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Öğe Meme kanserli hastalarda Pet - BT ile tümör özellikleri arasındaki ilişki(Van Yüzüncü Yıl Üniversitesi Tıp Fakültesi, 2022) Sezgin, Yasin; Karhan, Oğur; İleri, Serdar; Ebinç, Senar; Bilen, Erkan; Ürün, Muslih; Yerlikaya, HalisAmaç: Meme kanseri dünya çapında kadınlarda en sık görülen ve en sık ölüme yol açan kanserdir. Pozitron emisyon tomografisi (PET) - bilgisayarlı tomografinin (BT) onkolojide kullanımı giderek artan öneme sahip olmaktadır. Çalışmamızda tümörün bazı özelliklerine göre 18 F-floro-2-deoksi-D-glukoz ( 18 F-FDG) tutulum yoğunluğu arasındaki ilişkiyi araştırmayı planladık. Gereç ve Yöntem: Çalışmamızda onkoloji kliniğimize meme kanseri teşhisi ile başvuran ve PET-BT çekimi yapılan 414 hastanın dosyası retrospektif incelendi. Çalışmaya 18-90 yaş aralığında olan meme kanserli hastalar dahil edildi. İkincil malignitesi olan, akli dengesi yerinde olmayan, 18 yaşından küçük ve 90 yaşından büyük hastalar çalışma dışı bırakıldı. Moleküler alt tiplere, tümör boyutlarına, vücut kitle indeksine ve proliferasyon indekslerine göre FDG tutulumları araştırıldı. Bulgular: Çalışmaya dahil edilen 414 hastanın yaş ortalaması 48.8 yıldı. Hastaların büyük çoğunluğunun alt tipi; invaziv duktal karsinom idi. Tanı anında 86 hasta metastatik evrede iken, 327 hasta lokal veya lokal ileri evredeydi. Çalışmada Ki-67 artışı ile FDG tutulumunun artışı arasında korelasyon saptandı ve istatiksel olarak anlamlı bulundu. Sonuç: Çalışmada tümör boyutu büyük olanlarda daha fazla FDG tulumu mevcut idi. Aynı şekilde proliferasyon indeksi artışında ve invaziv duktal karsinomda daha yüksek FDG tutulumu mevcut idi. Tümör özellikleri ile FDG tutulumları arasındaki ilişki gelecekte bireyselleştirilmiş tedavi için prediktif bir belirteç olarak kullanılabilir.Öğe Prognostic factors and the prognostic role of inflammation indices in malignant pleural mesothelioma(Bayçınar Tıbbi Yayıncılık, 2023) Ebinç, Senar; Oruç, Zeynep; Kalkan, Ziya; Karhan, Oğur; Urakçı, Zuhat; Küçüköner, Mehmet; Kaplan, Muhammet Ali; Işıkdoğan, AbdurrahmanBackground: In this study, we aimed to investigate the prognostic factors of malignant pleural mesothelioma and the prognostic value of inflammation indices in malignant pleural mesothelioma. Methods: Between January 2002 and December 2019, a total of 132 patients (74 males, 58 females; mean age: 55 years; range, 31 to 79 years) diagnosed with malignant pleural mesothelioma were retrospectively analyzed. Patients’ demographic data and laboratory results were recorded. The prognostic value of the following five inflammation indices was evaluated: neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, advanced lung cancer inflammation index, C-reactive protein/albumin ratio, and prognostic nutritional index. Results: Of all patients, 81% (n=107) were aged 65 or older and 61.4% (n=81) had an epithelioid histology. Of 12 variables examined in the multivariate analysis for their relationship with survival, age ≥65 years, non-epithelioid subtype, and prognostic nutritional index <40 were found to be poor prognostic factors. Based on the score constructed from these factors, the good prognostic group (score 0-1) had a median overall survival of 21 months and a one-year survival rate of 77.9%, while the poor prognostic group (score 2-3) had a median overall survival of nine months and a one-year survival rate of 29.7%. Conclusion: Our study results indicate that age ≥65 years, prognostic nutritional index <40, and non-epithelioid histological subtype are poor prognostic factors of malignant pleural mesothelioma.