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    Comparison of the efficacy and safety of 3 months of CAPOX followed by 3 months of capecitabine and 6 months of CAPOX/FOLFOX in the adjuvant treatment of low-risk stage-III colon cancer treated surgically
    (Karger, 2023) Bardakci, Murat; Esmer, Derya; Hafizoglu, Emre; Yaslikaya, Sendag; Genc, Tugrul Burak; Ozcelik, Melike; Erdat, Efe Cem
    Introduction: In the adjuvant treatment of low-risk stage-III colon cancer treated surgically, 3 months of CAPOX followed by 3 months of capecitabine is not a common clinical practice. Since there are no data on this practice in the literature, we have no idea how often it is used. However, it should be noted that this application is used in some centers due to the cumulative neurotoxicity of oxaliplatin but there are insufficient data in the literature on its efficacy.Methods: The data of patients with colon cancer treated surgically who were followed up in 12 different oncology centers in Turkey between November 2004 and June 2022 were analyzed retrospectively.Results: The study included 194 patients. The treatment arms were as follows: 3 months of CAPOX followed by 3 months of capecitabine = arm A and CAPOX/FOLFOX (6 months) = arm B. There were 78 patients (40.2%) in arm A and 116 patients (59.8%) in arm B. The median age and sex distribution were similar between the treatment arms. The median follow-up period of all patients was 34.4 months (95% CI, 29.1-39.7). When arm A was compared with arm B, 3-year disease-free survival (DFS) was 75.3% vs. 88.4% and 5-year DFS was 75.3% vs. 82.8%, respectively. There were similar DFS outcomes between the treatment arms (p=0.09). Rates of any grade of neuropathy were numerically lower in arm A, but the difference between the treatment arms was not statistically significant (51.3% vs. 56.9%; p=0.44). The frequency of neutropenia was similar between the treatment arms.Discussion/Conclusion: In this study, the efficacy and safety of the 3 months of CAPOX followed by 3 months of capecitabine chemotherapy regimen in the adjuvant treatment of low-risk stage-III colon cancer treated surgically was proven. This result may also support the discontinuation of oxaliplatin at 3 months while continuing fluoropyrimidines, which is a common clinical practice but lacks sufficient data.
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    The importance of serum and pleural fluid level of vascular endothelial growth factor (VEGF) and VEGF fluid/serum ratio in the differential diagnosis of malignant mesothelioma-related pleural effusion
    (Termedia Publishing House Ltd., 2017) Düzköprü, Yakup; Oruç, Zeynep; Kaplan, Muhammet Ali; Ülkü, Refik; Tanrıkulu, Çetin; Esmer, Derya; Bırak, Ali; Küçüköner, Mehmet; Urakçı, Zuhat; Işıkdoğan, Abdurrahman
    Aim of the study: Vascular endothelial growth factor (VEGF) is one of the parameters that has been studied in differential diagnosis of malignant fluids. This study is aimed at evaluate applicability of serum, fluid VEGF level and fluid to serum VEGF ratio in the diagnosis of malignant pleural mesothelioma (MPM). Material and methods: The patients with pleural effusion over age of 18, between 2011 and 2015 were included in the study. They were divided into three groups: Group 1 - mesothelioma patients; group 2 - other malignancies; and group 3 - benign aetiologies. Group 1 and 2 were termed as the malignant group. Fluid, serum VEGF levels, and the ratio of fluid/serum VEGF level were studied to evaluate the fluid/ serum VEGF ratio in all groups. Results: Twenty cases with mesothelioma, 44 cases with other malignancies, and 20 cases with benign aetiologies were included in this study. No statistically significant difference was found according to serum VEGF levels for all groups, (group 1: 437 ±324 pg/ ml, group 2: 354 ±223 pg/ml, group 3: 373 ±217 pg/ml, p = 0.836), while fluid VEGF levels showed a statistically significant difference (group 1: 3359 ±700 pg/ml, group 2: 2175 ±435 pg/ml, group 3: 1092 ±435 pg/ml, p = 0.041). The ratio of fluid to serum VEGF levels showed a difference, at the significance limit, between the malignant (group 1 and group 2) and benign (group 3) groups (8.83 ±1.29 vs. 4.57 ±1.07, p = 0.059) but showed a statistically significant difference between the mesothelioma and benign groups (12.11 ±1.68 vs. 4.57 ±1.07, p = 0.044). Conclusions: The VEGF fluid/serum ratio may be an applicable parameter in the differential diagnosis of malignant fluids, especially MPM.