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Öğe Adjuvant chemoradiotherapy in 450 patients with gastric cancer: The multicenter retrospective study.(Amer Soc Clinical Oncology, 2011) Kucukoner, M.; Isikdogan, A.; Bilici, M.; Tekin, S. B.; Uncu, D.; Cetin, B.; Dane, F.[Abstract Not Available]Öğe Endocrine therapy alone vs chemotherapy plus endocrine therapies for the treatment of elderly patients with endocrine-responsive and node positive breast cancer: A retrospective analysis of a multicenter study (Anatolian Society of Medical Oncology)(Imprimatur Publications, 2013) Inal, A.; Akman, T.; Yaman, S.; Ozturk, S. Demir; Geredeli, C.; Bilici, M.; Inanc, M.Purpose: The extra benefit of adding chemotherapy to effective endocrine therapy (ET) has not been clearly or consistently identified in patients older than 70 years with estrogen receptor (ER) positive and node positive breast cancer. The aim of this study was to evaluate the efficacy of adjuvant ET vs chemotherapy plus endocrine therapies (Chemo/ET) in such patients. Methods: In this retrospective multicenter study 191 patients >= 70 years with operated hormone receptor positive breast cancer, who were administered adjuvant ET or Chemo/ET were assessed. Results: The median patient follow-up time was 29.0 months (range 1-252). Therefore disease free survival (DFS) and overall survival (OS) analysis was limited, due to the rather short median follow-up, and only 30-month cumulative percentages are reported herein. The 30-month DFS rates were 50.0% in the ET arm and 49.0% in the Chemo/ET arm (p=0.79). The 30-month OS rates were 86% in the ET arm and 96.0% in the Chemo/ET arm (p=0.08). Cox proportional hazard model showed that only surgery was independent prognostic factor for survival (p=0.047), while tumor size showed a strong trend for statistical significance (p=0.051). Conclusion: The addition of chemotherapy to endocrine therapy in older patients has no significant impact on DFS and OS.Öğe Hypertrophic Cardiomyopathy as a Clinical Component of Congenital Cytomegalovirus Infection(Univ West Indies Faculty Medical Sciences, 2016) Demir, F.; Yilmazer, M. M.; Dalli, S.; Yolbas, I.; Uluca, U.; Bilici, M.; Turan, M. I.We report hypertrophic cardiomyopathy in a newborn with congenital cytomegalovirus infection. The neonate had distinct signs of congenital cytomegalovirus infection including petechiae, jaundice, intracranial calcifications, cerebral ventriculomegaly and chorioretinitis together with hypertrophic cardiomyopathy. Following determination of anti-cytomegalovirus IgM, viral DNA was also isolated from the plasma of the patient by polymerase chain reaction. Although cytomegalovirus is a relatively frequent cause of myocarditis in childhood, it was rarely reported to be associated with cardiac abnormalities such as structural heart disease, atrioventricular block, or dilated cardiomyopathy. To our knowledge, this is the first case with congenital cytomegalovirus infection and hypertrophic cardiomyopathy.Öğe Prognostic analysis of patients with operable gastric cancer and tolerability to adjuvant radiochemotherapy(Aepress Sro, 2013) Kucukoner, M.; Arpaci, E.; Isikdogan, A.; Bilici, M.; Uncu, D.; Cetin, B.; Dane, F.The aim of this study is to evaluate the tolerability and toxicity of adjuvant chemoradiotherapy (CRT) and to analyze the prognosis in patients with operable gastric cancer. The retrospective analysis included 723 patients with operable gastric cancer; stage IB-IV (M0), received adjuvant CRT from 8 Medical Centers in Turkey between 2003 and 2010. The patients' age, sex, tumor localization, Lauren classification, grade and stage of the disease, type of dissection, the toxicity and tolerability status and survival rate were analyzed. All patients were divided into two groups as tolerable group to adjuvant CRT and intolerable group to adjuvant CRT. Among the patient, 73.9% had stage III-IVM0 disease; 61.0% had the intestinal type of gastric cancer, 51.1% had the distal type, and 61.4% had undergone D2 dissections. The number of patients who completed the entire course of the adjuvant CRT was 545 (75.4%). The median follow-up period was 20.8 months (range: 1.5-107 months). Overall Survival (OS) rates were 80% and 52%, while the relapse free survival (RFS) rates were 75% and 48% at 1 and 3 years, respectively. In the univariate analysis of the groups based on the the age defined as <65 or >= 65 (p=0.16 / p=0.003), Lauren classification (p=0.004 / p<0.001), localization of tumor (p=0.02 / p=0.04), tumor grade (p=0.06 / p=0.003), disease stage (p<0.001 / p<0.001), type of dissection (p=0.445 / p=0.043), presence or absence of toxicity (p=0.062 / p=0.077) and tolerability of the therapy (p=0.002 / p=0.001). In the cox regression analysis, tumor stage (Hazard Ratio (HR): 0.332; 95% confidence interval (CI): 0.195-0.566; p<0.001), and tolerability (HR: 0.516; 95% CI: 0.305-0.872; p=0.014), were found to be related with the OS. Tumor stage (HR: 0.318; 95% CI: 0.190-0.533; p=<0.001) and tolerability (HR: 0.604; 95% CI: 0.367-0.995; p=0.048) were observed to be statistically significant in terms of the RFS. We have observed that whether a patient can or cannot tolerate adjuvant CRT due to its toxicity is an independent prognostic factor besides the known prognostic factors like tumor stage and Lauren classification. We are of the opinion that the treatment of patients who cannot tolerate adjuvant CRT should be replaced with less toxic adjuvant therapies.