Öğe Prognostic importance of primary tumor location in RAS mutant metastatic colorectal cancer(Dicle Üniversitesi Tıp Fakültesi, 2019) Akdeniz, Nadiye; Kaplan, Muhammet Ali; Küçüköner, Mehmet; Urakçı, Zuhat; Sezgin, Yasin; Ebinç, Senar; Bilen, Erkan; Karhan, Oğur; Laçin, Şahin; Büyükbayram, Hüseyin; Işıkdoğan, AbdurrahmanObjective: The prognostic value of tumor location in patients with metastatic colorectal cancer (mCRC) was reported by recent analyses in RAS wild-type patients. However, there is no enough specific data regarding prognostic value of primary tumor location in RAS mutated mCRC patients. We aimed to find if there is any relation between tumor prognosis and primary tumor location in patients with RAS mutated mCRC. Method: This retrospective study included 57 patients with mCRC who were diagnosed and treated in our hospital between January 2011 and December 2017. Characteristics features of the patients were obtained from our institution patient medical records. Patients were included to the present study if KRAS or NRAS mutation was detected in tumor tissues.Results: Twenty-nine (50.9%) of patients were female and the median age of all patients was 52 (18-80) years. Forty (70.2%) of 57 patients were defined as left side (LS) and 17 (29.8%) of patients were located in the right side (RS). As first line systemic treatment, twenty-five (43.9%) patients had received oxaliplatin-based chemotherapy while 32 (56.1%) patients had received irinotecan-based chemotherapy. Tumor sidedness did not affect on progression-free survival (PFS) (mPFS, 10.9 months for LS vs 8.1 months for RS, p=0.400) and overall survival (OS) (mOS, 20.9 months for LS vs 20.8 months for RS, p=0.930).The patients who had oxaliplatin based chemotherapy regimens showed better OS rate than irinotecan based regimens (28.7months vs16.3 months, p=0.017, respectively). Conclusion: Our study results support the thought that claims the sidedness of primary CRC in metastatic setting does not have effect on PFS and OS in patients with RAS mutant mCRC. However, our findings also underline the necessity of studies with larger patient populations and subgroup analyzes to evaluate potential prognostic and molecular features to determine the standart approach to this specific subgroup of the disease.Öğe Prognostıc Factors In Testıcular Cancer(2024) Sezgin, Yasin; Karhan, Oğur; Biçer, Abdurrahman; İleri, Serdy; Yerlikaya, Halis; Tunç, Sezai; Aydın, İbrahimAim: Testicular cancer is the most common cancer in men aged 15-35 years and accounts for 1% of all lifetime male cancers. There are two histologic subtypes: seminoma and nonseminoma. In our study, we aimed to investigate the factors predicting recurrence in early-stage testicular cancer. Materials and Methods: Our study is a retrospective study of early stage testicular cancer admitted to the medical oncololi clinic of our hospital between 2006-2018. During the study, 344 patient files were reviewed and 130 patients who met the study criteria were included in the study. Our primary aim in this study was to investigate the factors predictive of recurrence in early stage testicular cancer. Results: When evaluating PFS in patients with nonseminoma with and without lymphovascular invasion, no median PFS value was reached in either group. However, PFS was worse in patients with LVI (p=0.037). When comparing stage 1 with stage 2 seminoma patients, no median PFS values could be reached, but there was a statistical difference between the two groups in terms of recurrence (p=0.019). Conclusions: In our study, we found no association between tumor size, embryonal carcinoma predominance, tunica albuginea invasion, spermatic cord involvement and tumor marker values and recurrence in nonseminoma germ cell testicular tumors. PFS was shorter in patients with LVI compared to those without LVI. Lymphovascular invasion, spermatic cord involvement, tunica albuginea involvement, and rete testis involvement were not associated with disease recurrence in seminoma patients, whereas higher disease stage predicted the risk of recurrence.