Browsing by Author "Urun, Muslih"

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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.
The Comparison of Flot Vs. Mdcf Regimens in Neoadjuvant Setting for Locally-Advanced Gastric Cancer
(2023) Urun, Muslih; Sahin, Suleyman; Ürün, Yonca Yılmaz; Sakin, Abdullah
Objectives: To compare the pathological tumor response and survival of mDCF (modified docetaxel+cisplatin+5- flourosil) vs. FLOT (5-flourosil+oxaliplatin+dosataxel) regimens in the neoadjuvant setting for patients with locally- advanced gastric adenocarcinoma. Methods: A total of 72 patients, 44 males and 28 females, who were diagnosed with locally-advanced gastric adeno- carcinoma and treated with neoadjuvant chemotherapy were included. Postoperative pathological tumor response, disease free survival (DFS) and overall survival (OS) were compared between the two treatment groups (FLOT and mDCF group). Results: Median DFS was 19.0 months in the FLOT arm (long rank p=0.218), while median DFS could not be reached in the mDCF arm. Rate of DFS in 6, 12,18 and 24 months were 95,4%, 80,9%, 63% and 42% in FLOT group, respectively. In mDCF group, rate of DFS in 6, 12, 18 and 24 months were 100%, 88%, 71,2% and 62,2%, respectively. Median OS was not reached in both groups (long rank p=0.514). There was no significant difference between the treatment regimens (mDCF and FLOT) in terms of response to the treatment, DFS, and OS. Conclusion: Since no significant difference was observed between the regimens in terms of treatment response and survival, we think that cisplatin can be preferred instead of oxaliplatin as a part of neoadjuvant treatment regimen in elderly patients with diabetic neuropathy or high risk of neuropathy.
Covıd-19 Pandemı̇sı̇nı̇n Palyatı̇f Bakım Merkezı̇ndekı̇ Kanser Hastaları Üzerı̇ndekı̇ Etkı̇sı̇nı̇n Değerlendı̇rı̇lmesı̇; Öncesi & Sonrası
(2024) Kaya, Zeynep İrmak; Beypinar, Ismail; Urun, Muslih
AMAÇ: Kanser hastalarında COVID-19 enfeksiyonundan kaynaklanan yüksek ölüm riskine ek olarak, kanser tanısındaki gecikmeler kanser hastalarının tedavisinin gecikmesine neden olabilir. Bu çalışmada, Türkiye'de pandemi öncesi ve sonrası bir yıllık dönemler arasında kanser hastalarının tanı, evre ve prognoz gibi özelliklerindeki değişikliklerin değerlendirilmesi amaçlanmıştır. GEREÇ VE YÖNTEM: Palyatif serviste 11 Mart 2019 ile 11 Mart 2021 tarihleri arasında palyatif tedavi alan hastaların kayıtları retrospektif olarak incelendi. Hasta dosyalarından yaş, cinsiyet, tanı, tanı tipi, tedavi tipi, palyatif servise geliş yeri ve taburculuk şekli retrospektif olarak tarandı. Tekrarlayan yatışları olan hastaların ilk yatışları değerlendirildi. Hasta kayıtları yetersiz olan hastalar çalışma dışı bırakıldı. BULGULAR: Radyolojik olarak kanser tanısı konulan hastaların oranı artmıştır. Pandemi öncesi dönemde hastaların %9,1'inde radyolojik olarak kanser bulgusu saptanırken, pandemi sonrası dönemde bu oran %16,2 idi. Hastalar yatarak palyatif bakım öncesi aldıkları onkolojik tedavi açısından değerlendirildiğinde anlamlı fark saptandı (p=0,002). Bu fark pandemi sonrası onkolojik tedaviye uygun olmayan hastaların oranındaki artıştan kaynaklanmaktaydı. SONUÇ: Pandeminin yeni tanı alan ve palyatif bakım hizmetlerine ihtiyaç duyan hastalar üzerinde büyük etkileri olduğunu düşünüyoruz. Bu çalışmada, pandemi sonrası dönemde radyolojik olarak kanser tanısı alan ve palyatif bakım servislerinde tedavi gören kanser hastalarında artış gözlemlendi.
