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Öğe Biased view against biopsy among cancer patients and its reasons(Drunpp-Sarajevo, 2012) Kucukoner, Mehmet; Inal, Ali; Kaplan, Muhammed Ali; Urakci, Zuhat; Isikdogan, AbdurrahmanObjective: Because the belief that biopsy causes spread of the disease, is a widely accepted opinion among the people in our region. The aim of this study is to assess the view of patients diagnosed with cancer about biopsies and evaluate the factors influencing this. Material and Methods: Three hundred and twenty four patients who presented themselves to the Department of Medical Oncology between October 2009 and March 2010, were included in the study. Data were obtained from patient charts and evaluations of questionnaires. Results: Among those patients with low level of education, the number of people who are thinking that biopsy is harmful, was significantly high (p=0.001). The gender of patients thinking that biopsy was harmful was more female (p=0.065). However, significantly elderly patients (76.8%, n=99) aged over 40 years, considered biopsy as harmful compared to those aged less than 40 years (p=0.078). Significant differences were found in biopsy perception of patients based on their economic status (p=0.023). Conclusions: The education level of the patient should be taken into consideration in diagnosing cancer with biopsy and subsequent transition to treatment steps the consciousness level of the patient should be certainly increased as well.Öğe Biologic subtypes and first relapse pattern in curative surgery performed breast cancer patients: Study of Anatolian Society of Medical Oncology.(Lippincott Williams & Wilkins, 2013) Kaplan, Muhammet Ali; Arslan, Ulku Yalcintas; Isikdogan, Abdurrahman; Oksuzoglu, Berna; Inanc, Mevlude; Akman, Tulay; Inal, Ali[Abstract Not Available]Öğe Brain metastases in HER2-positive metastatic breast cancer patients who received chemotherapy with or without trastuzumab(Springer Japan Kk, 2015) Kaplan, Muhammet Ali; Ertugrul, Hamza; Firat, Ugur; Kucukoner, Mehmet; Inal, Ali; Urakci, Zuhat; Pekkolay, ZaferObjective The aim of this study was to assess whether trastuzumab usage is a risk factor for the development of brain metastasis (BM) in human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer (MBC) and factors affecting survival after development of BM. Materials and methods One hundred thirty-two patients treated with (treatment group) or without trastuzumab (control group) with brain metastasis were retrospectively analyzed. Results Ninety of the 132 HER2-positive MBC patients were in the treatment group and 42 were in the control group. BM was significantly increased in patients who were treated with trastuzumab in two or more lines (58.5 vs 24.1 %, p < 0.001). Trastuzumab and lapatinib usage after BM and age were independent prognostic factors for overall survival in univariate and multivariate analysis. Conclusion The risk for BM was increased in patients who were treated with trastuzumab in two or more lines. Using trastuzumab and lapatinib after BM and age were independent prognostic factors for time to death from BM.Öğe Can LMWH improve the outcome of patients with inoperable stage III non-small cell lung cancer?(Termedia Publishing House Ltd, 2012) Kucukoner, Mehmet; Isikdogan, Abdurrahman; Kaplan, Muhammed Ali; Inal, Ali; Zinciroglu, S.; Cit, Murtaza; Cil, TimucinAim of the study: Lung cancer is the most common malignancy, accounting for one-third of all deaths from cancer. Some studies have shown that low molecular weight heparin (LMWH) significantly prolongs the survival of patients with non-small cell lung cancer (NSCLC). The aim of this study was to determine the effects of treating inoperable stage III NSCLC with LMWH in addition to concurrent chemoradiotherapy. Material and methods: Eighty-two patients with inoperable stage III NSCLC were evaluated at Dicle University's Medical Oncology Department