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Öğe Characteristics of newly diagnosed hepatocellular carcinoma patients across Turkey: Prospective multicenter observational 3K registry study(Aves, 2021) Akarca, Ulus Salih; Ünsal, Belkıs; Sezgin, Orhan; Yalçın, Kendal; Akdoğan, Meral; Gönen, Can; Gündüz, Feyza; Özenirler, Seren; Sonsuz, Abdullah; Dinçer, Dinç; Tekin, Salim Başol; Yücel, İdris; Akbulut, Hakan; Alkım, Canan; Özyılkan, Özgür; Baygül, Arzu; Çevik, Zeynep MerveAims: To evaluate patient profile for epidemiological and clinicopathological characteristics and potential risk/prognostic factors in newly diagnosed hepatocellular carcinoma (HCC) patients across Turkey. Methods: A total of 547 patients (mean (SD) age 62.6 (10.3) years, 81.9% were males) were included in this registry study. Data on patient characteristics, etiologies of HCC, laboratory values, and tumor characteristics and stages were recorded at study enrollment. Results: HBV infection (68.2%) was the leading etiology, followed by HCV infection (17.2%), HDV infection (5.5%), alcohol (6.4%), and NAFLD (3.5%), as the major etiologies. Considering that 51.6% of the patients had >5 cm HCC, 44% were Child-Pugh B/C and 57% were BCLC B-D, it appears that a significant group of HCC patients were diagnosed at advanced stages. Of 540 patients, 271 (50.2%) were referred or applied with the diagnosis of HCC. Patients with HCC at presentation had larger tumor size (median (min-max) 6.6 (0-30) vs. 4.8 (0-90) cm, P<.001) and more advanced BCLC stage (Stage C-D in 40.8% vs. 26.4%, respectively, P=.005), compared to patients who were diagnosed during follow-up. Conclusions: Our findings revealed that HBV infection was the leading etiology and a moderate-to-advanced disease was evident in more than half of patients at the time of diagnosis. HCC patients diagnosed at follow-up had smaller tumor size and earlier BCLC stage.Öğe Low molecular weight heparin (LMWH) increases the efficacy of cisplatinum plus gemcitabine combination in advanced pancreatic cancer(Wiley, 2007) İçli, Fikri; Akbulut, Hakan; Utkan, Güngör; Yalçın, Bülent; Dinçol, Dilek; Işıkdoğan, Abdurrahman; Demirkazık, Ahmet; 0000-0002-7451-2786; 0000-0003-1631-5739Background: In this non-randomized study we aimed to assess the efficacy of the addition of low molecular weight heparin (LMWH) to gemcitabine (GEM) plus cisplatinum (CDDP) combination chemotherapy on survival by prevention of thromboembolic complications in patients with advanced pancreatic cancer (APC). Patients and Methods: Between November 1999 and February 2004, 69 consecutive patients with APC were treated with GEM (800 Mo,/M2, day 1, day 8) plus CDDP (35 mg/m(2), day 1, day 8) every 21 days +/- LMWH (nadroparine calcium, 2,850 IU/day until disease progression). Ten out of 35 patients in LMWH group and 10 out of 34 patients in chemotherapy alone group had primary inoperable locally advanced disease and the rest of the patients had metastatic disease. Results: Total response rate was 58.8% (11.7% CR) for the patients treated with LMWH and 12.1% for those treated without LMWH (P = 0.0001). LMWH group had a better median time to progression (TTP) and survival when compared to control group (7.3 vs. 4.0 months, P = 0.0001; 13.0 vs. 5.5 months, P = 0.0001). The toxicity was similar and acceptable in both groups. Conclusion: Addition of LMWH to GEM plus CDDP combination significantly improved the response and survival in patients with APC and the current schedule deserves to be tested in phase III trials. J. Surg. Oncol. 2007;95:507-512. (C) 2006 Wiley-Liss, Inc.Öğe Nine weeks versus 1 year adjuvant trastuzumab in patients with early breast cancer: an observational study by the Turkish Oncology Group (TOG)(Springer Japan Kk, 2015) Icli, Fikri; Altundag, Kadri; Akbulut, Hakan; Paydas, Semra; Basaran, Gul; Saip, Pinar; Dogu, Gamze G.Background Optimal duration of adjuvant trastuzumab in early breast cancer is an unresolved issue. In this observational study, we compared the outcome of 9 weeks and 1 year adjuvant trastuzumab in early breast cancer patients in Turkey. Methods Records of 680 patients with HER2-positive early breast cancer who received adjuvant trastuzumab plus chemotherapy were obtained and patients were followed up to compare the disease-free survival (DFS) outcome of 9 weeks versus 1 year trastuzumab. Results Nine weeks and 1 year trastuzumab was given to 202 (29.7 %) and 478 (70.3 %) patients, respectively. There was a significantly lower rate of patients with negative lymph nodes in the 9-week trastuzumab group. At median 3 years of follow-up from the date of starting trastuzumab, the DFS rates were 88.6 and 85.6 %, respectively (p = 0.670). When adjusted for all the prognostic factors that were significant on univariate analysis, again there was no significant difference in DFS between the groups (HR 0.675; 95 % CI 0.370-1.231; p = 0.200). Cardiac toxicity defined as a >= 15 % decrease in LVEF was significantly higher in the 1-year trastuzumab group (1.88 % versus none for 1-year and 9-week trastuzumab groups, respectively; p = 0.050). Conclusion The results of this observational study suggest that DFS outcome of 9 weeks of adjuvant trastuzumab may be comparable to 1 year adjuvant trastuzumab: this needs confirmation by randomized trials.Öğe Prognostic significance of serum matrix metalloproteinase 9 (MMP-9) levels in patients with sarcomas(Akad Doktorlar Yayinevi, 2008) Yaman, Emel; Yalcin, Buelent; Utkan, Guengoer; Akbulut, Hakan; Isikdogan, Abdurrahman; Sencan, Orhan; Buyukcelik, AbdullahSarcomas are heterogeneous groups of tumors that are seen rarely. Although great efforts have been made to identify prognostic factors apart from grade, histology and tumor size, they're not so obvious yet. In this study, the prognostic role of serum matrix metalloproteinase (MMP)-9 levels in patients with sarcoma was evaluated. Eighty-eight patients with a diagnosis of sarcoma were included in the study. Additionally in 14 patients with osteosarcoma, serum MMP-9 levels were analyzed twice. one in preoperative period during neoadjuvant chemotherapy and one in postoperative period. Sixteen healthy volunteers composed the control group. Serum MMP-9 levels have been evaluated quantitively by ELISA method. Serum MMP-9 levels were higher significantly compared to control group (p < 0.005). Patients with metastatic disease have higher serum MMP-9 levels compared to the non-metastatic ones which were statistically non-significant (p: 0.9). Similarly, no difference in serum MMP-9 levels was observed between patients with intermediate-high grade tumors and with low grade tumors. Moreover, statistically significant decrease in serum MMP-9 levels was observed in patients in postoperative period compared to preoperative period (p: 0.016). Although this study was performed in small number and heterogeneous group of patients, the difference in serum MMP-9 levels between sarcoma patients and control group, especially in the presence of measurable lesions and in postoperative period of the same patients, suggests that serum MMP-9 levels may be used as a tumor marker in patients with sarcoma.