Do Nutritional and Inflammatory Indices Predict Response in Geriatric Gastric Cancer Patients Treated With Neoadjuvant Flot Regimen
(Sage Publications inc, 2025) Urun, Yonca Yilmaz; Urun, Muslih
Introduction: Docetaxel-based chemotherapy is a standardized neoadjuvant treatment for gastric cancer. There are still no reliable indicators to predict tumor response and prognosis of geriatric patients prior to chemotherapy. The aim of our study was to investigate the value of pretreatment prognostic nutritional index (PNI), serum albumin, total lymphocyte, neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) in predicting the response to treatment in geriatric gastric cancer patients treated with FLOT (5-Fluorouracil, leucovorin, oxaliplatin, and docetaxel) regimen as neoadjuvant chemotherapy. Methods: A total of 91 geriatric gastric cancer patients (>= 65-year-old) who received a neoadjuvant FLOT regimen were retrospectively analyzed. Pretreatment data, including demographic characteristics, complete blood count, serum albumin level (g/dL), serum tumor markers (CEA and CA19-9), PNI values and other clinicopathological parameters, were collected. Independent sample t-tests and Mann-Whitney U tests were used to analyze quantitative independent data. In the analysis of independent qualitative data, the chi-squared test and Fischer's exact test were used when the chi-squared test conditions were not met. Results: The mean age was 69.9 +/- 4. There were 22 patients in the treatment-responsive group and 69 in the treatment-nonresponsive group. Serum albumin levels were significantly higher in the treatment-responsive group. The lymphocyte counts were significantly lower in the treatment-responsive group. Additionally, both disease-free survival and overall survival were significantly extended in patients who responded to treatment. Conclusion: We demonstrated that serum albumin and total lymphocyte counts, which are easily accessible blood parameters routinely examined before treatment, may predict the response in geriatric gastric cancer patients receiving neoadjuvant FLOT treatment. However, larger prospective, multicenter studies are required to confirm this relationship.
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.
Prognostic Value of Imdc Score in Non-Small Cell Lung Cancer Receiving Immunotherapy: Old Dog, New Tricks
(Springer Heidelberg, 2025) Beypinar, Ismail; Urvay, Semiha; Urun, Muslih; Ercek, Berrak; Demir, Hacer; Yildiz, Canan; Balcik, Onur Yazdan
Background Although there are multiple treatment options, oncologists lack appropriate biomarkers for determining the efficacy and toxicity of immunotherapy. In this study, we aimed to use a combination of the clinical parameters of IMDC risk groups at the time of diagnosis to predict the effectiveness of immunotherapy. Methods This multicenter cross-sectional study retrospectively analyzed non-small cell lung cancer (NSCLC) patients receiving nivolumab for the prognostic effects of clinical factors, including the IMDC score. Results Two hundred and five patients were enrolled in this study. There was no favorable group because the TTI was less than 1 year in the entire study group in the IMDC. The IMDC score and IMDC groups showed significant differences in PFS (p < 0.001; p < 0.001, respectively). Intermediate and poor-risk groups had PFS of 8 and 3 months PFS, respectively. The IMDC group showed a significant effect on OS (p = 0.002). The intermediate- and poor-risk groups had 12- and 4-month OS, respectively. The TTI risk factor excluded patient numbers in the favorable, intermediate, and poor risk groups were 47, 129, and 29, respectively, in the revised IMDC group (rIMDC). The prognostic effect of the rIMDC score and groups remained significant (p < 0.001 and p < 0.001, respectively). The classical IMDC had a significant effect on PFS in the multivariate analysis (p = 0.016). Also, rIMDC score in multivariate analysis resulted with significant effect on OS (p = 0.035). Conclusion To date, this is the first study to prove that the IMDC may be a valuable option for predicting both prognosis and treatment efficacy in NSCLC patients receiving especially second or further lines nivolumab treatment.