between 2005 and 2010. All patients were treated with concurrent chemoradiotherapy (CRT) with or without LMWH (enoxaparin 4000 IU/day) depending on the patient's risk of thrombosis. The primary objectives were to determine disease-free survival (DES) and overall survival (OS) for patients treated with LMWH. Results: A total of 38 patients in the LMWH negative group and 44 patients in the LMWH positive group were included in the study. The median OS was 11.2 months for the enoxaparin recipients and 12.7 months for the non-enoxaparin group (p = 0.4). The median DES was 9.3 months with CRT alone and 10.0 months with CRT plus enoxaparin (p = 0.9). The one-year OS rates were 47% and 34% for groups treated with CRT and enoxaparin plus CRT, respectively, while the two-year OS rates were 23% and 21%, respectively. No significant difference was noted between the two groups in terms of grade 3-4 hematologic toxicity and mucositis (p = 0.3). Conclusions: This study did not demonstrate improvements in survival for patients with NSCLC treated with enoxaparin. LMWH's positive contribution is still controversial.Öğe Cisplatin-Based Therapy for the Treatment of Elderly Patients with Non-Small-Cell Lung Cancer: a Retrospective Analysis of a Single Institution(Asian Pacific Organization Cancer Prevention, 2012) Inal, Ali; Kaplan, M. Ali; Kucukoner, Mehmet; Urakci, Zuhat; Karakus, Abdullah; Isikdogan, AbdurrahmanBackground: In spite of the fact that platinum-based doublets are considered the standard therapy for patients with advanced non-small-cell lung cancer (NSCLC), no elderly-specific platinum based prospective phase III regimen has been explored. The aim of this retrospective singlecenter study was to evaluate the efficacy and side effects of cisplatin-based therapy specifically for the elderly. Methods: Patients receiving platinum-based treatment were divided into three groups. In the first group (GC), Gemcitabine was administrated at 1000 mg/m(2) on days 1, 8 and cisplatin was added at 75 mg/m(2) on day 1. In the second group (DC), 75 mg/m(2) docetaxel and cisplatin were administered on day 1. The third group (PC) received 175 mg of paclitaxel and 75 mg of cisplatin on day 1. These treatments were repeated every three weeks. Result: GC arm had 36, the DC arm 42 and the PC arm 29 patients. Grade III-IV thrombocytopenia was higher in the GC arm (21.2% received GC, 2.8% received DC, and 3.8% received PC), while sensory neuropathy was lower in patients with GC arm (3.0%, 22.2%, and 23.1% received GC, DC and PC, respectively). There were no statistically significant difference in the response rates among the three groups (p>0.05). The median Progression-free survival (PFS) was 5.0 months and the median Overall survival (OS) in each group was 7.1, 7.4 and 7.1 months, respectively (p>0.05). Conclusion: The response rate, median PFS and OS were similar among the three treatment arms. Grade III-IV thrombocytopenia was higher in the GC arm, while the GC regimen was more favorable than the other cisplatin-based treatmetns with regard to sensory neuropathy.Öğe 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, AliBackground: 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.Öğe Clinical characteristics, treatment and survival outcomes in malignant pleural mesothelioma: An institutional experience in Turkey(Imprimatur Publications, 2014) Kucukoner, Mehmet; Kaplan, Mehmet Ali; Inal, Ali; Urakci, Zuhat; Abakay, Ozlem; Tanrikulu, Abdullah Cetin; Abakay, AbdurrahmanPurpose: To compare treatment modalities and investigate potential prognostic factors for survival in patients with malignant pleural mesothelioma (MPM). Methods: The present study has investigated the data of 150 patients with MPM who were examined and treated in our center from 2005 to 2012. Results: The study included 87 male (58%) and 63 female (42%) patients. Surgical resection (pleurectomy/decortications (P/D), and extrapleural