Browsing by Author "Sezgin, Yasin"

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Adjuvant Platin Bazlı Tedavi Verilen Evre Iıb-ıııa Küçük Hücreli Dışı Akciğer Kanseri Hastalarında Adjuvant Tedaviye Kadar Geçen Sürenin Hastalıksız Sağkalıma Etkisi
(2023) Ürün, Muslih; Uysal, Emre; Sezgin, Yasin
Amaç: Küratif cerrahi rezeksiyon geçiren ve adjuvan tedavi verilen küçük hücreli dışı akciğer kanseri hastalarında adjuvan tedaviye kadar geçen sürenin hastalıksız sağ kalımla ilişkisini araştırmayı amaçladık. Gereç ve Yöntemler: Çalışmamızda 2010-2020 yılları arasında küratif cerrahi rezeksiyon geçirmiş ve adjuvan tedavi alan evre IIB-IIIA hastalar retrospektif olarak değerlendirildi. Tedaviye 6 haftadan önce ve sonra başlayanlar olarak kategorize edilip radyolojik nükse kadar geçen zaman hesaplandı. Bulgular: Toplam 89 hasta değerlendirildi. Hastaların 52’sinde adjuvan tedavi ameliyattan sonra 6 içinde başlamışken 37’sinde ise 6 haftadan sonra başladı. Tedaviye 6 haftadan sonra başlanan hastalarda hastalıksız sağkalım istatistiksel olarak anlamlı derecede daha düşük bulundu (p=0,014). Ayrıca çok değişkenli analizde ECOG performans skorunun 0 olması ve adjuvan tedaviye 6 haftadan önce başlanması bağımsız prognostik faktörler olarak bulundu (p=0,001, p=0,045) Sonuçlar: Küratif rezeksiyon uygulanan ve adjuvan tedavi planlanan küçük hücreli dışı akciğer kanseri hastalarında tedaviye 6 haftadan sonra başlamak hastalıksız sağkalımı kısaltmıştır. Bulgularımıza göre tedaviye 6 haftadan önce başlanması önerilmektedir.
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.
Caffeine Mitigates Tamoxifen-Induced Fatty Liver in Wistar Rats
(Acta Cirurgica Brasileira, 2024) Sezgin, Yasin; Bora, Ejder Saylav; Arda, Duygu Burcu; Uyanikgil, Yigit; Erbas, Oytun
Purpose: Tamoxifen, a widely used drug for breast cancer treatment, is associated with adverse effects on the liver, including the development of fatty liver. This study aimed to investigate the potential protective effect of caffeine against tamoxifen-induced fatty liver in Wistar rats. Methods: Rats were divided into normal control, tamoxifen + saline, and tamoxifen + caffeine. Plasma samples were assessed for biochemical markers related to oxidative stress, inflammation, liver function, and cell damage. Additionally, liver histopathology was examined to quantify the extent of fatty infiltration. Results: In the tamoxifen + saline group, elevated levels of plasma malondialdehyde (MDA), tumor necrosis factor-alpha (TNF-alpha), alanine aminotransferase (ALT), cytokeratin 18, and soluble ST2 were observed compared to the normal control group, indicating increased oxidative stress, inflammation, and liver injury (p < 0.01). Moreover, histopathological examination revealed a significant increase in fatty infiltration (p < 0.001). However, in the tamoxifen + caffeine group, these markers were markedly reduced (p < 0.05, p < 0.01), and fatty infiltration was significantly mitigated (p < 0.001). Conclusion: The findings suggest that caffeine administration attenuates tamoxifen-induced fatty liver in rats by ameliorating oxidative stress, inflammation, liver injury, and cell damage. Histopathological evidence further supports the protective role of caffeine. This study highlights the potential of caffeine as a therapeutic intervention to counter tamoxifen-induced hepatic complications, contributing to the optimization of breast cancer treatment strategies.
