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    Easier and more explanatory indices by integrating leukocyte lymphocyte ratio (LLR) and prognostic nutritional index (PNI) to IPS systems in cases with classical Hodgkin lymphoma
    (Pergamon-Elsevier Science Ltd, 2021) Paydas, Semra; Lacin, Sahin; Dogan, Mutlu; Barista, Ibrahim; Yildiz, Birol; Seydaoglu, Gulsah; Karadurmus, Nuri
    The aim of this study is to determine the power of he international prognostic scoring systems (IPS-7 and IPS-3) and to obtain indices by integrating leukocyte lymphocyte ratio (LLR) and prognostic nutritional index (PNI) factors as prognostic indicators in cases with classical Hodgkin lymphoma (cHL). 1012 patients with cHL were evaluated with 2 different IPS-4 scores with four parameters: stage, age, hemoglobin level, and either LLR or PNI. Statistical package SPSS v 22.0 was used. Two different Cox regression models were obtained for OS and PFS. Model 1 showed LLR >= 5,8 as the highest risk for OS and anemia as the highest risk for PFS. Model 2 showed PNI <= 45,2 as the highest risk for OS and anemia as the highest risk for PFS. IPS-4 scores obtained by integrating either LLR or PNI to IPS-3 integration of a biologic parameter either LLR or PNI need to be determined with clinical risk scoring parameters.
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    The effect of exercise on disease-free survival and overall survival in patients with breast cancer
    (Springer London Ltd, 2022) Akdeniz, Nadiye; Kaplan, Muhammet Ali; Kucukoner, Mehmet; Urakci, Zuhat; Lacin, Sahin; Ceylan, Emre Husnu; Isikdogan, Abdurrahman
    Background Positive effects of exercise in cancer patients have been reported. Aim To investigate whether intensity, duration, and timing of exercise affect disease relapse and mortality risk in patients with breast cancer (BC). Methods Patients with local or locally advanced stages of BC between January 2018 and January 2020 were recruited in the study. Sociodemographic and clinicopathological characteristics of patients were recorded. Exercise evaluation was performed by preparing a questionnaire and asking the patients face-to-face questions in the outpatient clinic. Results Risk of relapse was 58% lower in patients who exercised than inactive patients (p = 0.004). Patients who exercised for 2 to 5 days per week had a 63% lower relapse risk than inactive patients (p = 0.010). Risk of relapse was 66% lower in the patients who exercised for less than 1 h or 3 metabolic equivalent of task (MET)-hours per week when compared to inactive patients (p = 0.037). Similarly, relapse risk was 62% lower in patients who exercised between 1 to 3 h or 3 to 8.9 MET-hours per week than inactive patients (p = 0.026). Mortality risk was lower in patients who exercised than patients who did not (p = 0.027). A significantly decreased mortality risk was found in both groups that included patients who exercised for 1 to 5 days per week and patients who exercised for less than 3 h or 9 MET-hours per week when compared to inactive patients. Conclusion Exercise was associated with decreased relapse and mortality rates in patients with BC. Therefore, exercise should be recommended to BC patients as a significant component of the treatment.
