Browsing by Author "Yasar, Nurgul"

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Adrenocortical Carcinoma: Single Center Experience
(2020) Seçmeler, Şaban; Can, Orcun; Yasar, Nurgul; Geredeli, Caglayan; Demir, Cumhur; Sakin, Abdullah; Cihan, Sener
Objective: The prevalence of adrenocortical carcinoma (ACC) is approximately 0.02% of all cancers, and the annual incidence is approximately 1-2 per million population. ACC is more aggressive, and the prognosis of ACC is poorer in adults than that in pediatric patients. We aimed to investigate the clinicopathological characteristics and factors affecting overall survival (OS) in patients with ACC who were followed-up and treated in our hospital.Methods: The patients, who were treated and followed up in the oncology clinic between 2006 and 2018, were included in the study. The patients who were diagnosed with ACC in the pathologic evaluation were included.Results: A total of 10 patients, five men (50%) and five women (50%), were included in the study. The mean age was 42.4 years (range=18-67). Six patients (60%) were stage 3, and four patients (40%) were stage 4. Eight patients (80%) underwent surgery. The release of glucocorticoid and/or androgen was detected in six patients (60%). Recurrence developed in six patients (100%), and seven patients (70%) died during the follow-up. The median OS was 13 months in patients with stage 3 disease, and the median OS was eight months in patients with stage IV disease (Log-rank p=0.177). The eastern cooperative oncology group performance status (ECOG PS) and performing of surgery were detected as the most significant factors affecting OS (Log-rank p=0.01, Log-rank p=0.02).Conclusion: The significant factors for OS were found to be surgery and ECOG PS in our study.
Assessment of Pretreatment Albumin-Bilirubin Grade in Pancreatic Cancer Patients With Liver Metastasis
(Imprimatur Publications, 2020) Sakin, Aysegul; Sahin, Suleyman; Sakin, Abdullah; Atci, Muhammed Mustafa; Yasar, Nurgul; Arici, Serdar; Cihan, Sener
Purpose: This study aimed to assess the effect of pretreat- ment albumin-bilirubin (ALBI) score on treatment outcomes in pancreatic cancer (PC) patients with liver metastasis at the time of diagnosis treated with chemotherapy (CT) in the first-line setting. Methods: This was a retrospective study of 273 PC patients >= 18 years of age who had liver metastasis at the time of diagnosis and received CT in the first-line. ALBI score was calculated through the following formula; [(log10 bilirubin (mu mol/L)x0.66)+[albumin(g/l)x-0.0852]. Patients were strati- fied into 3 categories based on the ALBI score as follows; grade I:ALBI <=-2.60, grade II:-2.60-1.39. Results: A total of 273 patients, [180 (65.9%) men and 93 (34.1%) women], were evaluated. The median age was 60 years. ALBI grade was I in 45 (16.4%) patients, II in 156 (57.1%) patients, and III in 72 (26.5%) patients. Based on the ALBI grade, median progression-free survival (mPFS) was 9 months in grade I patients, 6 months in grade II patients, and 4 months in grade III patients (p=0.002), with median overall survival (mOS) durations of 12 months vs. 8 months vs. 5 months, respectively (p<0.001). Multivariate analysis showed that ALBI grade II (HR,1.543) or III (HR,2.260) negatively affected survival. Conclusion: A higher pretreatment ALBI grade is related to worse OS and PFS in PC patients with liver metastasis treated with a first-line CT, and therefore it can help predict the treatment outcomes in these patients.
Does the Waiting Period for Genetic Tests Affect the Prognosis in Chemotherapy-Treated De Novo Metastatic Non-Small Cell Lung Cancer Patients Without a Driver Mutation
(Karger, 2021) Arici, Serdar; Sakin, Abdullah; Cekin, Ruhper; Secmeler, Saban; Yasar, Nurgul; Cihan, Sener
Introduction: The length of the necessary waiting period to test driver mutations may generate anxiety in patients and clinicians. For this reason, an investigation was conducted to determine whether the duration between diagnosis and the start of first-line chemotherapy (DDC) in non-small cell lung cancer (NSCLC) patients without driver mutations has an impact on prognosis. Methods: The study included 303 de novo metastatic NSCLC patients without a driver mutation and patients were divided into 2 groups according to DDC: <= 30 days (group A) or >30 days (group B). The determinant factors for progression-free survival (PFS) and overall survival (OS) were examined by Cox regression analysis. Results: The mean DDC was calculated as 38.2 +/- 54.5 days. The number of patients in group A and B were 183 and 120, respectively. The median PFS in groups A and B was 5.0 and 6.0 months (p = 0.268) and the median OS was 10.0 and 11 months, respectively (p = 0.341). Univariate and multivariate analyses revealed that DDC was not a factor associated with PFS and OS. Conclusion: Our results show that a higher DDC was not associated with a worse prognosis in metastatic NSCLC patients without driver mutations. In this context, it is safer for patients and their physicians to wait for test results before starting chemotherapy.