pneumonectomy (EPP)) was performed in 32 (36.7%) patients; 87 patients (58%) received chemotherapy alone and 16 (10.7%) had surgery, chemotherapy and radiotherapy (trimodal treatment). The median progression free and overall survival (PFS and OS) for all patients were 10.6 and 14.8 months, respectively. No statistically significant difference was observed between the patients who received pemetrexed/cisplatin (N=54) and gemcitabine/cisplatin (N=28) in terms of PFS and OS (p=0.145, p=0.244, respectively). Also, no statistically significant difference was registered between operated and non operated patients (PFS and OS, p=0.416, p=0.095, respectively). There was no difference in both PFS and OS rates between patients who had P/D or EPP (p=0.87, p=0.652, respectively). Log rank analysis: Eastern Cooperative Oncology Group performance status (ECOG PS)(p=0.018), histology (p < 0.001), stage (p < 0.001) and leukocytosis (p=0.005) were found to be significant prognostic factors of OS. At multivariate analysis, ECOG PS (p=0.016) and stage (p < 0.001) were independent prognostic factors for OS. Conclusion: Median OS was approximately 1 year. ECOG PS, histological type, stage and presence of leukocytosis were prognostic factors that affected both PFS and OS. EPP or P/D surgical options did not provide difference in terms of survival. Survival rates in patients who received a combination of platinum analogues with pemetrexed or gemcitabine as front-line chemotherapy were similar.Öğe Clinical characteristics, treatment, and survival outcomes in malignant pleural mesothelioma: A institution experience in Turkey(Lippincott Williams & Wilkins, 2013) Kucukoner, Mehmet; Kaplan, Muhammed Ali; Inal, Ali; Urakci, Zuhat; Abakay, Ozlem; Tanrikulu, Abdullah; Abakay, Abdurrahman[Abstract Not Available]Öğe COMPLEMENTARY AND ALTERNATIVE MEDICINE USAGE IN CANCER PATIENTS IN SOUTHEAST OF TURKEY(African Networks Ethnomedicines, 2013) Kucukoner, Mehmet; Bilge, Zulfikar; Isikdogan, Abdurrahman; Kaplan, M. Ali; Inal, Ali; Urakci, ZuhatThe aim of this study was to investigate the frequency of complementary and alternative medicine (CAM) methods and clinical characteristics in cancer patients in southeast of Turkey. A total of 324 patients (173 female) were enrolled to this study. Questionnaire was applied to all patients individually for approximately 15 minutes by a doctor. At least one CAM method was used by 62% (n=201) of the patients. 82.5% (n=166) of patients treated with CAM were using at least one herbal species. Likewise, 40.9% (68/166) of these patients were using herbal mixtures and 39.8% (66/166) of them were using single herbal as nettle (Urtica dioica) or its seed, 19.3 % (32/166) of them were using other herbals. CAM methods were preferred more frequently by the patients with metastatic stage (p=0.005), receiving palliative treatment (p<0.001), chemotherapy (p=0.020), in between 40-60 ages patient groups (p=0.002), and when duration of disease was lengthened (p=0.002). CAM use among cancer patients is quite common. Presence of metastatic cancer at diagnosis, receiving chemotherapy and palliative treatment and long disease duration were found as main associated factors for CAM usage.Öğe Cranial Magnetic Resonance Imaging in the Staging of HER2-positive Breast Cancer Patients(Karger, 2013) Kaplan, Muhammet A.; Inal, Ali; Kucukoner, Mehmet; Urakci, Zuhat; Ekici, Faysal; Firat, Ugur; Zincircioglu, Seyit B.Aim: The aim of the current study was to evaluate whether early detection of brain metastases (BMs) could improve survival outcomes in human epidermal growth factor receptor 2 (HER2)-positive breast cancer patients. Material and Methods: HER2-positive breast cancer patients without BMs who had no neurological symptoms within 12 months from diagnosis or relapse time of the disease were included in the study. The patients were distributed into 2 groups: Group 1 comprised patients without metastases; group 2 comprised patients with metastases. The symptomatic historic control group with BMs was defined retrospectively for survival comparisons. Results: 55 (57.3%) and 41(42.7%) patients were in groups 1 and 2, respectively. 