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    Biological Subtypes and Distant Relapse Pattern in Breast Cancer Patients After Curative Surgery (Study of Anatolian Society of Medical Oncology)
    (Karger, 2016) Kaplan, Muhammet A.; Arslan, Ulku Y.; Isikdogan, Abdurrahman; Dane, Faysal; Oksuzoglu, Berna; Inanc, Mevlude; Akman, Tulay
    Purpose: The aim of the study was to investigate the association between the molecular subtypes and patterns of relapse in breast cancer patients who had undergone curative surgery. Methods: We retrospectively evaluated 1,350 breast cancer patients with relapses after curative surgery between 1998 and 2012 from referral centers in Turkey. Patients were divided into 4 biological subtypes according to immunohistochennistry and grade: triple negative, HER2 overexpressing, luminal A and luminal B. Results: The percentages of patients with luminal A, lumina! B, HER2-overexpressing, and triple-negative breast cancer were 32.9% (n = 444), 34.9% (n = 471), 12.0% (n = 162), and 20.2% (n = 273), respectively. The distribution of metastases differed among the subgroups: bone (66.2% and 53.9% in lumina! A and B vs. 38.9% in HER2-overexpressing and 45.1% in triple negative, p < 0.001), liver (40.1% in HER2-overexpressing vs. 24.5% in lumina! A, 33.5% in luminal B, and 27.5% in triple negative, p < 0.001), lung (41.4% in triple negative and 35.2% in HER2-overexpressing vs. 30.2% and 30.6% in luminal A and B, p = 0.008) and brain (25.3% in HER2overexpressing and 23.1% in triple negative vs. 10.1% and 15.1% in lumina! A and B, p < 0.001). Conclusions: Organ -specific metastasis may depend on the molecular subtype of breast cancer. Tailored strategies against distant metastasis concerning the molecular subtypes in breast cancer should be considered. (C) 2016 S. Karger GmbH, Freiburg.
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    Childhood, Adolescents, and Young Adults (?25 y) Colorectal Cancer: Study of Anatolian Society of Medical Oncology
    (Lippincott Williams & Wilkins, 2013) Kaplan, Muhammet A.; Isikdogan, Abdurrahman; Gumus, Mahmut; Arslan, Ulku Y.; Geredeli, Caglayan; Ozdemir, Nuriye; Koca, Dogan
    Purpose: To evaluate the clinicopathologic characteristics and treatment outcomes of young patients with colorectal cancer (CRC). Methods: Between May 2003 and June 2010, 76 patients were found eligible for this retrospective study. Age, sex, presenting symptoms, patients with acute presentation, family history, presence of polyps, histologic features, localization and stage of the tumor, treatment outcomes, time and site of recurrence, sites of metastasis, and survival outcomes were recorded from the patient files. Results: Seventy-six patients (55.3% male) with a median age of 23 years were evaluated. Patients were evaluated in 2 groups as follows: child-adolescent (0 to 19 y, n=20) and young adult (20 to 25 y, n=56). Sex and symptoms (abdominal pain and rectal bleeding) were significantly differed between the groups and acute presentation was close to statistical significance. Overall survival significantly increased in patients undergoing curative surgery (P<0.001). Other parameters affecting the survival was stage of disease (P=0.004). Response to palliative chemotherapy in metastatic patients (P=0.042) and postoperative adjuvant chemotherapy had a statistically significant survival advantage (P=0.028). Conclusions: Diagnosis of CRC should not be excluded solely on the basis of age. CRC features in young-adult patients are more similar to adults compared with that of child-adolescent patients according to the symptoms and presentation. In patients with CRC in this age group, curative surgery, adjuvant chemotherapy, and palliative chemotherapy provide survival advantage.
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    The Clinical and Demographic Characteristics of Our Cases with Primary Bone Tumors and Soft Tissue Tumors
    (Akad Doktorlar Yayinevi, 2016) Oruc, Zeynep; Kaplan, Muhammet A.; Yerlikaya, Halis; Celik, M. Ali; Oruc, Idris; Urakci, Zuhat; Kucukoner, Mehmet
    The current study aimed to investigate the clinical and demographic characteristics of the patients with sarcoma who were treated and followed-up in Dicle University Medical Oncology Department. We retrospectively investigated the medical records of 547 patients who were diagnosed with sarcoma in the Dicle University School of Medicine, Department of Medical Oncology, between 2007 and 2015. When we considered the total number of patients (total 23,264) admitted to our center between 2007 and 2015, the rate of our patients with sarcoma was found to be 2.3% of this total number. Primary bone tumor and soft tissue sarcoma were determined in 32% (n=172) and 68% (n=375) of the patients, respectively. The most frequent histological type was osteosarcoma. The age, location of the primary tumor, adjuvant chemotherapy, location of relapse (local, metastatic), history of smoking, and comorbid diseases showed statistically significant differences between two groups. The overall survival and progression-free survival also did not differ significantly between the primary bone tumors and soft tissue tumors (p=0.65). The rate of our patients with sarcoma was 2.3% of the total number of patients (total 23,264) admitted to our center. This rate is higher than that in the literature. It is hard to interpret the results of the study, however it has been confirmed that the soft tissue sarcomas and primary bone tumors differ with regard to the age at diagnosis, location of tumor, location of relapse, prevalence of adjuvant chemotherapy and risk factors.