The Effect of Body Mass Index on Location of Recurrence and Survival in Early-Stage Colorectal Cancer
(Wolters Kluwer Medknow Publications, 2020) Sakin, Abdullah; Samanci, Nilay Sengul; Secmeler, Saban; Arici, Serdar; Can, Orcun; Yasar, Nurgul; Cihan, Sener
Introduction: Obesity has become one of the major public health problems in many countries. Controversial results were reported in publications on the relationship between obesity and mortality in patients diagnosed with colorectal cancer (CRC) and that receive curative treatment. In this study, we evaluated the effects of body mass index (BMI) on the location of recurrence and disease-free survival (DFS) in patients with early-stage CRC. Materials and Methods: Patients that were followed up and treated in the Department of Medical Oncology between 1999 and 2016 were retrospectively included in the study. Patients with operated Stage I, II, and III CRC were included in the study. Patients were divided into three groups based on their BMI (kg/m2) of below 25, between 25 and 30, and above 30. Results: A total of 950 patients, of which 527 (55.5%) were male and 423 (44.5%) were female, were included in the study. The median age of the patients was 56 years. Of the patients, 408 (42.4%) had BMI of <25, 370 (38.9%) had BMI between 25 and 30, and 172 (18.2%) had BMI of 30. Local recurrence rate was significantly higher in the group with BMI >= 30 compared to the other groups (P <0.01). When compared with DFS, there was a statistically significant difference between groups with BMI of <25 and >= 30 (P = 0.02) and that difference was more evidently observed in Stage III (P = 0.02). There was no statistically significant difference of overall survival in the BMI groups (P = 0.87). In multivariate analysis, the BMI >= 30 (hazard ratio [HR], 1.49, 95% confidence interval [CI], 1.02-2.17), rectal tumor (HR, 1.70, 95% CI, 1.15-2.51), Stage III (HR, 3.91, 95% CI, 1.86-8.25), number of positive lymph nodes (HR, 1.05, 95% CI, 1.03-1.07), and R1 resection (HR, 3.47, 95% CI, 1.71-7.05) were identified as independent risk factors negatively affecting DFS. Conclusion: In this study, we observed that the high BMI increased the risk of recurrence, especially in Stage III CRC patients, and that the recurrence frequently occurred locally.
The Effect of Body Mass Index on Treatment Outcomes in Patients With Metastatic Non-Small Cell Lung Cancer Treated With Platinum-Based Therapy
(Routledge Journals, Taylor & Francis Ltd, 2021) Sakin, Aysegul; Sahin, Suleyman; Mustafa Atci, Muhammed; Yasar, Nurgul; Demir, Cumhur; Geredeli, Caglayan; Cihan, Sener
To investigate the effect of body mass index(BMI) on treatment outcomes and side-effect profile in metastatic non-small cell lung cancer(NSCLC) patients receiving platinum-based chemotherapy(ChT) in the first-line setting. This was a retrospective analysis of 233 NSCLC patients who were treated and followed up from 2008 through 2018. NSCLC patients who had metastatic disease at the time of diagnosis and were treated with platinum-based ChT in the first-line setting were included. The patients were divided into 2 groups based on the BMI as follows; BMI < 25 kg/m(2)and BMI >= 25 kg/m(2). This retrospective analysis enrolled 233 patients, 35 (15.0%) of whom were female. The BMI in 132 patients (56.2%) was < 25 kg/m(2). The median age was 58 years (range, 21-90). Median progression-free survival(PFS) was 7 mo, in the patients with BMI >= 25 kg/m(2)compared to 5.0 mo, in those with BMI < 25 kg/m(2)(p = 0.032), with corresponding median overall survival(OS) durations of 12 vs. 9 mo, (p = 0.003). In multivariate analysis, ECOG PS 2, grade III histology, and brain or bone metastasis negatively affected OS, whereas BMI >= 25 kg/m(2)positively affected OS. A high BMI prior to therapy in patients with NSCLC treated with platinum-based ChT in the first-line setting was associated with more favorable PFS and OS.
