Browsing by Author "Secmeler, Saban"

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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.
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 Predictive Role of Metabolic Tumor Volume on No Response To Neoadjuvant Chemotherapy in Patients With Breast Cancer
(Sage Publications Ltd, 2020) Arici, Serdar; Karyagar, Sevda S.; Karyagar, Savas; Geredeli, Caglayan; Cekin, Ruhper; Secmeler, Saban; Cihan, Sener
Introduction To evaluate the predictive significance of pretreatment metabolic tumor volume on pathologic response in patients who received neoadjuvant chemotherapy for breast cancer. Methods Seventy patients who received neoadjuvant chemotherapy between 2013 and 2017 years were enrolled in the study. Pathologic responses and 18-fluorodeoxyglucose positron emission tomography/computed tomography metabolic dates of patients were obtained from archive files. Results Forty-six (65.7%) patients were in stage II and 24 (34.3%) patients were in stage III; 25 (35.7%) patients were human epidermal growth factor receptor 2 positive, 46 (65.7%) patients were estrogen receptor-positive, 26 (37.1%) patients were progesterone receptor-positive. According to the Miller-Payne grading system, 24 (34.3%) patients constituted 100% pathological response; patients with 91-99% pathological response were 12 (17.1%), the number of patients with non-pathologic response was 6 (8.6%). Median metabolic tumor volume was 7.3 cm(3) (7.1 +/- 3.5), 8.8 (11.4 +/- 9.4), 7.7 (8.3 +/- 4.6) and 22 cm(3) (19.8 +/- 11.0) in patients with stages IIA, IIB, IIIA, and IIIB, respectively (p = 0.032). In Miller-Payne grading, the median metabolic tumor volume value was higher in patients with no pathologic response group than 100% response group (p = 0.003). The cut-off metabolic tumor volume value determining no pathologic response was calculated as higher than 13.62 cm(3) (sensitivity 83.3% and specificity 82.8%). Conclusions Our study results suggest that higher pretreatment metabolic tumor volume values are predictive on no pathologic response in patients treated with neoadjuvant chemotherapy for breast cancer.
The Prognostic Importance of Microsatellite Instability Status in Turkish Stage Ii and Iii Gastric Cancer Patients Who Received Adjuvant Chemotherapy
(Akad Doktorlar Yayinevi, 2021) Arici, Serdar; Erhan, Selma Sengiz; Geredeli, Caglayan; Atci, Muhammed Mustafa; Secmeler, Saban; Cekin, Ruhper; Cihan, Sener
Some retrospective studies in different populations have evaluated the prognostic value of microsatellite instability status (MSI) in patients with gastric cancer (GC). A small number of studies have focused on the effect of MSI status on the outcome of GC patients who have received adjuvant chemotherapy (CT). Medical records of 318 patients with stage II or III GC who had been treated with adjuvant CT after D2 gastrectomy between 2016 and 2019 were scanned. Eligible patients were divided into two groups: MSI-H and microsatellite stable (MSS). The determinant factors were examined using Cox regression analysis. A statistical significance level of alpha was accepted as p < 0.05. The study included 207 GC patients and 21 (10.1%) MS-high patients. A median disease-free survival was not reached (95% CI NR) in MSI-H patients, whereas a median disease-free survival was 30 months in MSS patients (95% CI 24.3-35.6) (p= 0.046). A median overall survival (OS) was not reached in MSI-H patients, whereas a median overall survival of 46 months (95% CI: 28.8 - 60.1) was reached in MSS patients (p= 0.032). In the multivariate Cox regression analysis for OS, female gender and MSI-H status were positive predictors of OS, whereas stage III disease negatively affected OS (p= 0.009, p= 0.030, and p= 0.009, respectively). Microsatellite instability status may be a prognostic factor in stage II and III Turkish GC patients who have received adjuvant oxaliplatin-based CT.
