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    Clinical and Pathologic Features of Patients with Rare Ovarian Tumors: Multi-Center Review of 167 Patients by the Anatolian Society of Medical Oncology
    (Asian Pacific Organization Cancer Prevention, 2013) Bilici, Ahmet; Inanc, Mevlude; Ulas, Arife; Akman, Tulay; Seker, Mesut; Babacan, Nalan Akgul; Inal, Ali
    Background: Non-epithelial malignant ovarian tumors and clear cell carcinomas, Brenner tumors, transitional cell tumors, and carcinoid tumors of the ovary are rare ovarian tumors (ROTs). In this study, our aim was to determine the clinicopathological features of ROT patients and prognostic factors associated with survival. Materials and Methods: A total of 167 patients with ROT who underwent initial surgery were retrospectively analyzed. Prognostic factors that may influence the survival of patients were evaluated by univariate and multivariate analyses. Results: Of 167 patients, 75 (44.9%) were diagnosed with germ-cell tumors (GCT) and 68 (40.7%) with sex cord-stromal tumors (SCST); the remaining 24 had other rare ovarian histologies. Significant differences were found between ROT groups with respect to age at diagnosis, tumor localization, initial surgery type, tumor size, tumor grade, and FIGO stage. Three-year progression-free survival (PFS) rates and median PFS intervals for patients with other ROT were worse than those of patients with GCT and SCST (41.8% vs 79.6% vs 77.1% and 30.2 vs 72 vs 150 months, respectively; p=0.01). Moreover, the 3-year overall survival (OS) rates and median OS times for patients with both GCT and SCST were better as compared to patients with other ROT, but these differences were not statistically significant (87.7% vs 88.8% vs 73.9% and 170 vs 122 vs 91 months, respectively; p=0.20). In the univariate analysis, tumor localization (p<0.001), FIGO stage (p<0.001), and tumor grade (p=0.04) were significant prognostic factors for PFS. For OS, the univariate analysis indicated that tumor localization (p=0.01), FIGO stage (p=0.001), and recurrence (p<0.001) were important prognostic indicators. Multivariate analysis showed that FIGO stage for PFS (p=0.001, HR: 0.11) and the presence of recurrence (p=0.02, HR: 0.54) for OS were independent prognostic factors. Conclusions: ROTs should be evaluated separately from epithelial ovarian cancers because of their different biological features and natural history. Due to the rarity of these tumors, determination of relevant prognostic factors as a group may help as a guide for more appropriate adjuvant or recurrent therapies for ROTs.
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    Hypersensitivity and tumor lysis syndrome associated with cetuximab treatment: should we be afraid?
    (Sage Publications Ltd, 2015) Cihan, Sener; Atasoy, Ajlan; Yildirim, Yasar; Babacan, Nalan Akgul; Kos, Tugba Fahriye
    The majority of the chemotherapy agents in use today cause various infusion reactions, from mild flushing to life-threatening events. The frequency of the reported hypersensitivity reactions induced by cetuximab varies between 3% and 22%. It is recommended in the literature to stop the infusion and replace cetuximab with panitumumab in case of hypersensitivity reactions observed during the treatment of colon cancer. Tumor lysis syndrome (TLS) may occur in colorectal cancers with heavy tumor load. Tumor lysis syndrome may be life-threatening. In our patient with widespread bone and liver metastases, treatment continued with cetuximab as a combination therapy with irinotecan in spite of the hypersensitivity and TLS led to a complete treatment response. The complete response observed after 3 months through continued therapy in our patient may present an example supporting treatment with cetuximab in spite of severe reactions.
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    A Metastatic Parachordoma Case
    (Gazi Univ, Fac Med, 2014) Cihan, Sener; Cihan, Birsen Songul; Atasoy, Ajlan; kos, Tugba Fahriye; Babacan, Nalan Akgul
    Parachordoma is a soft tissue tumor with a high risk of local recurrence. Despite the fact that parachordomas mostly have an indolent course, distant metastasis can be seen on rare occasion. We hereby report a case of a 28-year-old male who was initially diagnosed with parachordoma five years ago when he presented with a mass on his right shoulder. He suffered from local recurrence twice within the first two years after his surgery. Metastatic disease later presented itself with a mass in his left retro-orbital fossa. The patient underwent a partial surgical resection and the pathologic evaluation was reported as ''myoepithelial tumor metastasis''. The patient's systemic work up showed bilateral pulmonary metastatic nodules and metastasis in the right sacroiliac joint. After radiotherapy for the sacroiliac and left orbital mass, chemotherapy was initiated. The regimen consisted of ifosfamide, mesna and doxorubicin. Follow-up evaluation revealed a minimal decrease in size in the pulmonary nodules and the retro-orbital mass. There was no 18-FDG uptake in the sacroiliac mass on PET-BT. In conclusion, surveillance carries importance due to the risk of metastasis for patients with parachordoma. Systemic chemotherapy consisting of doxorubicin and ifosfamide could be used successfully.