The Effects of Fulvestrant Treatment on Hormone Receptor-Positive Metastatic Breast Cancer
(2020) Geredeli, Çağlayan; Cihan, Sener; Arıcı, Serdar; Seçmeler, Şaban; Yasar, Nurgul; Sakin, Abdullah; Can, Orcun
Objectives: To determine fulvestrant efficacy and tolerability in Turkish patients with hormone receptor-positive metastatic breast cancer.Methods: Patients who developed metastasis while taking tamoxifen or aromatase inhibitors in the adjuvantperiod or metastatic disease at the diagnosis. Fulvestrant 500 mg was administered intramuscularly every 28days. Progression-free survival (PFS) and overall survival (OS) durations were calculated.Results: In this particular research, totally 137 patients were participated. Median PFS was 9 months (95%CI, 5.7-10.3). The 12-month PFS rate was calculated as 42%, and the 36-month PFS rate was 17%. The medianPFS was not reached in the first line use of fulvestrant in the metastatic period but 9 months and 7 months inthe second and subsequent lines respectively. Results indicated that this difference was statistically significant(p = 0.002). It was shown that patients with liver and brain metastasis had lower PFS compared patients withno liver and no brain metastasis. The estimated median OS was 38 months after fulvestrant started. The 12-month OS rate was calculated as 82.4%, and the 36-month OS rate was 50%.Conclusions: Fulvestrant contributes both PFS and OS in patients with hormone receptor-positive metastaticbreast cancer and this effect is more clear in using fulvestrant as first-line treatment.
Efficacy and Tolerability of Adjuvant Therapy in ≥70-Year Patients With T3n0m0 Colorectal Cancer: an Observational Study
(Sage Publications Ltd, 2020) Sakin, Abdullah; Yasar, Nurgul; Sahin, Suleyman; Arici, Serdar; Secmeler, Saban; Can, Orcun; Cihan, Sener
Background:This study aimed to retrospectively investigate the efficacy and tolerability of adjuvant chemotherapy in >= 70-year-old patients with stage IIA (T3N0M0) colorectal cancer. Methods Lymphovascular invasion, perineural invasion, margin positivity, dissected lymph node count of <12, and presence of perforation/obstruction were accepted as risk factors. Those patients with at least one risk factor were regarded as having high risk.Results:The study included 168 patients, among which 95 (56.5%) were male and 73 (43.5%) were female. The median age of patients was 73 years (range: 70-94). One hundred one (60.1%) patients were identified to have high risk. Eighty-one (87%) patients received 5-flourouracil+leucovorin and 12 (13%) patients received capecitabine regimens as adjuvant chemotherapy. The patients receiving capecitabine regimen had significantly higher rates of dose reduction at initiation and during the treatment. Among low-risk group, there was no statistically significant difference between patients with and without adjuvant chemotherapy in terms of disease-free survival or overall survival (p = 0.528 and p = 0.217, respectively). In high-risk group, patients receiving adjuvant chemotherapy significantly differed from those not receiving adjuvant chemotherapy in terms of median disease-free survival and overall survival (p = 0.009 and p < 0.001, respectively). While the grade, lymph node status, and adjuvant chemotherapy were identified as the most significant independent factors for disease-free survival, the most significant factors for overall survival were the age, Eastern Cooperative Oncology Group performance status, adjuvant chemotherapy, and recurrence.Conclusion:The findings of our study showed improved disease-free survival and overall survival in high-risk >= 70-year-old patients who received adjuvant chemotherapy due to T3N0M0 colorectal cancer. We believe that 5-flourouracil+leucovorin or capecitabine regimens should be recommended for these older high-risk patients who could receive adjuvant chemotherapy regardless of age.
