Browsing by Author "Sakin, Abdullah"

Now showing 1 - 20 of 48

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.
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.
Association Between Body Mass Index and Survival in Patients With De Novo Metastatic Non-Small Cell Lung Cancer
(int Scientific information, inc, 2024) Urun, Muslih; Guner, Gurkan; Sezgin, Yasin; Sakin, Abdullah; Kilickap, Saadettin
Background: This retrospective study from a single center included 289 patients diagnosed with advanced non-small cell lung cancer (NSCLC) between 2010 to 2017 and aimed to evaluate the effects of body mass index (BMI) on overall survival. Material/Methods: This retrospective study involved 289 patients diagnosed with metastatic-stage NSCLC at a single institution between January 2010 and December 2017. Patients were categorized into 2 groups based on their BMI at diagnosis: those with a BMI <25 kg/m(2) and those with a BMI >= 25 kg/m(2). Univariate and multivariate Cox regression analyses were conducted to identify factors associated with overall survival. Results: A total of 289 patients (241 men, 48 women) were included in the study, with a mean age of 60.1 +/- 11.1 years. Among them, 175 patients (60.6%) had a BMI less than 25 kg/m(2). Multivariate analysis revealed that BMI, pathological diagnosis, and complete response after first-line treatment were independently associated with survival in patients with lung cancer. Predicted survival time was significantly shorter in the BMI <25 group than in the BMI >= 25 group (9.3 months vs 13.0 months, P<0.05). Conclusions: The study demonstrated that a higher BMI at the time of diagnosis is associated with improved overall survival in patients with de novo metastatic NSCLC. BMI may serve as an important prognostic factor in this patient population. Future prospective, multi-center studies are necessary to further validate the role of BMI in predicting survival outcomes in NSCLC patients across different treatment modalities.
Characteristic Features and Prognostic Factors in Gastric Cancer Patients With Bone Metastases: Multicenter Experience
(Taylor & Francis Ltd, 2025) Hamdard, Jamshid; Bilici, Ahmet; Sakin, Abdullah; Kahraman, Seda; Yasin, Ayse Irem; Kalaci, Ender; Seker, Mesut
We evaluated the incidence, clinicopathological features, prognostic factors, progression-free survival (PFS) and overall survival (OS) of patients with gastric cancer and bone metastases. The medical records of 110 patients with bone metastases were retrospectively analyzed. In our study, the incidence of bone metastases was 3.2%. The median patient age was 60 years. A total of 68 (61.8%) patients exhibited synchronous metastases, and 42 (38.2%) patients developed metachronous metastases. Alkaline phosphatase (ALP) levels were high in 54 (49%) patients. At the median follow-up time of 9.8 months, median PFS and OS times were 4.7 and 6.3 months, respectively. The median interval from the diagnosis to bone metastases was 9.3 months. Univariate analysis showed that Eastern Cooperative Oncology Group Performance Status (ECOG PS) >= 2, stage at diagnosis, time of metastases, number of metastases, presence of extraskeletal metastases, use of zoledronic acid treatment, palliative chemotherapy post-bone metastases and radiotherapy to bone metastases were significant prognostic indicators for PFS. Additionally, ECOG PS >= 2, stage at diagnosis, time of metastases, number of metastases, presence of extraskeletal metastases, zoledronic acid treatment, palliative chemotherapy post-bone metastases, and radiotherapy to bone metastases significantly influenced OS. Moreover, in multivariate analysis, ECOG PS, time of metastases, presence of extra-bone metastases, and the use of palliative chemotherapy after bone metastases were found to be independent prognostic factors for PFS. Moreover, ECOG PS, time of metastases, and use of palliative chemotherapy after bone metastases were significantly independent prognostic indicators for OS. Our findings show that the presence of synchronous metastases, use of palliative chemotherapy, use of zoledronic acid after bone metastases, and ALP level within the normal range were significantly associated with prolonged OS in gastric cancer patients with bone metastases.