Chemotherapy Efficacy and Tolerability in Metastatic Gastric Cancer Patients Aged 75 Years and Older
(2023) Sezgin, Yasin; Ürün, Yonca Yılmaz
Objectives: More than half of gastric cancer patients have no chance of resection at the time of diagnosis. In gastric cancer, which has increased frequency with age, chemotherapy efficacy and tolerability in metastatic gastric cancer aged 75 and over have been investigated due to the fact that the elderly patient population is not sufficiently involved in the studies. Methods: In our study, the clinical and demographic characteristics of patients, treatment regimens and responses, prognostic factors, grad 3-4 toxicity, progression-free survival (PFS) and overall survival (OS) were examined. Results: In the study involving 118 patients, PFS was 5.8 months and OS was 8.4 months. A disease control rate of 38.1% was achieved with chemotherapy. Conclusion: Since the OS in this study was 10.5 months in patients with ECOG PS 0-1, 13.8 months in patients who received two lines or more, and the frequency of side effects was acceptable, we believe that this patient population should not be left untreated. Since there are acceptable survival values even with single-agent therapies, monotherapy can be recommended for patients with poor ECOG PS and combination therapies can be recommended for patients with good PS without comorbidities.
Comparison of First-Line Chemotherapeutics and Validation of the Eortc Prognostic Index in Malignant Pleural Mesothelioma: Retrospective Single-Centre Experience
(Coll Physicians & Surgeons Pakistan, 2024) Sezgin, Yasin; Karhan, Ogur; Ileri, Serdar; Ebinc, Senar; Tunc, Sezai; Urakci, Zuhat
Objective: To evaluate the efficiency of pemetrexed cisplatin in comparison with gemcitabine cisplatin and to validate the EORTC (European Organisation for Research and Treatment of Cancer) prognostic score in combination chemotherapy treatment for malignant pleural mesothelioma. Study Design: An observational study. Place and Duration of the Study: Department of Oncology, Dicle University Hospital, Diyarbakir, Turkiye, from October 2000 to Methodology: Malignant pleural mesothelioma (MPM) patients with EORTC score 0- were recruited. Factors affecting the prognosis of the disease and the effectiveness of first-line treatment were retrospectively analysed. EORTC prognostic score was calculated with a cut-off and survival analyses were used by the Kaplan-Meier method. Log-rank and univariable Cox regression tests were used to search for prognostic factors' impact on survival. Results: Patients who received gemcitabine cisplatin treatment had a median progression-free survival (PFS) of 9 months, while those who received pemetrexed cisplatin therapy had a median PFS of 7 months. Median overall survival (OS) was 17 months in the gemcitabine cisplatin group and 18 months in the pemetrexed cisplatin group (p = 0.051). When the low-risk group was compared with the high-risk group, the median OS was found to be statistically significant (p = 0.009). Conclusion: The EORTC prognostic score, which is used for prognostic prediction in the period when pemetrexed is not utilised in the treatment of MPM, accurately predicts prognosis subsequent to the administration of pemetrexed in treatment. In the context of first-line treatment, cisplatin in combination with gemcitabine and cisplatin in combination with pemetrexed demonstrated comparable efficacy with respect to both overall survival and progression-free survival.
Comparison of the Efficacy of Dual Chemotherapy Regimens in Second-Line Treatment of Metastatic Esophageal Squamous Cell Carcinoma
(2024) Guner, Gurkan; Sezgin, Yasin
Objectives: This study aimed to compare the efficacy of folinic acid plus 5-fluorouracil plus irinotecan (FOLFIRI), carboplatin plus paclitaxel, and cisplatin plus 5-FU regimens in second-line treatment of metastatic esophageal squamous cell cancer. Methods: The study included patients over the age of 18 with a diagnosis of esophageal squamous cell carcinoma, stage 4 disease, who had progressed after first-line chemotherapy treatment for metastatic disease and received a dual chemotherapy regimen as a second-line chemotherapy. Results: The mean age of 58 patients was 56.4±12.3 years and 33 (56.9%) of them were women. Among 58 patients, 18 received carboplatin plus paclitaxel, 25 received cisplatin plus 5-FU and 15 received FOLFIRI regimen. Second-line chemotherapy responses were 6.9% complete, 41.4% partial, 17.2% stable, and 34.5% of the patients developed pro- gression. The median follow-up was 4.5 mo (0-46 mo). The median OS for all cohort was 14 mo (95% CI, 4.38-23.62) and there was no statistically difference between three groups (p=0.737). Conclusion: In our study, we observed that doublet chemotherapy regimens were effective in the second series treat- ment of metastatic squamous cell carcinoma and may be a good option for patients with good performance status and no access to immunotherapy.