The Evaluation of Efficacy and Tolerability of Gemcitabine Vs. Capecitabine Therapy in the Second-Line Setting for Metastatic Pancreatic Cancer Patients With Poor Performance Status
(2019) Yasar, Nurgul; Sakin, Abdullah; Cihan, Şener; Geredeli, Caglayan; Atcı, Muhammed Mustafa; Sahin, Suleyman; Demir, Cumhur
Aim: The aim of this study was to evaluate the efficacy and tolerability of single-agent gemcitabine vs.capecitabine therapy in the second-line setting for metastatic Pancreatic Cancer (mPC) patients withpoor performance status.Material and methods: A total of 48 patients with mPC, who were followed and treated in oncologycenter between 2012 and 2017, were included. After a failure of first-line therapy, patients with an ECOGPS 2 treated with capecitabine or gemcitabine monotherapy in the secondline setting were retrospectively analyzed.Results: Of the 48 patients, 26(54.2%) were males and 22(45.8%) were females. The median age of thepatients was 62 years(range, 31-82). Treatment regimens in the first-line setting were as follows;gemcitabine+cisplatin in 24(50%) patients, gemcitabine+nub-paclitaxel in 4(8.3%) patients, FOLFIRINOXin 8(16.7%) patients, FOLFOX in 8(16.7%) patients, and gemcitabine+oxaliplatine in 4(8.3%) patients. Afterprogression on first-line therapy, 29(60.5%) patients were treated with capecitabine in the second-linesetting, while 19(39.5%) patients were given gemcitabine. Median progression-free survival was found tobe 4 months(95% CI,1.9-6.0) in patients receiving capecitabine compared to 2 months(95% CI, 0.5-3.4) inthose treated with gemcitabine (p¼0.271). Median overall survival was 6.0 months(95% CI, 2.0-9.9) inpatients receiving capecitabine therapy versus 5.0 months (95% CI, 1.0-8.9) in those treated with gemcitabine monotherapy (p¼0.353).Conclusions: Optimal second-line treatment for mPC has not yet been established. In the present study,capecitabine monotherapy was compared to gemcitabine and it was found that they both had similarefficacy in the second-line treatment for mPC patients who were not eligible for combination chemotherapy regimen.
Factors Affecting Disease-Free Survival in Operated Nonmetastatic Gastrointestinal Stromal Tumors
(Academic Press inc Elsevier Science, 2019) Sakin, Abdullah; Can, Orcun; Arici, Serdar; Yasar, Nurgul; Geredeli, Caglayan; Demir, Cumhur; Cihan, Sener
Background: Possibly originating from interstitial Cajal cells, gastrointestinal stromal tumors (GISTS) have variable biological behaviors. In this study, we aimed to examine the factors affecting the disease-free survival (DFS) in patients with GIST who underwent operation. Material and methods: The study included the patients who were followed up and treated for GIST in our oncology clinic between 2002 and 2017. The Armed Forces Institute of Pathology criteria (Miettinen risk score) were used for risk stratification of patients. Results: Seventy-four patients were included to the study, where female patients constituted 52.7%, and the median age was 56 (range: 24-83) y. Most common primary tumor location was the stomach (51.4%), followed by the small intestine (33.8%), colorectum (10.8%), and retroperitoneum (4.1%). Miettinen risk score showed 12 patients (16.7%) at very low risk, 15 patients (20.8%) at low risk, 18 patients (25%) at intermediate risk, and 27 patients (37.5%) at high risk. DFS was significantly lower in patients with small intestine involvement than in cases with stomach involvement (P = 0.004). DFS was significantly lower in patients at high risk than in patients with no high risk (P = 0.034). Small intestine localization (hazard ratio [HR], 8.98; 95% confidence interval [CI], 1.14-8.18), high-risk score (HR, 5.16; 95% CI, 1.42-12.75), c-kit positivity (HR, 0.24; 95% CI, 0.13-0.69), and adjuvant therapy (HR, 0.37; 95% CI, 0.20-0.92) were found to be the most significant factors affecting DFS. Conclusions: Our study showed negative effects of small intestine localization and high-risk category and positive effects of c-kit positivity and adjuvant therapy on DFS in patients with GIST who underwent operation. When a decision will be made in favor of adjuvant therapy, tumor localization and c-kit mutation should also be considered in addition to risk score. (C) 2019 Elsevier Inc. All rights reserved.