The Clinical Importance of Androgen Receptor Status in Response To Neoadjuvant Chemotherapy in Turkish Patients With Local and Locally Advanced Breast Cancer
(Karger, 2020) Arici, Serdar; Sengiz Erhan, Selma; Geredeli, Caglayan; Cekin, Ruhper; Sakin, Abdullah; Cihan, Sener
Purpose:To investigate whether androgen receptor (AR) status affects neoadjuvant chemotherapy (NACT) in stage II and III Turkish breast cancer patients.Methods:The histological response for breast and axilla was assessed according to the Miller-Payne grading system. In light microscopy, nuclear staining in tumor cells was evaluated, and nuclear staining above 1% was accepted as positive for AR expression. The patients were divided into 3 groups according to the intensity of AR staining: low, moderate, and high.Results:In total, 71 women with breast cancer were included in the study. In univariate analysis, age, menopause status, tumor diameter, stage, histological grade, Ki-67, estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 (HER-2) status were tested to determine which of these factors were associated with >90% responsiveness. AR negativity was found to be the only statistically significant factor. In multivariate analysis, AR positivity at each intensity was found to be the single important factor affecting decreasing pathologic response in patients receiving NACT for breast cancer.Conclusion:Our results show that AR positivity is associated with poor response to NACT in Turkish breast cancer patients and that AR positivity is independent of stage, hormone receptor status, HER-2 status, and disease stage.
The Clinical Importance of Fibroblast Growth Factor 23 on Advanced Non-Small Cell Lung Cancer Patients Without Druggable Alterations in Genes as Egfr or Alk or Ros1 Fibroblast Growth Factor 23 and Non-Small Cell Lung Cancer
(2020) Cihan, Şener; Çekin, Ruhper; Seçmeler, Şaban; Atcı, Muhammed Mustafa; Ocak, Birol; Sakin, Abdullah; Arıcı, Serdar
Objectives: We aimed to investigate the relation between serum fibroblast growth factor (FGF) 23 levels and clinicopathologic features of stage 3B and 4 non-small cell lung cancer (NSCLC) patients without druggable alterations ingenes as epidermal growth factor receptor (EGFR) or rearrangements of the anaplastic lymphoma kinase (ALK) or c-ROSoncogene 1 (ROS1), by comparing healthy control group.Methods: This was a prospective, single-center study. Newly diagnosed stage 3B and 4 NSCLC patients without druggable alterations in genes as EGFR, ALK or ROS1 and healthy control in similar age, without any chronic disease andvitamin D deficiency were enrolled in the study. Fibroblast growth factor 23 levels were compared between groups.Results: Forty men newly diagnosed stage 3B and 4 patients and 24 healthy men were enrolled. The median age ofpatients and controls were 54.7 and 53.1 years. The number of patients were 22 (55.0%) and 18 (45.0%) in stage 3B andstage 4 groups respectively. The mean FGF 23 level was calculated as 87.7±58.0 pg/ml in patients group and 63.1±11.4pg/ml in control group (p=0.045). Fibroblast growth factor 23 levels were 85.5±42.5 pg/ml and 89.6±69.1 in metastaticand non-metastatic patients respectively (p=0.532). The median FGF 23 levels were 91.1±58.4 pg/ml and 92.5±60.8 pg/ml in squamous cell carcinoma and adenocarcinoma groups respectively (p=0.926).Conclusion: Our study suggests that high FGF-FGFR interaction may be causative for stage 3B and 4 NSCLC withoutdruggable alterations in genes as EGFR, ALK or ROS1 and is important in terms of suggesting the FGF pathway as a newtreatment target in NSCLC 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 Conversion Ofrasstatus in Metastatic Colorectal Cancer Patients After First-Line Biological Agent Treatment
(Wiley, 2021) Arici, Serdar; Hamdard, Jamshid; Sakin, Abdullah; Sengiz Erhan, Selma; Atci, Muhammed Mustafa; Cekin, Ruhper; Bilici, Ahmet