Öğe Rare Breast Cancer Types: A Study About Characteristics, Outcomes, and Peculiarities(2020) Kaplan, Muhammet Ali; Karhan, Oğur; Urakçı, Zuhat; Ebınc, Senar; Akdeniz, Nadiye; Sezgin, Yasin; Nacir, MustafaObjective: We aimed to explore different features of rarely seen breast cancer (BC) subtypes, including their stage, molecularsubtypes, treatment choices, and prognosis. Material and Methods: We retrospectively screened patients who were diagnosed with BC inour hospital between July 2010 and June 2018. A total of 97 patients who had micropapillary, cribriform, mucinous, papillary, tubular, apocrine, metaplastic, medullary, and myoepithelial subtypes of BC were finally included in the current study.Results: Ninety-four (96.9%) patients were females. Patients with cribriform and mucinous subtypes were in the younger median age of 41 and 45 years, respectively, whereaspapillary cases were reported in the oldest median age (64.5 years). Lymph node and TNM stages showed a statistical difference between thesubtypes (p=0.029 and p=0.008, respectively). Most of the cribriform (60%), metaplastic (66.7%), and papillary (70%) cases were diagnosedwithout lymph node involvement. Apocrine (79%) and micropapillary (75%) tumors mostly presented with nodal involvement. Whilemedullary (75%), tubular (66.7%), and cribriform (66.7%) carcinomas were more likely to be diagnosed at stage II, micropapillary (70.8%),and apocrine (62.5%) carcinomas were mostly diagnosed at stage III. Mucinous, tubular, and cribriform tumors were noticed in the luminalgroup. Medullary, metaplastic, apocrine, and papillary tumors included triple-negative subgroups. HER2-enriched tumors included apocrine(62.5%), medullary (50%), and micropapillary (25%) subtypes. Disease-free survival and overall survival of the patients showed marginal statistical significance according to tumor subtypes (p=0.086, p=0.085, respectively). Conclusion: In this study, we investigated important features, clinical behavior, management, and outcomes of several rare BC subtypes. We opine that the current study may prove instrumental andinformative for both daily clinical practice and future studies.Öğe Rare occurrence of synovial sarcoma originating from dura mater(Istanbul Tip Fakultesi, 2019) Akdeniz, Nadiye; Küçüköner, Mehmet; Kaplan, Muhammet Ali; Urakçı, Zuhat; Yerlikaya, Halis; Karhan, Oğur; Teke, Fatma; Işıkdoğan, AbdurrahmanPrimary or metastatic dura mater sarcomas are rarely seen, and dural synovial sarcomas are quite rare. Here we report the case of a 60-year-old man who presented with headache, nausea, and vomiting and was found to have a 63×33×40-mm mass with solid and cystic components in parieto-occipital lobe. The mass was resected completely, with no residue detected on postoperative magnetic resonance imagining. On pathological evaluation, a vimentin-, S100-, transducer-like enhancer of split 1-, BCL-2-, and EMApositive and desmin-, PR-, CD99-, PANCK-, and GFAP-negative synovial sarcoma with Ki-67 proliferation index of 12% was detected. Postoperatively, chemotherapy has been started, and it will be followed by radiotherapy. Primary meningeal-derived sarcomas are rare, and differential diagnosis with other meningeal mesenchymal tumors is based on the findings of morphological and immunohistochemical analyses.Öğe Real-life data of pazopanib usage inm soft tissue sarcoma(2023) İleri, Serdar; Yerlikaya, Halis; Ürün, Muslih; Sezgin, Yasin; Karhan, OğurAbstract: Objective: Soft tissue sarcomas are heterogeneous group of malignancies consisting of more than 50 subtypes. Although it is rare, it is usually resistant to chemotherapy and has a poor prognosis. In this study, we planned to investigate the efficacy, tolerability and side-effect profile of pazopanib in metastatic soft tissue sarcomas. Method-Material: Our study was a single-center retrospective study and included metastatic patients over the age of 18 who were treated with pazopanib. Data of 37 patients were obtained in retrospective medical records. In patients using pazopanib; Tumor location, histological subtype, tumor grade, disease stage, the line at which pazopanib was used, efficacy, tolerability, and side-effect profile of pazopanib were examined. Findings: The mean age of the patients at diagnosis was 49. Pleomorphic sarcoma was the most common subtype. The progression-free survival (PFS) of patients after first-line therapy was 18 weeks. The median overall survival (OS) of the patients was 20 months. The median PFS with pazopanip was 18 weeks. Conclusion: In the study we conducted research in terms of effectiveness and side effects; the use of pazopanib in soft tissue sarcoma was found to be effective in terms of both PFS and OS. Side effects were tolerable and treatable. In our study, a PFS of 32 weeks was obtained in patients with hypothyroidism and at 16 weeks in patients who did not. In this respect, development of hypothyroidism may be a predictive parameter for response.