Factors Affecting Survival and Treatment Efficacy in Breast Cancer Patients With Bone Marrow Metastasis
(Wiley-hindawi, 2020) Sakin, Abdullah; Sakalar, Teoman; Sahin, Suleyman; Yasar, Nurgul; Demir, Cumhur; Geredeli, Caglayan; Cihan, Sener
Factors Affecting Survival in Operated Pancreatic Cancer: Does Tumor Localization Have a Significant Effect on Treatment Outcomes
(Kare Publ, 2020) Sakin, Abdullah; Sahin, Suleyman; Sakin, Aysegtil; Atci, Muhammed Mustafa; Arici, Serdar; Yasar, Nurgul; Cihan, Sener
OBJECTIVE: This study aims to investigate the factors affecting survival in operated pancreatic ductal adenocarcinoma (PDAC) and the possible prognostic effect of primary tumor localization on treatment outcomes. METHODS: In this study, 98 patients with curatively-operated PDAC, who were followed up and treated for the years 2008 through 2018, were enrolled. Metastatic and locally advanced stages and patients under 18 years of age were excluded from this study. Patients were divided into two groups based on the primary tumor localization as *head or *body/tail. RESULTS: Sixty-seven (68.3%) patients were male and 31 (31.7%) were female, with a median age of 62 years (range, 35-82 years). The numbers of patients with a primary tumor located in *head vs.*body/tail were 74 (75.4%) vs. 24 (24.6%), respectively. Patients with a primary tumor located in *head vs.*body/tail; median disease-free survival was 16.0 months vs. 13 months (p=0.972), respectively, with corresponding median overall survival was 25 months vs. 33 months (p=0.698). The level of carcinoembryonic antigen(CEA) at diagnosis (Hazard ratio[HR], 1.09 95%CI, 1.01-1.18), stage III disease (HR, 2.09 95%CI, 1.16-4.35), and receiving adjuvant treatment (HR, 0.20 95%CI, 0.09-4.34) were the independent predictors of survival. CONCLUSION: Our study revealed that high levels of CEA at diagnosis and stage III disease adversely affected the survival in non-metastatic PDAC patients, while receiving adjuvant therapy had a positive effect on survival. The findings suggest that primary tumor localization did not affect survival in operated PC patients. The results on this issue are still inconsistent and under debate in the literature.
Factors Affecting Survival in Patients With Isolated Liver-Metastatic Colorectal Cancer Treated With Local Ablative or Surgical Treatments for Liver Metastasis
(Imprimatur Publications, 2019) Sakin, Abdullah; Sahin, Suleyman; Atci, Muhammed Mustafa; Yasar, Nurgul; Geredeli, Caglayan; Aribal, Serkan; Cihan, Sener
Purpose: Local treatments for isolated synchronous or metachronous liver metastases in colorectal cancer (CRC) have been shown to improve overall survival (OS). The aim of this study was to investigate the factors affecting OS in CRC patients with isolated liver metastasis in whom the primary tumor and corresponding liver metastasis were treated with curative intent using local ablative or surgical methods. Methods: A total of 47 CRC patients presenting with an initial or subsequent isolated liver metastasis, who were treated with local surgical or ablative treatment for liver metastasis with curative intent, were enrolled in this study between 2007 and 2017. The possible factors affecting OS were analyzed. Results: Out of the 47 patients, 35 (74.5%) were male. The median age was 61 (25-80) years. Thirty-four (72.3%) patients underwent liver metastasectomy, while 13 (27.7%) patients were treated with non-surgical local ablative therapies (NSLAT) for liver metastasis. Median OS (mOS) could not be reached in patients who underwent metastasectomy at the time of diagnosis compared to 55 months in those undergoing metastasectomy following a chemotherapy period (p=0.03). Patients treated with NSLAT had a mOS of 60 months compared to "not reached'' in those who underwent liver metastasectomy (p=0.45). mOS was higher in patients with pT4 stage vs.