Aim The aim was to investigate theRASdiscordance between initial and recurrent metastasectomy specimens in metastatic colorectal cancer (mCRC) patients treated with chemotherapy (CT) plus biological agents in a first-line setting. Methods Patients who had been treated with CT plus bevacizumab or cetuximab or panitumumab followed by R0 resection for potentially resectable colorectal cancer liver metastases were scanned. Among these, patients who developed resectable new metastases after a disease-free interval longer than 6 months were included in the study. We compared theRASmutation status between the first biopsy and the second metastasectomy specimen. Results A total of 82 mCRC patients treated with CT plus biological agents in a first-line setting were included in the study. The first biopsy assessment showed wild-typeRAStumours in 39 (47.6%) patients and mutantRAStumours in 43 (52.4%) patients. The mean time for new operable liver metastasis after R0 resection was 15.5 months. In the second metastasectomy specimens, the numbers of wild-type and mutantRAStumours were 30 (36.6%) and 52 (63.4%), respectively. The comparison with the first biopsy specimens showedRASstatus conversions in 17 (20.7%) patients. Univariate comparison between patients with and withoutRASstatus conversion revealed that grade, pathological T stage, wild-typeRAStumour and longer biological agent use time in the first-line treatment were significant factors forRASconversion. Conclusion Our results suggest that re-biopsy is needed for an optimal second-line treatment decision in mCRC patients regardless of backbone biological agent, especially in patients with wild-typeRASmCRC.
The Demographic Features and Clinical Characteristics of Soft Tissue Sarcoma; Single Center Experience
(2020) Budancamanak, Serkan; Sakin, Abdullah
Giriş: Yumuşak doku sarkomları (YDS) son derece nadir görülmektedir. Çalışmamızda YDS tanısı ile takip ve tedavisi yapılan hastaların klinikopatolojik ve demografik verilerinin incelenmesi ve evrelere göre sağkalımlarının geriye dönük olarak incelenmesi amaçlandı. Materyal: Çalışmaya 2010-2019 yılları arasında onkoloji kliniğinde YDS tanısı ile takip ve tedavisi yapılan hastalar alındı. Çalışmaya 18 yaş üzerinde, YDS dışında malignitesi olmayan ve verilerine eksiksiz ulaşılabilen tüm hastalar alındı. Bulgular: Çalışmaya 32 (%52,5) kadın 29 (%47,5) erkek olmak üzere toplam 61 hasta alındı. Hastaların ortanca yaşı 61 yıl (22-81) idi. Hastaların 43 (%70,5) ü non-metastatik evrede iken, 18 (%29,5) hasta tanı anında metastatik evrede idi. 36 (%59) extremite dışı yerleşimli, 25 (%41) hasta ekstremite yerleşimli idi. 58 (%95,1) hastaya primer tümörüne cerrahi uygulanmıştı. Metastatik evrede olan hastalarda en sık metastaz lokalizasyonu Akciğer olup 8 (%13.1) hastada vardı. Non- metastatik olan 18 (%41,9) hastada nüks gelişmişti. En sık nüks lokalizasyonu olarak lokal nüks 11(%57,9) hastada gelişmişti. Histolojik alt tip olarak en sık Leiomiyosarkom 15 (%24,6) hastada gözlenmişti. Non metastatik olan 5 (%11,6) hastaya neoadjuvan tedavi, 19 (%44,2) hastaya adjuvan kemoterapi, 11 (%30,6) hastaya adjuvan radyoterapi verilmişti. Metastatik olan ve nüks gelişen hastalardan 25 (%69,4) üne ilk seri kemoterapi verilmişti. Non metastatik olan hastalarda evreler arasında (evre I,II ve III) hastalıksız sağkalım ve genel sağkalım açısından istatistiksel olarak fark yoktu(p= 0.508, p=0.331 sırasıyla). Metastatik hastalarda genel sağkalım 21 ay saptanırken, non-metastatik olan hastalarda genel sağkalım süresine ulaşılamamıştı (p<0.001) Tartışma ve sonuç: Çalışmamızda bölgemizdeki YDS incelenmiş olup, hastaların 1/3 metastatik evrede başvurduğu, yarısından fazlasının ekstremite dışı olduğu, histolojik olarak en sık leiomyosarkom görüldüğü gözlendi. Ayrıca metastatik olanların en sık akciğer metastazı ile başvurduğu, Non-metastatik olanlarda ise en sık lokal nüks ile nüks ettiği gözlendi.