Concomitant Use of Proton Pump Inhibitors and Cdk4/6 Inhibitors in Metastatic Hormone-Positive Breast Cancer: a Real-World Cohort Study
(Karger, 2024) Karhan, Ogur; Ileri, Serdar; Urakci, Zuhat; Arvas, Hayati; Kilic, Delyadil Karakas; Sezgin, Yasin; Tunc, Sezai
Introduction: Conflicting evidence exists regarding the concurrent use of cyclin-dependent kinase (CDK) 4/6 inhibitors and proton pump inhibitors (PPIs) in the treatment of breast cancer. This study aimed to investigate whether PPI use interferes with the efficacy of CDK4/6 inhibitors. Methods: This retrospective, multicenter, real-world study included 205 patients with hormone receptor-positive, HER2-negative metastatic breast cancer. Patient data were collected from January 2020 to August 2023. Patients who received either ribociclib or palbociclib, with or without a PPI, were included. Median progression-free survival (mPFS) was estimated using the Kaplan-Meier method, and factors associated with mPFS were analyzed using Cox regression. Results: Among the patients, 100 received palbociclib and 105 received ribociclib. In the palbociclib group, 40 patients (40%) used a PPI, and 60 (60%) did not. The mPFS was 16.1 months for patients with a PPI versus 22.2 months for those without (p = 0.26). In the ribociclib group, 44 patients used a PPI and 61 did not use a PPI. The median PFS was comparable between patients receiving PPIs and those not receiving PPIs (19.3 months and 20.7 months, respectively). Poor PFS was associated with liver metastasis, brain metastasis, and high Ki-67. Conclusion: Concomitant use of PPIs with ribociclib or palbociclib did not affect the efficacy of either CDK4/6 inhibitor. PPIs can be administered alongside these medications when clinically indicated. (c) 2024 S. Karger AG, Basel.
An Interesting Cause of Hyperandrogenemic Hirsutism
(Hindawi Ltd, 2014) Atmaca, Murat; Seven, Ismet; Ucler, Rjfki; Alay, Murat; Barut, Veysi; Dirik, Yaren; Sezgin, Yasin
Mild clinical signs of hyperandrogenism such as hirsutism may appear during the menopausal transition as part of the normal aging process, but the development of frank virilization suggests a specific source of androgen excess. We report a case of a 68-yearold woman with signs of virilization that had started 6 months before. Clinical analyses revealed high levels of serum testosterone for a postmenopausal woman. Pelvic MRI and abdomen CT showed no evidence of ovarian and adrenal tumor. Postmenopausal hyperandrogenism can be the result of numerous etiologies ranging from normal physiologic changes to ovarian or rarely adrenal tumors. Our patient was found to have iatrogenic hyperandrogenism. This condition is rarely reported cause of virilization.
Prognostic Significance of the Advanced Lung Cancer Inflammation Index in Metastatic Small Cell Lung Cancer: a Retrospective Analysis of 96 Patients
(int Scientific information, inc, 2024) Urun, Muslih; Guner, Guerkan; Sezgin, Yasin; Uysal, Emre; Sakin, Abdullah; Kilickap, Saadettin
Background: The advanced lung cancer inflammation index (ALI) is regarded as a potential indicator of systemic inflammation. This retrospective study aimed to evaluate the prognostic role of the ALI in 96 patients with advanced small cell lung cancer (SCLC). Material/Methods: This retrospective study included 96 patients who were diagnosed with extensive stage SCLC in a single institution between 2016 and 2022. The formula for ALI is body mass index (kg/m2)xserum 2 )xserum albumin (g/dL)/neutrophil to lymphocyte ratio. Patients were divided into low inflammation (ALI >= 32.5) and high inflammation (ALI <32.5) groups. Kaplan-Meier analysis and Cox proportional analysis were conducted to assess the association between the ALI and patient prognosis. Results: Median age was 61 (range: 41-82) years. Median follow-up was 9 months, and median overall survival (OS) was 10 months (95% CI: 7.75-12.45). A lower ALI score (ALI <32.5) was correlated with a poorer OS than was a higher ALI score (median OS 7 months for ALI <32.5 95% CI: 4.6-9.3 vs 15 months for ALI >= 32.5, 95% CI: 10.6-19.3, P <0.001). In the multivariate analysis, ALI score, Eastern Cooperative Oncology Group performance status, brain metastasis, and bone metastasis were identified as independent prognostic factors. Conclusions: ALI score is a substantial predictor of survival in SCLC as in other types of cancer types. Patients with a low ALI score have poorer survival. Assessment of ALI can identify lung cancer patients at high risk of poor prognosis and can be a useful prognostic marker in clinical practice.