Prognostic Significance of Mean Platelet Volume on Local Advanced Non-Small Cell Lung Cancer Managed With Chemoradiotherapy
(Nature Portfolio, 2019) Sakin, Abdullah; Secmeler, Saban; Arici, Serdar; Geredeli, Caglayan; Yasa, Nurgul; Demiraf, Cumhur; Cihan, Sener
Mean platelet volume (MPV), the most commonly used measure of platelet size, and is altered in patients with malignancies. The aim of this study was to investigate the effect of MPV on overall survival (OS) of patients with locally advanced (Stage IIIA/B) inoperable non-small cell lung cancer (NSCLC). This retrospective study included patients who received concomitant chemoradiotherapy (CCRT) with cisplatin + etoposide regimen due to locally advanced stage IIIA/B NSCLC. The study included a total of 115 cases, consisting of 110 (95.7%) male and 5 (4.2%) female patients. The mean age of the patients was 61.3 +/- 10.4 (22-82) years. ROC curve generated by MPV for OS yielded an AUC of 0.746 (95% CI 0.659-0.833), (p < 0.001). MPV was detected as > 9 fL with a sensitivity of 74.4% and a specificity of 72.0%. In patients with stage IIIA, median OS was 45.0 months (95% CI 17.3-74.1) and 21 months (95% CI 10.6-31.3) in groups with MPV > 9.0 fL and <= 9.0 fL, respectively (p = 0.013). In patients with stage IIIB, median OS was 44.0 months (95% CI 13.8-60.6) and 16 months (95% CI 9.5-22.4) in groups with MPV > 9.0 fL and <= 9.0 fL, respectively (p = 0.036). ECOG performance score, total platelet count, and MPV were found as the most significant independent factors affecting survival (p < 0.001, p = 0.008, and, p = 0.034, respectively). In this study, we showed that decreased pre-treatment MPV was an independent risk factor for survival in NSCLC patients who were administered CCRT. As part of routine complete blood count panel, MPV may represent one of the easiest measuring tools as an independent prognostic marker for survival in locally advanced NSCLC.
Prognostic Significance of Primary Tumor Localization in Stage Ii and Iii Colon Cancer
(Baishideng Publishing Group inc, 2018) Sakin, Abdullah; Arici, Serdar; Secmeler, Saban; Can, Orcun; Geredeli, Caglayan; Yasar, Nurgul; Cihan, Sener
Aim To investigate the effects of tumor localization on disease free survival (DFS) and overall survival (OS) in patients with stage I -III colon cancer. METHODS This retrospective study included 942 patients with stage. and. colon cancer, which were followed up in our clinics between 1995 and 2017. The tumors from the caecum to splenic flexure were defined as right colon cancer (RCC) and those from splenic flexure to the sigmoid colon as left colon cancer (LCC). RESULTS The median age of the patients was 58 years (range: 19-94 years). Male patients constituted 54.2%. The rates of RCC and LCC were 48.4% (n = 456) and 51.6% (n = 486), respectively. During the median follow-up of 90 mo (range: 6-252 mo), 14.6% of patients developed recurrence and 9.1% of patients died. In patients with stage. and. disease with or without adjuvant therapy, DFS was similar in terms of primary tumor localization (stage.; P = 0.547 and P = 0.481, respectively; stage.; P = 0.976 and P = 0.978, respectively). In patients with stage. and. disease with or without adjuvant therapy, OS was not statistically significant with respect to primary tumor localization (stage.; P = 0.381 and P = 0.947, respectively; stage.; P = 0.378 and P = 0.904, respectively). The difference between median OS of recurrent RCC (26 +/- 6.2 mo) and LCC (34 +/- 4.(mo) cases was eight months (P = 0.092). CONCLUSION Our study showed no association of tumor localization with either DFS or OS in patients with stage. or. colon cancer managed with or without adjuvant therapy. However, post-recurrence OS appeared to be worse in RCC patients.