11 of the 96 patients (11.5%) had occult BMs, and 9 of them were in group 2 whereas only 2 patients were in group 1 (22% vs. 3.6%, respectively; p = 0.008). While the median survival times from the first metastasis (28.7 vs. 22.5 months, respectively; p = 0.561) and BM (6.8 vs. 6.1 months, respectively; p = 0.511) were similar, cerebral death was numerically different (16.7% vs. 46.3%; p = 0.221) between asymptomatic (n = 9) and symptomatic patients (n = 53). Conclusions: BMs were detected very rarely in asymptomatic, non-metastatic HER2-positive breast cancer patients compared with asymptomatic, metastatic patients. Furthermore, although early detection of BMs decreases the cerebral death rate, it does not prolong the survival rate in metastatic patients.Öğe Efficacy and safety results of pemetrexed administration in non-small cell lung cancers, a multicenter study of the Association of Anatolian Medical Oncology.(Lippincott Williams & Wilkins, 2013) Yasar, Nurgul; Unal, Olcun Umit; Geredeli, Caglayan; Inal, Ali; Berk, Veli; Sari, Ebru; Durnali, Ayse[Abstract Not Available]Öğe ERCC1 and XRCC1 single nucleotide polymorphisms can guide treatment decision in patients with metastatic non-small cell lung cancer(2020) Demirkazik, Ahmet; Isikdogan, Abdurrahman; Inal, Ali; Karaagac, Mustafa; Bozcuk, Hakan; Akkuloglu, Tuba; Artac, MehmetResults from studies in several cancers on single nucleotide polymorphisms (SNPs) suggest that DNA repair capacity may have prognostic implication for disease recur-rence, survival, and responses to treatment. This study aimed to evaluate the potential prognostic value of SNPs as biomarkers in patients with metastatic non-small cell lung cancer (mNSCLC) treated with platinum. Analysis of SNPs from peripheral blood cells was performed by polymerase chain reaction. Excision repair cross-comple-menting group 1 (ERCC1)-Asn118Asn, excision repair cross-complementing group 2 (ERCC2)-Lys751Gln, X-ray repair cross-complementing group 1 (XRCC1)-Arg-399Gln, and tumor protein 53 (TP53)-Arg72Pro polymorphisms were evaluated in conjunction with clinical and pathological parameters, and survival. The median pro-gression-free survival (PFS) and overall survival (OS) of 145 patients were 5.1 months and 30.9 months, respectively. In the univariate analysis ERCC1 genotype, XRCC1 genotype, and Eastern Cooperative Oncology Group Performance Status (ECOG-PS) were significant parameters for OS. In the multivariate analysis ERCC1 genotype, XRCC1 genotype, and ECOG-PS retained their significance. The median OS was 45.2 months for the ERCC1 normal (CC) and heterozygote (CT) genotypes, and 25.5 months for the ERCC1 mutant (TT) genotype. The median OS was 31.4 months for the XRCC1 normal (AA) and heterozygote (AG) genotypes, and 23.1 months for the XRCC1 mutant (GG) genotype. The median OS was 30,7 months for ECOG-PS? 1 and 10.2 months for ECOG-PS? 2. ERCC1 and XRCC1 genotypes, and ECOG-PS independently predicted OS in mNSCLC patients. Additional studies are needed for the further evaluation of potential prognostic SNPs in mNSCLCÖğe Evaluation of Clinical Contributions Provided by Addition of the Brain, Calvarium, and Scalp to the Limited Whole Body Imaging Area in FDG-PET/CT Tumor Imaging(Hindawi Ltd, 2014) Tasdemir, Bekir; Dostbil, Zeki; Inal, Ali; Unal, Kemal; Yildirim, Sule; Simsek, F. SelcukPurpose. The aim of this study was to detect additional findings in whole body FDG-PET/CT scan including the brain, calvarium, and scalp (compared to starting from the base of the skull) in cancer patients and to determine contributions of these results to tumor staging and treatment protocols. Materials and Methods. We noted whether the findings related to the brain, calvarium, and