Browsing by Author "Tuncer, Ilyas"

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Analysis of Factors Associated With Survival in Advanced Stage Gastric Adenocarcinoma
(Kare Publ, 2005) Alici, Suleyman; Kaya, Serap; Izmirli, Mustafa; Tuncer, Ilyas; Dogan, Ekrem; Ozbek, Hanefi; Sayarlioglu, Hayriye
In this study, 138 patients with high grade gastric adenocarcinoma who were admitted to Yuzuncu Yil University, Medical School, Department of Medical Oncology between September 1999 and April 2002 were retrospectively evaluated in terms of the effects of clinicopathological parameters and treatment approaches on survival by single and multiple variable analyses. Patients histopathologically diagnosed as gastric adenocarcinomas with stage IV M0 (without distant organ metastasis) or stage IV M1 (with distant organ metastasis) were included in the study. Mean age of the patients was 61.1 (34-84), 64.6% male and 35.5% female. The ratio of patients with a performance score of 2-3 was 55%. The BMI was below 20 in 53.6% of the patients. According to histological grading, 41.9% of patients had indifferentiated adenocarcinoma, mucinous cell adenocarcinoma or signet ring cell adenocarcinoma. 84% of patients were clinically at stage IV M1. The percentage of patients with tumor localized upper 1/3 of stomach was 60.8%. While 19.6% of patients had received surgical treatment, 47% of the patients had received chemotherapy as adjuvant or paliative purposes. The percentage of the patients who responded to the therapy (complete response + partial response + stable response) was 39% and the percentage of patients who had progression was 7.2%. Overall median survival time was 3.1 months and three years survival rate was 8%. At single variable analysis, BMI, clinical stage, surgery, type of surgery and serum level of albumin were significant prognostic factors related to overall median survival time. Gender, clinical stage, surgery, type of surgery, hemoglobine concentration and serum level of albumin were found to be significant prognostic factors related to survival without progression (p<0.05). The factors found to be significant related to overall survival rate in single variable analysis were reevaluated in multiple variable analysis. No surgical treatment, paliative surgery (compared to radical surgery), BMI below 20 were found to be the statistically significant poor prognostic factors related to survival. The factors found to be significant related to survival without progression in single variable analysis were evaluated in multiple variable analysis and no surgical treatment (compared to surgery), male gender (compared to female) were found to be statistically significant poor prognostic parameters. In terms of both overall survival and survival without progression, whether performing surgery or not was statistically most significant independent prognostic factor. In conclusion, no surgical treatment, paliative surgery instead of radical surgery, and BMI below 20 on first admission were determined as poor prognostic factors related to survival in patients with high grade gastric adenocarcinoma.
Analysis of Survival Factors in Patients With Advanced-Stage Gastric Adenocarcinoma
(int Scientific information, inc, 2006) Alici, Suleyman; Kaya, Serap; Izmirli, Mustafa; Tuncer, Ilyas; Dogan, Ekrem; Ozbek, Hanefi; Sayariloglu, Hayriye
Background: Prognosis in patients with gastric cancer is determined by the tumor itself, as well as certain patient-related factors. Material/Methods: In this study, 138 patients with high-grade gastric adenocarcinoma who were admitted to our hospital between September 1999 and April 2002 were retrospectively evaluated in terms of the effects of clinicopathological parameters and treatment approaches on survival by single and multiple variable analyses. Patients histopathologically diagnosed as having gastric adenocarcinomas with stage IV M-0 (without distant organ metastasis) or stage IV M-1 (with distant organ metastasis) were included in the study. Results: Overall median survival time was 3.1 months and three-year survival rate was 8%. With single variable analysis, body mass index (BMI), clinical stage, surgery, type of surgery, and serum level of albumin were significant prognostic factors related to overall median survival time. Gender, clinical stage, surgery, type of surgery, hemoglobin concentration, and serum level of albumin were found to be significant prognostic factors related to survival without progression (p < 0.05). No surgical treatment, palliative surgery (compared with radical surgery), and BMI below 20 were found to be the statistically significant poor prognostic factors related to survival in multiple variable analysis. In terms of both overall survival and survival without progression, performing surgery or not was statistically the most significant independent prognostic factor. Conclusions: No surgical treatment, palliative surgery instead of radical surgery, and BMI below 20 on first admission were determined as poor prognostic factors related to survival in patients with high-grade gastric adenocarcinoma.
