Browsing by Author "Topuz, E"

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Clinical Characteristics of Gestational Trophoblastic Disease at a Single Institute
(Tohoku Univ Medical Press, 2002) Alici, S; Eralp, Y; Saip, P; Argon, A; Basaran, M; Topuz, E; Aydiner, A
ALICI, S., ERALP, Y., SAIP, P., ARGON, A., BASARAN, M., Topuz, E. and AYDINER, A. Clinical Characteristics of Gestational Trophoblastic Disease at A Single Institute. Tohoku J. Exp. Med., 2002, 197 (2), 95-100-Gestational trophoblastic diseases (GTD) represent a group of malignancies classified as invasive mole, chorlocarcinoma, and placental-site trophoblastic tumors. The overall cure rate in the treatment of this malignant disorder now exceeds 90%. The aim of this study is retrospectively to evaluate the clinical characteristics and effectiveness of single-agent chemotherapy (CT) and combination chemotherapy according to the World Health Organization (WHO) risk groups of gestational trophoblastic diseases. Thirty one patients with GTD were treated in our institute between 1990-1998. Median age at presentation was 29 years (range 19-70 years). All patients were classified with respect to the WHO scoring system. According to this system, patients were divided into three clinical groups: low-risk nonmetastatic (low-risk group with good prognosis), low-risk metastatic, and high-risk metastatic (high risk group with poor prognosis). Eighteen patients in the nonmetastatic low-risk group with favorable prognostic factors received single agent CT (methotrexate and folinic acid), while 3 patients with metastatic low-risk and 10 patients in the metastatic high-risk group with poor prognosis received combination CT (EMA-CO). Complete response (CR) was obtained in all patients in the low risk group with good prognosis, whereas 9/13 (69%) patients in the poor prognosis group achieved CR and 4 (31%) had partial responses. This clinical classification system may be currently prefer for determining initial therapy in women with malignant gestational trophoblastic tumors. And, our report confirms that the alternating EMA/CO regimen is a well-tolerated and effective combination for the treatment of women with high-risk GTD. gestational trophoblastic diseases; EMA/CO; choriocarcinoma (C) 2002 Tohoku University Medical Press.
Colorectal Cancer in Young Patients: Characteristics and Outcome
(Tohoku Univ Medical Press, 2003) Alici, S; Aykan, NF; Sakar, B; Bulutlar, G; Kaytan, E; Topuz, E
Colorectal cancer is predominantly a disease of the elderly population, but this disease is unusual in patients 40 years of age or under, and controversy persists as to prognosis in this subset of patients. The aim of this study was to determine the clinicopathologic features and their impact on patients survival of colorectal cancer in patients aged 40 years or younger, and to compare them with those of older patients. The records of 466 patients with non-metastatic colorectal adenocarcinoma who were referred between 1991 and 1999 to the University of Istanbul, Institute of Oncology, following curative surgery were retrospectively analysed. The clinicopathologic features of 84 (18%) colorectal cancers (group A; male: female ratio 48: 36) which occurred in patients aged 40 years or younger were compared with 382 colorectal. cancers in older patients (group B; male: female ratio 194: 188). Patient gender, performance status, T stage, N stage, TNM stage, histologic grade, location of tumor, lymphatic invasion, serum levels of LDH and CEA, and survival rates were compared as prognostic factors. There was no statistically significant difference between group A and group B with respect to patient gender, performance status, T stage, N stage, TNM stage, histologic grade, location of tumor, serum levels of LDH and CEA, and survival rates of colorectal cancers. The proportion of lymphatic invasion was present in 27% of patients in group A vs. 12% in group B. With median follow-up of 69 months, the overall 5-year survival rate was 61% in group A and 56% in group B. In the univariate survival analysis according to age groups (group A and B), advanced TNM stage, location of rectal tumor, presence of lymphatic invasion, and presence of high serum LDH and CEA levels are predictors of poorer survival in young patients with colorectal. cancer. In the Cox-Regression analysis, location of tumor and TNM stage were determined as independent prognostic factors for survival. This study revealed no difference in clinicopathologic characteristics in patients with colorectal cancer aged 40 years or younger compared with those aged above 40 years. However, in patients aged 40 years or younger, distal location of tumor and advanced stage should be considered as poor prognostic factors for overall survival. (C) 2003 Tohoku University Medical Press.
Oral Etoposide (Vp16) in Platinum-Resistant Epithelial Ovarian Cancer (Eoc)
(Lippincott Williams & Wilkins, 2003) Alici, S; Saip, P; Eralp, YI; Aydiner, A; Topuz, E
This phase II study evaluates the efficacy and toxicity of a prolonged schedule second-line and third-line treatment of oral VP16 in patients with measurable advanced ovarian cancer resistant to, or relapsed following, platinum-based chemotherapy. Twenty-two eligible women with progressive or relapsed ovarian cancer resistant to platinum-based therapy were included in this study. All the patients had received more than one prior treatment, and had evidence of disease progression within 6 months of the previous chemotherapy. Eleven patients had received more than two different chemotherapy regimens. Fifteen patients had received consolidation therapy with intraperitoneal cisplatin after an initial treatment course with six cycles of a platinum-based combination regimen. All patients with measurable disease observed in abdominal computed tomography scans were given oral VP16 at a daily dose of 50 mg/m(2) for 14 consecutive days with 4 weekly intervals. Among 22 assessable patients, there were one complete response (CR) and three partial responses (PR), so the objective response rate, which is the addition of CR and PR rates, was 18%. Seven patients (32%) had stable disease. Median duration of response and stable disease was 2.5 months (range: 1-10 months). Overall median survival was 11 months from study entry (range: 3-36 months). Toxicity for most patients was mild, but a few severe myelotoxicities occurred, and there were no treatment-related deaths. According to World Health Organization toxicity criteria grade III/IV thrombocytopenia was seen in 4 of 22 patients, grade III/IV neutropenia in 6 of 22 patients, and grade III anemia was observed in 3 of 22 patients. Non-hematologic toxicity was mild, and mucositis was the most frequently observed nonhematologic toxicity. Oral etoposide has considerable activity with a tolerable toxicity profile for the treatment of platinum-resistant epithelial ovarian cancer.