Öğe 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, AbdurrahmanBackground: 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.Öğe THE ROLE OF SERUM CARCINOEMBRYONIC ANTIGEN TO PREDICT RESPONSE OF TREATMENT IN NON-SMALL CELL LUNG CANCER PATIENTS Karsinoembriyonik Antijeninin Küçük Hücreli Dışı Akciğer Kanseri Hastalarında Tedavi Yanıtını Tahmin Etmedeki Rolü(Yozgat Bozok University, 2021) Akdeniz, Nadiye; Kaplan, Muhammet Ali; Küçüköner, Mehmet; Urakçı, Zuhat; Karhan, Oğur; Yerlikaya, Halis; Işıkdoğan, AbdurrahmanABSTRACT Objective: We aimed to determine tumor marker levels in patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) at the time of diagnosis, to investigate the sensitivity and specificity of changes in Carcinoembryonic antigen (CEA) level in the assessment of treatment response along with the prognostic significance of this marker. Material and Methods: The study included 100 patients with NSCLC diagnosed in our institution. Age, stage, histologic subtype, tumor marker levels at the time of diagnosis, the change in serum CEA levels and the as-sociation with treatment response were analyzed. The treatment responses of the patients were evaluated either clinical response or progressive disease. Results: CEA level was stable or decreased in 86 (86%) clinical response, in contrary to elevation of CEA levels in 26 (74.3%) progressive response. The response to therapy and the change in CEA level were shown 86% ratio of sensitivity and 74.2% ratio of specificity in all patients regardless of baseline CEA levels. On the other hand, in patients with high baseline levels of CEA, sensitivity of the change in CEA level was 95% and specificity was 71.4%. Positive predictive value and negative predictive value were calculated as 90.5% and 65%, respectively. Conclusion: Change of CEA levels were associated with treatment response in patients with NSCLC. Given that it can be readily measured in serum samples, serum CEA level is a beneficial marker in follow-up and treatment response monitorization of these patients. The baseline level of CEA was not a prognostic factor. Keywords: Carcinoembryonic Antigen; Non-Small Cell Lung Cancer; Prognosis ÖZET Amaç: Lokal ileri veya metastatik küçük hücreli dışı akciğer kanseri (KHDAK) tanılı hastalarda tanı anında tümör belirteç düzeylerini belirlemeyi, tedavi yanıtının değerlendirilmesinde Karsinoembriyonik antijen (CEA) düzeyindeki değişikliklerin duyarlılığını ve özgüllüğünü prognostik önemi ile birlikte değerlendirmeyi amaçladık. Gereç ve Yöntemler: Çalışmaya 100 KHDAK tanılı hasta dahil edildi. Tanı anındaki yaş, evre, histolojik alt tip, tümör belirteçleri, serum CEA seviyelerindeki değişim ve tedavi yanıtı ile ilişkisi analiz edildi. Hastaların tedavi yanıtları, klinik yanıt alındı veya alınmadı şeklinde değerlendirildi. Bulgular: CEA düzeyi 26 (%74,3) progresif yanıtta yükselmesine karşın 86 (%86) klinik yanıtta stabil veya azalmıştı. Tedaviye yanıt ve CEA düzeyindeki değişiklik, başlangıç CEA düzeylerinden bağımsız olarak tüm hastalarda %86 duyarlılık oranı ve %74,2 özgüllük oranı göstermekteydi. Öte yandan, CEA başlangıç düzeyi yüksek olan hastalarda, CEA düzeyindeki değişikliğin duyarlılığı %95 ve özgüllüğü %71,4 idi. Pozitif prediktif değer ve negatif prediktif değer sırasıyla %90,5 ve %65 olarak hesaplandı. Sonuç: KHDAK hastalarında CEA düzeylerindeki değişiklik tedavi yanıtı ile ilişkilendirilmiştir. Serum örnekle-rinde kolaylıkla ölçülebildiği düşünüldüğünde, serum CEA düzeyi bu hastaların takip ve tedaviye yanıt moni-törizasyonunda yararlı bir belirteçtir. CEA'nın başlangıç seviyesi prognostik bir faktör olarak belirlenmemiştir. Anahtar Kelimeler: Karsinoembriyonik Antijen; Küçük Hücreli Dışı Akciğer Kanseri; Prognoz
