Browsing by Author "Urun, M."

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A Comparative Analysis of the Efficacy and Safety of Cisplatin and Oxaliplatin-Based Chemotherapy Regimens İn Elderly Patients With Metastatic Gastric Cancer
(Yuzuncu Yil Universitesi Tip Fakultesi, 2025) Urun, M.; Kara, M.
Gastric cancer is a common type of cancer. While surgical treatment is considered the standard approach in early stages, there is currently no standard chemotherapy regimen for advanced and metastatic stages. The incidence of gastric cancer increases with age, making treatment more challenging. The choice of chemotherapy becomes more important in the elderly due to comorbidities, drug interactions and drug side effects. In our study, we investigated the efficacy and side effects of treatments applied to elderly patients. For our study, patients with recurrent or metastatic gastric cancer who were treated and followed up at Van Yuzuncu Yil University Medical Faculty Hospital between January 2008 and January 2024 were evaluated. Medical records were collected including patient demographics, treatment regimens and responses, grade 3-4 toxicities, date of progression, last follow-up and death. Performance score was assessed according to the Eastern Cooperative Oncology Group (ECOG) criteria. The mean age of the patients was 73 years. The most common site of tumour occurrence was the gastric cardia. There were more male patients and the treatment responses were similar. However, there were notable differences in the incidence and severity of side effects. The survival data were comparable. Oxaliplatin and cisplatin-based chemotherapies have comparable effects in advanced gastric cancer in the elderly. However, the incidence of adverse effects differs, and cisplatin should be avoided in patients with nephrotoxicity. The number of patients is insufficient to draw definitive conclusions and further studies are needed. © 2025, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Positive Lymph Node Ratio as a New Prognostic Score in Geriatric Patients With Operated Gastric Cancer
(Elsevier Ltd, 2024) Acar, O.; Balcik, O.Y.; Urun, M.; Avci, T.; Sahbazlar, M.; Erdogan, A.P.
Objective: The pivotal prognostic determinant for recurrence and survival in surgically treated gastric cancer (GC) patients remains the lymph node status. Despite the adoption of D2 lymph node dissection as the standard approach in recent years, its association with increased morbidity in elderly patients raises concerns. This study aims to explore the prognostic significance of the Positive Lymph Node Ratio (PLNR) score in the context of recurrence and survival among elderly patients with surgically treated GC. Material and method: A retrospective review of files about surgically treated patients with GC was conducted. The prognostic impact of the PLNR score on overall survival (OS) was assessed through Receiver Operating Characteristic (ROC) analysis. Results: The cut-off value for the PLNR, determined through ROC analysis, was identified as 0.138. This value serves as a crucial threshold, as it distinguishes patients with a higher risk of poor outcomes. Patients with a PLNR score of 0.138 or below exhibited a median OS of 111 months, whereas those with a PLNR score above 0.138 had a significantly lower median OS of 22 months (p = 0.004). Conclusion: Our findings revealed that the PLNR emerged as an independent predictor of survival and recurrence in patients undergoing GC resection.However, it's important to note that while valuable, the PLNR system has limitations. It does not encompass the T stage, a key factor in cancer staging. Therefore, it cannot be a direct substitute for the comprehensive information TNM staging provides. It should be used as a supplementary tool in predicting prognosis, particularly in elderly patients unsuitable for standard lymph node dissection. © 2024 The Authors