Germline Mutations in Brca1 and Brca2 in Breast Cancer Patients With High Genetic Risk in Turkish Population
(Hindawi Ltd, 2019) Geredeli, Caglayan; Yasar, Nurgul; Sakin, Abdullah
Background. The guidelines recommend considering the BRCA1 and BRCA2 germline mutations in female patients with breast carcinomas. In this retrospective study, the BRCA1/2 mutation prevalence in high-risk breast carcinoma patients in a Turkish population was investigated. Materials and Methods. In high genetic risk breast carcinoma patients, the BRCA1 and BRCA2 germline mutations were identified by applying next-generation sequencing. Results. The results showed BRCA1/2 mutations in 19% of the total patients. In those with first-degree relatives with breast carcinoma histories, the BRCA1/2 mutation prevalence was also 19%. In the patients younger than 40 years old, the BRCA1/2 mutation prevalence was 19.5%. In the triple-negative breast carcinoma patients younger than 60 years old, the BRCA1/2 mutation prevalence was 24.2%. In the patients younger than 40 years old with triple-negative breast carcinomas, BRCA1/2 mutation positivity was found in 37.5% of the patients. Overall, in the Turkish population, the BRCA1/2 mutation prevalence ranges from 19% to 37% in patients with high-risk breast carcinomas. Conclusion. It is recommended to check for BRCA1/2 mutations in all high-risk breast carcinoma patients in the Turkish population.
The Impact of Tumor Regression Grade on Long-Term Survival in Locally Advanced Rectal Cancer Treated With Preoperative Chemoradiotherapy
(Sage Publications Ltd, 2020) Sakin, Abdullah; Sahin, Suleyman; Sengul Samanci, Nilay; Yasar, Nurgul; Demir, Cumhur; Geredeli, Caglayan; Cihan, Sener
Purpose The aim of this study is to investigate the prognostic effect of tumor regression grade (TRG) on long-term survival in locally advanced rectal cancer treated with preoperative chemoradiotherapy. Methods Medical records of 182 patients with locally advanced rectal cancer, who were treated with preoperative chemoradiotherapy followed by surgery between 2002 and 2016, were retrospectively reviewed. TRG was classified into five categories based on the pathological response as follows - TRG1: no viable cancer cell, TRG2: single cancer cell or small groups of cancer cells, TRG3: residual tumor outgrown by fibrosis, TRG4: residual tumor outgrowing fibrosis, TRG5: diffuse residual tumor without regression. TRG1, (TRG2+TRG3), and (TRG4+TRG5) were grouped as complete response, intermediate response, and no response, respectively. Results Of the 182 patients with locally advanced rectal cancer, 112 (61.5%) were male. The mean age was 54.4 (range, 25-87) years. The total number of patients in complete response, intermediate response, and no response group was 24 (13.2%), 105 (57.7%), and 53 (29.1%), respectively. The corresponding five-year relapse-free survival and overall survival rates were 79.8%-92.3%, 74.7%-79.4%, and 55.7%-55.8%, respectively (p < 0.05 for relapse-free survival, p < 0.05 for overall survival). According to ypTNM stage, there was no significant difference in relapse-free survival among TRG groups in ypStage I and II patients (p > 0.05). In ypStage III patients, relapse-free survival was 62 months in no response group vs. not reached in intermediate response group (p < 0.05). According to the ypTNM, there was no significant difference in overall survival among TRG groups in ypStage I, II, and III patients (p > 0.05). In the multivariate analysis, pathological complete response was found to be an independent variable for relapse-free survival and overall survival (hazard ratio (95% confidence interval), 0.34 (0.17-6.77), 0.39 (0.18-0.83), respectively). Conclusion This study showed that patients with pathological complete response to preoperative chemoradiotherapy had longer relapse-free survival and overall survival rates than those with residual disease.