Testis Kanserinde Prognostik Faktörler
(2024) Sezgin, Yasin; Karhan, Oğur; Abdurrahman,; İleri, Serdar; Yerlikaya, Halis; Tunç, Sezai; Aldemir, Mehmet Naci
Amaç: testis kanserleri 15-35 yaş arası erkeklerde en sık görülen kanser olup tüm yaşam boyu erkek kanserlerinin %1’ini oluşturmaktadır. Seminom ve nonseminom olarak iki histolojik subtipi vardır. Çalışmamızda erken evre testis kanserlerinde nüksü predikte eden faktörleri araştırmayı amaçladık Gereç ve Yöntemler: Çalışmamız, 2006-2018 yılları arasında hastanemiz Tıbbi onkololi kliniğine başvuran erken evre testis kanserlerinin incelendiği retrospektif bir çalışmadır. Çalışma sırasında 344 hasta dosyası taranmış olup çalışma kriterlerine uyan 130 hasta çalışmaya dahil edildi. Bu çalışmada primer amacımız erken evre testis kanserlerinde nüksü predikte eden faktörleri araştırmaktı. Bulgular: Nonseminoma hastalarında Lenfovasküler invazyonu olan ve olmayan hastaların PFS açısından yapılan değerlendirmede, her iki grupta da median PFS değerine ulaşılamadı. Ancak LVİ olan hastalarda PFS daha kötü olarak saptandı (p=0.037). Seminom hastalarında evre 1 ile evre 2’nin karşılaştırılmasında median PFS değerlerine ulaşılamadı, ancak iki grup arasında rekürrens açısından istatiksel farklılık vardı (p=0.019) Sonuçlar: Çalışmamızda nonseminom germ hücreli testis tümörlerinde tümör boyutu, embriyonel karsinom predominans, tunika albuginea invazyonu, spermatik kord tutulumu ve tümör markır değerleri ile nüks arasında bir ilişki saptamadık. LVİ olan ve olmayanlar kıyaslandığında, LVİ olan hastalarda PFS daha kısa idi. Seminom hastalarında lenfovasküler invazyon, spermatik kord tutulumu, tunika albuginea tutulumu ve rete testis tutulumu ile hastalık rekürensi arasında ilişki izlenmezken, hastalığın evresinin yüksek olması rekürrens riskini predikte etmekte idi.
Yumuşak Doku Sarkomunda Pazopanıb Kullanımına İlişkin Gerçek Hayat Verileri
(2023) İleri, Serdar; Yerlikaya, Halis; Ürün, Muslih; Sezgin, Yasin; Karhan, Oğur
Özet Amaç: Yumuşak doku sarkomu 50 den fazla alt sınıftan oluşan heterojen bir malignite grubudur. Nadir görülmekle birlikte genellikle kemoterapiye dirençli olup, prognozu kötüdür. Çalışmamızda metastatik yumuşak doku sarkomlarında pazopanib kullanımının etkinliği, tolerabilitesi ve yan etki profilini araştırmayı planladık. Yöntem: Çalışmamız tek merkezli retrospektif bir çalışma olup, metastatik olan ve pazopanib alan 18 yaş üstü hastalar dahil edildi. Geriye yönelik dosya taramasında toplam 37 hastanın verisine ulaşıldı. Pazopanib kullanan hastalarda; tümörün yerleşim yeri, histolojik alt tipi, tümör derecesi, hastalığın evresi, pazopanibin hangi basamakta başlandığı, pazopanibin etkinliği, tolerabilitesi, ve yan etki profili incelendi. Bulgular: Hastaların tanı sırasında ortalama yaş 49. Pleomorfik sarkom en sık görülen alt tip idi. Birinci basamak tedavi sonrası hastaların progresyonsuz sağ kalımı (PFS) 18 hafta idi. Hastaların genel sağ kalım (OS) ortanca sağ kalım 20 ay bulundu. Pazopanib ile ortanca PFS 18 hafta olarak saptandı. Sonuç: Etkinlik ve yan etki yönünden araştırma yaptığımız çalışmada; yumuşak doku sarkomunda pazopanib kullanımı hem PFS hem OS açısından etkin bulundu. Yan etkiler tolere edilebilir ve tedavi edilebilir yan etkilerdi. Çalışmamızda hipotiroidi gelişen hastalarda 32 hafta, gelişmeyelerde ise 16 haftalık bir PFS elde edildi. Bu açıdan hipotiroidi gelişim yanıt için bir prediktif parametre olabilir.