geredeli, C.; Aksaray, F.; Cihan, S.
Background: The aim of this study was to investigate the effect of platelet parameters before concurrent chemoradiotherapy (CCRT) on survival of patients with limited disease small cell lung cancer (LD-SCLC). Methods: This study consisted of patients who received CCRT due to LD-SCLC in the oncology clinic between 1997-2017. Examined platelet parameters included total platelet count (TPC), mean platelet volume, platelet distribution width, and platelet-lymphocyte ratio. The cut-off value for TPC was determined as 306x109/U (sensitivity: 62%, specificity: 75.5%), where patients below or equal to this level was classified as Group I, and those above as Group II. Results:The study included 90 patients whose mean age was 59 years (range: 42-83) and male ratio was 80.0% (n=72). Near three-fourths of patients (74.4%) were at clinical stage III. Among stage I-II patients, mOS was found as 126 months for Group I whereas it had not been reached in Group II (p=0.158). Stage III patients showed significantly lower mOS for Group 1 (16 [range: 14.1-17.8] months) compared to that in Group 2 (19.0 [range: 15.6-62.8] months; p=0.002). In multivariate analysis, Eastern Cooperative Oncology Group performance score (p=0.003), clinical stage (p < 0.001), prophylactic cranial irradiation (p=0.004), and TPC (p=0.031) was determined as the most significant factors affecting survival. Conclusion: Our study suggests association of high baseline levels of TPC to improved survival in patients scheduled to undergo CCRT for LD-SCLC. Considering easiness and universal availability of TPC measurement, potential utilization of this biomarker may be promising to predict survival, albeit requiring validation by further well-designated prospective studies. © 2019, Asian Pacific Organization for Cancer Prevention.
Efficacy and Safety of Perioperative Flot (5-Fu, Lv, Oxaliplatin, Docetaxel) Chemotherapy in Gastric and Gastroesophageal Junction Adenocarcinoma: Real-Life Data From Turkish Oncology Group
(Elsevier, 2021) Erol, C.; Basoglu, T.; Sakin, A.; Ozden, E.; Cubuk, D.; Yumuk, P. F.; Sendur, M. A. N.
Efficacy and Tolerability of First-Line Chemotherapy in Elderly Patients ( Age ≥70 Years) With Metastatic Gastric Cancer: a Multicenter Study of the Anatolian Society of Medical Oncology (Asmo)
(Oxford Univ Press, 2016) Aldemir, M. N.; Turkeli, M.; Hacioglu, B.; Sakin, A.; Yaman, E.; Coban, E.; Tekin, S. B.
Efficacy of Gemcitabine Plus Nab-Paclitaxel in Second-Line Treatment of Metastatic Pancreatic Cancer
(Elsevier, 2024) Sezgin, Y.; Karhan, O.; Urakci, Z.; Mecidova, N.; Araz, M.; Sakin, A.; Ergun, Y.
Factors Affecting Survival in Neuroendocrine Tumors: a 15-Year Single Center Experience
(Asian Pacific Organization for Cancer Prevention, 2018) Sakin, A.; Tambas, M.; Secmeler, S.; Can, O.; Arici, S.; Yasar, N.; Cihan, S.
Background: Neuroendocrine tumors are a heterogeneous group of tumors that can originate from all of the neuroendocrine cells in the body, mostly from the gastrointestinal tract. In addition to early diagnosis, streaming patients into appropriate prognostic groups is an important component of treatment. In this study, we examined the factors that affect survival in patients we followed in our center between 2000-2016. Methods: The demographic data, clinical and pathological features of patients were obtained from their medical files. TNM staging and tumor grading were performed according to AJCC and WHO 2010 classification. SPSS 15.0 for Windows programme was used for statistical analysis. Results: 85 patients (32 male, 53 female) were included into the study. The median age of the patients was 55,7 (27-83) years. Eighty percent of the tumors were of gastroenteropancreatic system, most commonly stomach (27.1%) origin. Nineteen patients (22.4%) died during follow-up. In univariate analysis; age (p < 0,001), stage (p=0.002), primary tumor localization (p=0.005), grade (p < 0.001), Ki-67 value (p < 0.001), number of metastases (p=0.001) and type of surgery (p < 0.001) were found to be factors affecting survival. Age (p=0.024) and Ki67 (p < 0.001) were the independent prognostic factors for survival in multivariate analysis. For the cut-off value of 6%, Ki-67 had a sensitivity of 83.3% and specifity of 71.4% for survival determination. Conclusion: Ki-67 ratio and age were the most important factors affecting survival in neuroendocrine tumors in our study. Ki-67 ratio has a high sensitivity and specificity for predicting survival, a cut-off value of 6% may be used to predict survival. © 2018, Asian Pacific Organization for Cancer Prevention.
Is Lymph Node Dissection Necessary for Staging While Undergoing Nephrectomy in Patients With Renal Cell Carcinoma
(Mosby Inc., 2021) Demir, T.; Aliyev, A.; Beşiroğlu, M.; Araz, M.; Köstek, O.; Sakin, A.; Türk, H.M.
Objective: The essential treatment for patients with renal cell carcinoma is nephrectomy. As no lymph node dissection (LND) could be performed in the majority of these patients, healthy staging could not be carried out. In this study, we investigated the impact of LND during nephrectomy on patient survival. Methods: A total of 181 patients—58 (32%) were female and 123 (68%) were male—were included in the study. Median follow-up period was 48 months. The patients were separated into 4 groups according to their stage during diagnosis; group 1 (T1–3N0M0), group 2 (T1–3NXM0), group 3 (T1–3N1M0), and group 4 (T1–4N0/XM1). The disease-free survival of nonmetastatic patients and the overall survival of all groups were calculated. Results: Mean age was 58.4 ± 12.0 years. Median survival for Group 1 could not be reached. Median survival was 89 months in Group 2, 50 months in Group 3, and 39 months in Group 4 (P <0.001). There was no statistically significant difference between the N1 and M1 groups (P = 0.297). For the NX patient group without LND, median survival was 89 months, which is worse than the N0 group and better than the N1 group (P = 0.002). Conclusions: Our study presumes that the patients without LND are not staged sufficiently, NX patients have worse survival rates when compared with N0 patients, node-positive patients have poor survival rates as do the metastatic patients, and it should be defined as TNM stage4. © 2020
Multiple Primary Synchronous Gastric, Esophageal, and Rectal Cancer and Isolated Esophageal Metastasis From Rectal Cancer: Case Report
(Turkiye Klinikleri, 2021) Sönmez, G.M.; Aytekin, A.; Erten, R.; Aldemir, M.N.; Sakin, A.; Esen, R.
Synchronous tumors are defined as two or more neoplasms either identified simultaneously or within 6 months after the initial diagnosis in the same patient. Herein, we report a 63-year-old man with synchronous gastric, rectal carcinoma, and in situ esophageal carcinoma who also had isolated esophageal metastasis from rectal carcinoma. The patient man was diagnosed with rectal carcinoma. 18F-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography was performed for staging and demonstrated increased 18F-FDG uptake in the rectum lesion as well as in the gastric cardia and corpus. Esophagogastroduodenoscopy was performed. After performing multiple biopsies, histopathological examination of the esophageal specimen demonstrated metastatic adenocarcinoma, in situ esophageal squamous cell carcinoma, and gastric adenocarcinoma. Isolated esophageal metastasis from rectal cancer is a highly rare entity. Gastric and esophageal cancers can be observed simultaneously with colorectal cancers; therefore, we recommend performing routine esophagogastroduodenoscopy for patients diagnosed with colorectal cancer. © 2021 by Turkish Society of Medical Oncology.