Effect of Ursodeoxycholic Acid Alone and Ursodeoxycholic Acid Plus Domperidone on Radiolucent Gallstones and Gallbladder Contractility in Humans
(Hindawi Ltd, 2012) Tuncer, Ilyas; Harman, Mustafa; Colak, Yasar; Arslan, Ismail; Turkdogan, M. Kursad
Background/Aims. The aim of this study was to compare the effects of ursodeoxycholic acid (UDCA) alone and UDCA plus domperidone on dissolution of solitary or multiple gallstones. Methods. Fifty-three patients with cholesterol gallstones were randomized into three treatment groups: group I (n = 22) was given UDCA (15 mg/kg/day) alone and group II (n = 18) was treated with domperidone (30 mg/day) in addition to UDCA. The control group (n = 13) was followed without a medical treatment. Gallbladder volumes and ejection fractions were measured sonographically in all patients before and after treatment. Results. After 12 months of treatment, stone dissolution was found in 9 (40.9%) of the patients in group I and 7 (38.8%) of the patients in group II. The difference was statistically significant compared to controls in both treatment groups (P < 0.05) but the two groups did not show a difference between each other (P > 0.05). All the patients that achieved dissolution had multiple gallstones except for one patient with a solitary stone in group I. Neither monotherapy of UDCA nor the combination with domperidone affected the ejection fraction of gallbladder. Conclusions. Combination with domperidone did not potentiate the efficacy of UDCA. It has been observed that both UDCA alone and UDCA plus domperidone treatment did not affect ejection fraction of gallbladder.
Screening for Celiac Disease Among Patients With Chronic Kidney Disease
(informa Healthcare, 2012) Sahin, Idris; Eminbeyli, Lokman; Andic, Safak; Tuncer, Ilyas; Koz, Suleyman
Aim: Celiac disease (CD) is considered to be a risk factor for chronic kidney disease (CKD) but there is no study determining the prevalence of CD, among patients with CKD. We aim to determine the prevalence of CD in patients with CKD. Materials and methods: Anti-endomysial IgA (EMA) antibody was screened in patients with CKD (glomerular filtration rate <60 mL/min). Patients who were EMA positive underwent upper gastrointestinal system endoscopy and intestinal biopsy for confirmation of definite diagnosis for CD. Results: Two hundred and ninety-two patients (161 males, mean age was 47.3 +/- 16.3 years) with CKD were included. The EMA testing was positive in 10 patients (6F/4M). Of these, eight underwent upper gastrointestinal endoscopy and biopsies, two of them rejected endoscopy. Biopsy specimen of one of the patients was not appropriate for histopathological examination. Specimens of remaining cases (4F/3M) were compatible with CD on histopathological examination. The EMA-positive CKD patients were 3.42% (1/29 cases) and frequency of CD was 2.39% (1/42 cases). Frequency of CD was 3.1% in females and 1.85% in males. Female/male ratio was 1.67. We did not find statistically significant difference between two groups according to age and gender. Apparent chronic gastrointestinal symptoms such as abdominal pain, distension, constipation, dyspepsia, and diarrhea were absent in patients diagnosed with CD. Differences between some laboratory parameters (such as complete blood count, albumin, calcium, phosphate, total cholesterol, ferritin, parathormone) of CD and non-CD patients were not significant statistically. Conclusion: Our results showed increased frequency of CD among patients with CKD and screening for CD in CKD population can be helpful.
Significance of Vegf and Microvascular Density in Gastric Carcinoma
(H G E Update Medical Publishing S A, 2009) Kosem, Mustafa; Tuncer, Ilyas; Kotan, Cetin; Ibiloglu, Ibrahim; Ozturk, Mustafa; Turkdogan, M. Kursad
Background/Aims: The aim of this study is to observe the relationship between the expression of vascular endothelial growth factor (VEGF), microvascular density (MVD) and the pathological characteristics of gastric carcinoma. Methodology: A total of 87 cases of gastric carcinomas were examined by immunohistochemical staining, using anti-VEGF and anti-CD34 antibodies. 62 out of 87 cases (71.2%). The MVD was 64.00 +/- 15.51 (mean SE) in VEGF-positive group and 48.33 +/- 12.71 in VEGF-negative group. Conclusions: The expression of VEGF is correlated with tumor angiogenesis, and VEGF plays an important role in new blood vessels formation. The expression of VEGF and MVD were closely correlated with the degree of differentiation and lymphatic metastasis, but not related to depth of cancer invasion, size of tumor, age or sex. Results: VEGF positive staining was obtained in 62 out of 87 cases (71.2%). The MVD was 64.00 +/- 15.51 (mean SE) in VEGF-positive group and 48.33 +/- 12.71 in VEGF-negative group. Conclusions: The expression of VEGF is correlated with tumor angiogenesis, and VEGF plays an important role in new blood vessels formation. The expression of VEGF and MVD were closely correlated with the degree of differentiation and lymphatic metastasis, but not related to depth of cancer invasion, size of tumor, age or sex.