scalp in 1359 patients had a potential to modify staging of the disease, chemotherapy protocol, radiotherapy protocol, and surgical management. We identified rates of metastatic findings on the brain, calvarium, and scalp according to the tumor types on FDG-PET/CT scanning. Results. We found FDG-PET/CT findings for malignancy above the base of the skull in 42 patients (3.1%), one of whom was a patient with an unknown primary tumor. Twenty-two of the metastatic findings were in the brain, 16 were in the calvarium, and two were in the scalp. Conclusion. This study has demonstrated that addition of the brain to the limited whole body FDG-PET/CT scanning may provide important contributions to the patient's clinical management especially in patients with lung cancer, bladder cancer, malignant melanoma, breast cancer, stomach cancer, and unknown primary tumor.Öğe Germ cell tumor in duodenum(Turkish Soc Gastroenterology, 2013) Kucukoner, Mehmet; Kaplan, Muhammed Ali; Inal, Ali; Ucmak, Feyzullah; Firat, Ugur; Isikdogan, Abdurrahman[Abstract Not Available]Öğe Image-Guided Subcutaneous Port Implantation in Patients with Malignant Diseases(Modestum Ltd, 2014) Onder, Hakan; Tekbas, Guven; Turmak, Mehmet; Inal, Ali; Ekici, Faysal; Gumus, Hatice; Onder, AkinTo present the results of our retrospective study on 49 totally implantable subcutaneous venous ports inserted in angiography unit under ultrasound and fluoroscopic guidance. 49 subcutaneous venous chest ports were placed in 48 patients (mean age, 49.3 +/- 16.7 years). One patient underwent port implantation twice. All the ports had single lumen catheters. The procedures were performed under ultrasound and fluoroscopic guidance in angiography unit. All ports were placed on the anterior chest wall. The technical success rate was 100%. There was no procedure-related minor or major complication. There was no early complication (in the first month). Late complications occurred at a rate of 8.3% (n:4). In patients with malignant diseases, radiological implantation of subcutaneous venous ports can be performed with similar or lower complication rates, as compared to the surgical literature, due to the obvious advantage of imaging guidance. Hence, port implantation with imaging guidance may become a more preferred implantation method in the future.Öğe Is diabetes mellitus a negative prognostic factor for the treatment of advanced non-small-cell lung cancer?(Elsevier Espana Slu, 2014) Inal, Ali; Kaplan, M. Ali; Kucukoner, Mehmet; Urakci, Zuhat; Kilinc, Faruk; Isikdogan, AbdurrahmanBackground: It has been demonstrated that there are a lot of different prognostic factors which Non-small cell lung are worthy of consideration whereas diabetes mellitus (DM) has not been clearly or consistently identified as a prognostic value in advanced non-small cell lung cancer (NSCLC). The aim Prognostic factors of this study was to investigate the prognostic significance of the characteristics of patients in advanced NSCLC. Specifically, we investigated the impact of DM for progression-free survival (PFS) and overall survival (OS) in patients receiving first-line platinum-based doublets chemotherapy. Methods: We retrospectively reviewed 442 patients with advanced NSCLC. DM and other potential prognostic variables were chosen for analysis in this study. Univariate and multivariate analyses were conducted to identify prognostic factors associated with survival. Result: The results of univariate analysis for OS were identified as having prognostic significance: performance status (p < 0.001), stage (p < 0.001), DM (p < 0.001), liver metastasis (p = 0.02) and brain metastasis (p < 0.001). Stage, diabetes mellitus, and liver metastasis were identified as having prognostic significance for PFS. Multivariate analysis showed that poor performance status, presence of DM and advanced stage were considered independent negative prognostic factors for OS (p 0.001, p < 0.001 and p < 0.001 respectively). Furthermore, DM and stage were considered independent negative prognostic factors for PFS (p 0.005 and p 0.001 respectively). Conclusion: In conclusion, DM at the time of diagnosis was associated with the negative prognostic importance for PFS and OS in the advanced stage patients who were receiving first-line platinum-based doublets chemotherapy. In addition poor performance status and advanced stage were identified as negative prognostic factors. (c) 2013 Sociedade Portuguesa de Pneumologia. Published by Elsevier Espana, S.L. All rights reserved.