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    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.
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    Relation of HBV infection and lymphoma in southeast region of Turkey
    (Oxford Univ Press, 2006) Kaplan, Muhammet A.; Cil, Timucin; Altintas, Abdullah; Isikdogan, Abdurrahman; Ayyildiz, Orhan; Muftuoglu, Ekrem
    [Abstract Not Available]
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    The role of basal 18F-FDG PET/CT maximum standard uptake value and maximum standard uptake change in predicting pathological response in breast cancer patients receiving neoadjuvant chemotherapy
    (Lippincott William & Wilkins, 2021) Akdeniz, Nadiye; Kömek, Halil; Küçüköner, Mehmet; Kaplan, Muhammet A.; Urakçı, Zuhat; Oruç, Zeynep; Işıkdoğan, Abdurrahman
    Objective The aim of this study was to determine the role of 18F-FDG PET/CT in predicting pathological response among patients diagnosed with local or locally advanced breast cancer and receiving neoadjuvant chemotherapy (NAC). Methods Basal SUVmax value were analyzed in 212 patients and 142 of these patients had posttreatment SUVmax value. Overall pathological complete response (pCR(C)) was defined as no evidence of residual invasive cancer in breast (pCR(B)) and axilla (pCR(A)). Basal SUVmax value of the breast (SUVmax(B)I) and axilla (SUVmax(A)I) and change in SUVmax of the breast (Delta SUVmax(B)) and axilla (Delta SUVmax(A)) were measured. The optimal cutoff value of SUVmax and Delta SUVmax were determined by receiver operating characteristic curve analysis. Results The number of patients with pCR(B) was 85 (40.1%), pCR(A) was 76 (42.5%) and pCR(C) was 70 (33%). In the artificial neural network-based analysis the Delta SUVmax(B) (100%) was the most important variable for predicting pCR(B). Delta SUVmax(A) (100%) was the most important variable in estimation of pCR(A). When pCR(C) was evaluated, the highest relation was found with Delta SUVmax(B). When the Delta SUVmax(B) cutoff value for pCR(B) and pCR(C) accepted as <=-87.9%, its sensitivity was 82.3 and 82.4%, and specificity was 72.5% and 65.9%, respectively (P < 0.001 and P < 0.001, respectively). When the Delta SUVmax(A) cutoff value for pCR(A) and pCR(C) accepted as <=-86.6%, its sensitivity was 94.3% and 97.6%, and specificity was 31.3% and 28.2%, respectively (P = 0.017 and P = 0.024, respectively). Conclusion Albeit varies according to the molecular subtypes of the breast cancer during NAC, Delta SUVmax value seems to be the most strong factor associated with pCR.
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    Survival impact of optimal treatment for elderly patients with colorectal cancer: A real world study
    (Wolters Kluwer Medknow Publications, 2021) Akdeniz, Nadiye; Küçüköner, Mehmet; Kaplan, Muhammet A.; Urakçı, Zuhat; Sezgin, Yasin; Karhan, Oğur; Işıkdoğan, Abdurrahman
    Background: In this real-life practice study, we aimed to find whether elderly colorectal cancer (CRC) patients in our center were treated optimally and also if this has an effect on overall survival (OS) or not. Methods: We have retrospectively screened 150 CRC patients older than 65 years, diagnosed in our institution between 2010 and 2018. As study variables, patient characteristics, tumor location, tumor, nodes, metastases stage, Eastern Cooperative Oncology Group performance status (ECOG PS), comorbidities, adjuvant or metastatic chemotherapy regimens, and treatment toxicity were recorded, and the OS rate of patients was assessed. Results: The median age was 72 (range 65 - 89) years and 48 (32%) patients had metastatic disease at the time of diagnosis. The median OS (mOS) in the suboptimal adjuvant treatment group was 31.5 (range 20.7-42.3) months, whereas mOS was not reached during the median follow-up time in the optimal treatment group (P = 0.036). The addition of oxaliplatin to chemotherapy had no benefit on mOS (P = 0.318). In the metastatic setting, the mOS in the optimal and suboptimal treatment group was 27.2 (range 10.7-43.7) months and 13.4 (range 7.5-18.8) months respectively, and was statistically significant (P = 0.001). Conclusion: Our study revealed that optimal treatment had a significant effect on the mOS of elderly CRC patients and it was well tolerated. Advanced age alone is not a sufficient parameter for precluding effective therapy in elderly patients with CRC.