Does the Waiting Period for Genetic Tests Affect the Prognosis in Chemotherapy-Treated De Novo Metastatic Non-Small Cell Lung Cancer Patients Without a Driver Mutation
(Karger, 2021) Arici, Serdar; Sakin, Abdullah; Cekin, Ruhper; Secmeler, Saban; Yasar, Nurgul; Cihan, Sener
Introduction: The length of the necessary waiting period to test driver mutations may generate anxiety in patients and clinicians. For this reason, an investigation was conducted to determine whether the duration between diagnosis and the start of first-line chemotherapy (DDC) in non-small cell lung cancer (NSCLC) patients without driver mutations has an impact on prognosis. Methods: The study included 303 de novo metastatic NSCLC patients without a driver mutation and patients were divided into 2 groups according to DDC: <= 30 days (group A) or >30 days (group B). The determinant factors for progression-free survival (PFS) and overall survival (OS) were examined by Cox regression analysis. Results: The mean DDC was calculated as 38.2 +/- 54.5 days. The number of patients in group A and B were 183 and 120, respectively. The median PFS in groups A and B was 5.0 and 6.0 months (p = 0.268) and the median OS was 10.0 and 11 months, respectively (p = 0.341). Univariate and multivariate analyses revealed that DDC was not a factor associated with PFS and OS. Conclusion: Our results show that a higher DDC was not associated with a worse prognosis in metastatic NSCLC patients without driver mutations. In this context, it is safer for patients and their physicians to wait for test results before starting chemotherapy.
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 Diabetes and Fasting Plasma Glucose on Treatment of Breast Cancer With Neoadjuvant Chemotherapy
(Mosby-elsevier, 2020) Arici, Serdar; Geredeli, Caglayan; Secmeler, Saban; Cekin, Ruhper; Sakin, Abdullah; Cihan, Sener
Purpose: To determine the effects of diabetes and fasting plasma glucose (FPG) level on the pathologic response in patients with breast cancer who received neoadjuvant chemotherapy. Methods: One hundred and thirty-five patients files who received neoadjuvant chemotherapy between 2013 and 2017 years, were scanned. Pathologic responses, diabetes, and FPG dates of patients were reached from archive files. Patients were grouped as diabetic and nondiabetic. Results: Patients with higher than 90% pathologically response according to Miller-Payne grading system, constituted 11 (44%) and 61 (55.5%) of patients: patients with equally or lower than 90% pathologically response were 14 (56%) and 49 (44.5%) and the number of patients with nonpathologic response 5 (20%) and 2 (1.8%) in diabetic and nondiabetic group, respectively. This difference between diabetic and nondiabetic groups was statistically significant (P=0.005). In Miller-Payne groups, the median FPG levels were 135 mg/dl (165.6 +/- 86.5), 96 mg/dl (110.0 +/- 30.6), 97 mg/dl (101.9 +/- 23.9). 91.5 mg/dl (102.5 +/- 44.3) and 93.5 mg/dl (112.0 +/- 61.2) respectively 0%, 1%-30%, 31%-90%, 91%-99%, and 100%. Patients with lower 91% pathologic response had statistically significant higher FPG levels compared with patients with higher patholocig response (P= 0.008). The cut-of FPG value to determine nonpathologic response was calculated 105 mg/dl (sensitivity 85.7% specificity 74.2%). The FPG, diabetes, lymph node positivity, and disease stage were statistically significant in the multivariate analysis for affecting non-pathologic response (P= 0.013, P=0.016, P= 0.036, and P=0.035 respectively). Conclusion: Diabetes and high FPG level may be predictive to the non-response of neoadjuvant chemotherapy in patients with breast cancer. (C) 2019 Elsevier Inc. All rights reserved.
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.
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 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.
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.