Öğe Is Diabetes Mellitus a Prognostic Factor for Survival in Patients with Small Cell Lung Cancer?(Asian Pacific Organization Cancer Prevention, 2012) Inal, Ali; Kaplan, M. Ali; Kucukoner, Mehmet; Urakci, Zuhat; Karakus, Abdullah; Nas, Necip; Guven, MehmetBackground: Previous studies have pointed to many different prognostic factors for small cell lung cancer (SCLC) but diabetes mellitus (DM) has not been clearly or consistently identified as of prognostic value. The aim of this study was to investigate the prognostic significance of the characteristics of patients and clinical laboratory tests in SCLC. Specifically, we investigated that the impact of DM for survival in the patients receiving first-line etoposide plus cisplatin (EP) chemotherapy. Methods: We retrospectively reviewed 161 patients with SCLC with a focus on DM and other potential prognostic variables were chosen for univariate and multivariate analyses with respect to survival. Result: Among the sixteen variables of univariate analysis, five were identified to have prognostic significance: performance status (PS) (p < 0.001), stage (p=0.001), DM (p=0.005), serum albumin (p < 0.001) and hemoglobin levels (p=0.03). Multivariate analysis showed PS, stage and serum albumin level to be independent prognostic factors for survival (p=0.02, p=0.02 and p=0.009 respectively), but DM was not an independnet factor. Conclusion: In conclusion, PS, stage and serum albumin level were identified as important prognostic factors, while DM at the time of diagnosis of SCLC did not have prognostic importance for survival.Öğe Is lymph node ratio prognostic factor for survival in elderly patients with node positive breast cancer? The Anatolian Society of Medical Oncology(Edizioni Luigi Pozzi, 2013) Inal, Ali; Akman, Tulay; Yaman, Sebnem; Ozturk, Selcuk Cemil; Geredeli, Caglayan; Bilici, Mehmet; Inanc, MevludeSeveral studies have now demonstrated that the lymph node ratio (LNR), as a superior indicator of axillary tumor burden to the number of excised nodes. While, about the prognostic value of LNR on the the survival of elderly patients is limited. The aim of this retrospective multicenter study is to evaluate the prognostic value of lymph node ratio in elderly patients with node positive breast cancer. METHODS: Onehundredeightyfour patient with operable breast cancer, recruited from 17 institutions, were enrolled into the retrospectively study. Eleven potential prognostic variables were chosen for analysis in this study. Univariate and multivariate analyses were conducted to identify prognostic factors associated with survival. RESULT: Among the eleven variables of univariate analysis, four variables were identified to have prognostic significance for Overall survival (OS): pathologic tumor size (T), No. of positive nodes (N), LNR and estrogen receptor-positive (ER). Among the eleven variables of univariate analysis, two variables were identified to have prognostic significance for Disease-free survival (DFS): N and LNR. Multivariate analysis by Cox proportional hazard model showed that 7; LNR and ER were considered independent prognostic factors for OS. Furthermore, LNR was considered independent prognostic factors for DFS. CONCLUSION: In conclusion, the LNR was associated with the prognostic importance for DFS and OS in elderly patients who were administered adjuvant treatments.