Mean Platelet Volume and Platelet Distribution Width Correlates With Prognosis of Early Colon Cancer
(Imprimatur Publications, 2020) Sakin, Aysegul; Sahin, Suleyman; Sakin, Abdullah; Karatas, Fatih; Samanci, Nilay Sengul; Yasar, Nurgul; Cihan, Sener
Purpose: Several platelet indices have been linked to prognosis of various cancers, including metastatic colorectal cancer. The aim of this study was to investigate the prognostic effect of mean platelet volume (MPV) and platelet distribution width (PDW) in early colon cancer (CC) patients. Methods: This retrospective study included early CC patients who were followed up and treated between 2005 and 2017. Relapse free survival (RFS) and overall survival (OS) were determined with respect to several demographic and clinical characteristics of patients, including MPV and PDW. The cut-off value was determined as >8.5 fL for MPV (sensitivity: 67.1%, specificity 54.5%) and <= 16% for PDW (sensitivity: 66.7%, specificity: 60.0%). Results: The study included 394 patients, 53.3% of which were male. Stage I, II, and III patients constituted 8.9%, 46.4%, and 44.7% of the study population, respectively. Among all patients, RFS and OS were significantly longer in patients with MPV <= 8.5 fL and PDW>16 fL (p <0.001 and p=0.011 for MPV, respectively; and p<0.001 and p=0.026 for PDW, respectively). In patients with stage III disease, those with MPV <= 8.5 fL had significantly longer RFS and OS compared to those with MPV >8.5 fL (p<0.001 and p=0.001, respectively). On the other hand, those with PDW>16% had significantly longer RFS than that in those with PDW <= 16 fL, among stage III patients (p<0.001). In multivariate analysis, stage, perineural invasion, lymphovascular invasion, adjuvant treatment, CEA, CA19-9, PDW, and MPV were found the most significant factors affecting RFS. Conclusion: Our study suggests that elevated MPV and decreased PDW appear to be unfavorable prognostic factors in early CC, especially in patients with stage III disease. Considering the wide availability and accessibility of these indices, it is reasonable to designate further larger prospective studies to clarify and verify their potential roles in early CC.
Non-Urothelial Bladder Cancers: Single Center Experience
(2019) Yasar, Nurgul; Arıcı, Serdar; Seçmeler, Şaban; Sakin, Abdullah; Demirel, Cumhur; Can, Orcun; Geredeli, Cağlayan
Objective: Bladder cancers are classified into two groups as urothelial and non-urothelial cancer (NUBC). In this study, we investigated the clinicopathological featuresand treatment responses in patients with NUBC who were diagnosed and treated in our center.Methods: The patients who were diagnosed and treated in our hospital between 2006 and 2017 were included in the study retrospectively. Patients with urothelial ormixed bladder cancers were excluded from the study.Results: A total of 16 patients with NUBC were included in the study. Six patients had squamous cell carcinoma, six patients had small cell carcinoma and four patientshad adenocarcinoma. Thirteen patients (81%) were male and three were female. Although there was no statistically significant difference between the groups in terms oflocalization of metastases (p=0.663), the most common site of metastasis was pelvic structures in squamous cell carcinoma group and multiple distant organ metastasiswere observed in small cell carcinoma group. The median survival in squamous cell carcinoma, adenocarcinoma, and small cell carcinoma was 11±5.3, 12±10, and2±1.8 months, respectively (logrank p=0.329).Conclusion: There are no large prospective randomized clinical studies to guide treatment in NUBC. In the light of these results, we recommend that these patientsshould participate in prospective clinical studies.
Prognostic Impact of Blood Transfusion in Patients With Metastatic Non-Small Cell Lung Cancer Receiving Chemotherapy
(Elsevier Ireland Ltd, 2019) Sakin, Abdullah; Sahin, Suleyman; Yasar, Nurgul; Demir, Cumhur; Arici, Serdar; Geredeli, Caglayan; Cihan, Sener
Purpose: To investigate the prognostic effects of Allogeneic Blood Transfusion (ABT) in patients with metastatic Non-Small Cell Lung Cancer (NSCLC) receiving Chemotherapy (CT) in the first-line treatment, comparing untransfused patients to those receiving blood transfusion during treatment period or before treatment period. Methods: This was a retrospective study of 433 patients with metastatic NSCLC receiving CT in the first-line treatment. Patients were categorized into 3 groups according to the transfusion strategy as follows; group-U (Untransfused patients, n = 303), group-B(patients receiving transfusion Before treatment period, n = 43), and group-D(patients receiving transfusion During treatment period, n = 87). Results: There were 433 patients in the analysis, consisting of 388 (89.6%) males, with a median age of 60 years (range, 21-92). The median Overall Survival(mOS) according to the ABT was 14 months for group-U, 9 months for group-B, and 7 months for group-D (p < 0.001). In subgroup analysis, patients with squamous cell carcinoma subtype, mOS was 11 months for group-U, 12 months for group-B, and 9 month for group-D (p = 0.074) The corresponding mOS durations for adenocarcinoma subtype were 21 months, 7 months, and 6 months (p < 0.001). Performing ABT during treatment period was found to be a negative independent factor related to OS (HR 1.50 for progression-free survival, 95% CI 1.15-1.97, HR 1.36 for OS, 95% CI 1.04-1.80). Conclusion: Our results demonstrated that ABT was significantly associated with earlier progression and shorter survival in patients with metastatic NSCLC, especially in adenocarcinoma histology, hence suggesting that transfusion strategy in this group should remain limited, and its benefit should outweigh the risk of progression.