Öğe Is there any significance of lung cancer histology to compare the diagnostic accuracies of 18F-FDG-PET/CT and 99mTc-MDP BS for the detection of bone metastases in advanced NSCLC?(Termedia Publishing House Ltd, 2014) Inal, Ali; Kaplan, Muhammed Ali; Kucukoner, Mehmet; Urakci, Zuhat; Dostbil, Zeki; Komek, Hail; Onder, HakanAim of the study: Bone scintigraphy (BS) and fluorine-18 deoxyglucose positron emission tomography computed tomography (18F-FDG-PET/CT) are widely used for the detection of bone involvement. The optimal imaging modality for the detection of bone metastases in histological subgroups of non-small cell lung cancer (NSCLC) remains ambiguous. The aim of this study was to compare the efficacy of 18F-FDG-PET/C and Tc-99m-methylene diphosphonate (Tc-99m-MDP) BS in the detection of bone metastases of patients in NSCLC. Specifically, we compared the diagnostic accuracies of these imaging techniques evaluating bone metastasis in histological subgroups of NSCLC. Material and methods: Fifty-three patients with advanced NSCLC, who had undergone both 18F-FDG-PET/CT and BS and were eventually diagnosed as having bone metastasis, were enrolled in this retrospective study. Results: The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 18F-FDG-PET/CT and BS were 90.4%, 99.4%, 98.1%, 96.6%, 97.0% and 84.6%, 93.1%, 82.5%, 93.2, 90.8%, respectively. The. statistics were calculated for 18F-FDG-PET/CT and BS. The kappa-value was 0.67 between 18F-FDG-PET/CT and BS in all patients. On the other hand, the kappa-value was 0.65 in adenocarcinoma, and 0.61 in squamous cell carcinoma between 18F-FDG-PET/CT and BS. The kappa-values suggested excellent agreement between all patients and histological subgroups of NSCLC. Conclusions: 18F-FDG-PET/CT was more favorable than BS in the screening of metastatic bone lesions, but the trend did not reach statistical significance in all patients and histological subgroups of NSCLC. Our results need to be validated in prospective and larger study clinical trials to further clarify this topic.Öğe Lack of any Impact of Histopathology Type on Prognosis in Patients with Early-Stage Adenocarcinoma and Squamous Cell Carcinoma of the Uterine Cervix(Asian Pacific Organization Cancer Prevention, 2014) Teke, Fatma; Yoney, Adnan; Teke, Memik; Inal, Ali; Urakci, Zuhat; Eren, Bekir; Zincircioglu, Seyit BurhanedtinBackground: The aim of this study was to evaluate the prognosis of patients with stage IA-IIB cervical carcinoma and to investigate a possible correlation of histology with prognosis. Materials and Methods: Two hundred fifty one patients with adenocarcinoma and squamous cell carcinoma (SCC) histology for FIGO (International Federation of Gynecology and Obstetrics) stage IA-IIB uterine cervical carcinomas at the Radiation Oncology Clinic of GH Okmeydani Training and Research Hospital between January 1996 and December 2006 were selected, analyzed retrospectively and evaluated in terms of general characteristics and survival. Disease-free survival (DFS) and overall survival (OS) was calculated using the Kaplan-Meier method and differences were compared with the log-rank test. Multivariate analysis using a Cox-proportional hazards model was used to adjust for prognostic factors and to estimate hazard ratio (HR) with 95% confidence interval (CI). Results: There was no differences between the two tumour types in age, stage, pelvic nodal metastasis, parametrial invasion, surgical margin status, DSI, LVSI, maximal tumor diameter, grade, and treatment modalities. 5-year OS and DFS were 73% and 77%, versus 64% and 69%, for SCC and adenocarcinoma, respectively (p>0.05). Multivariate analysis revealed independent prognostic factors including pelvic nodal metastasis and resection margin status for OS (p=0.008, p=0.002, respectively). Conclusions: Prognosis of FIGO stage IA-IIB cervical cancer patients was found to be the same for those with adenocarcinoma and SCC.