Prognostic Significance of Primary Tumor Localization in Stage Ii and Iii Colon Cancer
(Baishideng Publishing Group inc, 2018) Sakin, Abdullah; Arici, Serdar; Secmeler, Saban; Can, Orcun; Geredeli, Caglayan; Yasar, Nurgul; Cihan, Sener
Aim To investigate the effects of tumor localization on disease free survival (DFS) and overall survival (OS) in patients with stage I -III colon cancer. METHODS This retrospective study included 942 patients with stage. and. colon cancer, which were followed up in our clinics between 1995 and 2017. The tumors from the caecum to splenic flexure were defined as right colon cancer (RCC) and those from splenic flexure to the sigmoid colon as left colon cancer (LCC). RESULTS The median age of the patients was 58 years (range: 19-94 years). Male patients constituted 54.2%. The rates of RCC and LCC were 48.4% (n = 456) and 51.6% (n = 486), respectively. During the median follow-up of 90 mo (range: 6-252 mo), 14.6% of patients developed recurrence and 9.1% of patients died. In patients with stage. and. disease with or without adjuvant therapy, DFS was similar in terms of primary tumor localization (stage.; P = 0.547 and P = 0.481, respectively; stage.; P = 0.976 and P = 0.978, respectively). In patients with stage. and. disease with or without adjuvant therapy, OS was not statistically significant with respect to primary tumor localization (stage.; P = 0.381 and P = 0.947, respectively; stage.; P = 0.378 and P = 0.904, respectively). The difference between median OS of recurrent RCC (26 +/- 6.2 mo) and LCC (34 +/- 4.(mo) cases was eight months (P = 0.092). CONCLUSION Our study showed no association of tumor localization with either DFS or OS in patients with stage. or. colon cancer managed with or without adjuvant therapy. However, post-recurrence OS appeared to be worse in RCC patients.
The Relation Between Hemogram Parameters and Survival in Extensive-Stage Small Cell Lung Cancer
(Karger, 2019) Sakin, Abdullah; Sahin, Suleyman; Yasar, Nurgul; Demir, Cumhur; Arici, Serdar; Geredeli, Caglayan; Cihan, Sener
Purpose: To determine whether hemogram parameters have prognostic effects on survival in patients with extensive-stage small cell lung cancer (ED-SCLC). Methods: This retrospective analysis included 113ED-SCLC patients, who were followed in an oncology clinic. The data regarding the baseline patient demographic characteristics, complete blood count (white blood cell, red blood cell, hemoglobin, hematocrit, mean platelet volume, platelet, total neutrophil, total lymphocyte, total monocyte, neutrophil-to-lymphocyte ratio [NLR], platelet-to-lymphocyte ratio [PLR], and monocyte-to-lymphocyte ratio [MLR]), and survival were analyzed. According to the ROC curve drawn for overall survival (OS) analysis, the cutoff values were determined as follows: NLR >= 3, with 71.4% sensitivity and 63.6% specificity; PLR >= 0.150, with 68.1% sensitivity and 52.4% specificity; and MLR >= 0.367, with 64.4% sensitivity and 71.4% specificity. Results: Of the 113 patients with ED-SCLC, 92 (81.4%) were men and 21 (18.6%) were women. The median age was 65 years (range, 35-81 years). NLR was <3 in 40 (65.4%) patients. Patients with NLR <3 had significantly higher OS than those with NLR >= 3 (15 vs. 5 months, respectively, p < 0.001). Patients with PLR <150 had significantly higher median OS than those with PLR >= 150 (14 vs. 6 months, respectively, p = 0.014). The median OS was significantly greater in patients with MLR <0.367 compared to that in patients with MLR >= 0.367 (11 vs. 6 months, respectively, p = 0.016). In multivariate analysis, NLR was the only factor associated with OS (HR = 2.26, 95% Cl 1.24-4.10). Conclusion: NLR was determined as an independent negative prognostic factor for OS in ED-SCLC patients at diagnosis, thus may help determine disease prognosis as a useful prognostic marker.