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    Impact of tivozanib on patient outcomes in treatment of advanced renal cell carcinoma
    (Dove Medical Press Ltd, 2019) Yalcin, Suayib; Lacin, Sahin
    Renal cell carcinoma (RCC) is the most common type of kidney malignancy, and the clear-cell subtype represents the majority of RCCs. RCC is a heterogeneous disease in terms of genetic and histological features which determine the behavior of the disease. The von Hippel-Lindau (VHL) is a tumor suppressor gene and mutations of this gene are seen in 95% of clear-cell RCCs. Inactivation of VHL causes the accumulation of hypoxia-inducible factor-1 (HIF-1), and in turn, accumulation of HIF-1 induces overexpression of vascular endothelial growth factor (VEGF); the increase in VEGF expression makes RCC a highly vascularized tumor, and forms the rationale for antiVEGF treatment. In the past decade, improvement in the survival of RCC patients has been observed due to new effective therapies, such as antiVEGF and mammalian target of rapamycin (mTOR) targeting agents and immune checkpoint inhibitors. The majority of VEGF targeted agents are not just selective to VEGF receptors, but usually also have inhibitory effects on other kinases, such as c-KIT and FLT3. Tivozanib is an extremely potent and selective tyrosine kinase inhibitor (TKI) of VEGFR-1, 2, and 3, with a relatively long half-life, that is approved by the European Commission for the treatment of advanced/metastatic RCC. Tivozanib, at very low serum concentration can inhibit phosphorylation of VEGFR -1, -2, and -3 tyrosine kinase activity. This article summarizes the clinical data on tivozanib in the treatment of advanced/metastatic RCC.
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    Importance of Clinical and Pathological Characteristics of Meningiomas and Their Relationship with Somatostatin Receptor-2 Positivity
    (Sci Printers & Publ Inc, 2020) Sogutcu, Nilgun; Lacin, Sahin; Cetin, Abdurrahman
    OBJECTIVE: Numerous studies have been conducted on risk factors for meningioma, mostly investigating the relationship between meningioma tumor somatostatin receptor 2 status (SSTR2), tumor size, age at diagnosis, and tumor grade. This single-center study performed in patients undergoing meningioma resection was performed to investigate the relationships between tumor characteristics. STUDY DESIGN: This study involved a retrospective analysis of patients undergoing meningioma resection at our hospital. Univariate and multivariate logistic regression models were used to investigate the relationships between tumor SSTR2 expression status, progesterone receptor status, Ki-67 proliferation index, grade, and size, as well as to identify factors. RESULTS: A total of 81 patients had a median age at diagnosis of 50 (21-80) years. The overall survival (OS) periods in female and male patients were 100.2 and 56.4 months, respectively (p=0.02). There was a significant difference in OS rates between the patients <= 65 years of age and those > 65 (99.1 and 58.8 months, respectively) (p=0.008). The patients with tumors > 3 cm had poorer OS than patients with tumors <= 3 cm (p=0.004). There was no association between tumor SSTR2 expression status and OS; i.e., the OS periods were 75 months in patients with SSTR2-negative tumors, 100.2 months in those with weakly SSTR2-positive tumors, and 89 months in those with strongly SSTR2-positive tumors (p=0.472). CONCLUSION: Interestingly, despite the high positive expression rate of SSTR2, there was no relation between SSTR2 expression status and characteristic features of meningiomas. Therefore, further investigations of the role of SSTR2 receptor expression in meningiomas other than its diagnostic value are required.
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    Progesterone Receptor Status May be the Most Important Prognostic Factor for Meningiomas
    (Akad Doktorlar Yayinevi, 2019) Cetin, Abdurrahman; Lacin, Sahin; Sogutcu, Nilgun
    The aim of this study examined the relationships between progesterone receptor (PR) and estrogen receptor (ER) status in meningiomas and tumor grade, proliferative index (Ki67), and prognosis. Immunohistochemistry with monoclonal rabbit antibodies was performed on 4 mm paraffin sections of all tumors that were confirmed as meningiomas. Samples were assessed for tumor grade, PR and ER expression, and Ki67 status. Correlations among these parameters and their prognostic values were investigated. Overall survival (OS) was 91.4 months, and there was a significant difference in OS between genders. OS for females and males was 100.2 and 45.7 months, respectively (p= 0.02). When patients were divided into two groups by age, there was a significant difference in OS between those aged 50 years and younger and those older than 50 years, 113.2 and 65.1 months, respectively (p= 0.001). There was also a significant difference in OS based on PR status. OS among PR-negative patients was 43.8 months, whereas it was 93.7 months in weakly positive patients, and 95.2 months in strongly positive patients (p= 0.035). Overall, 10 (13.5%) patients had ER expression detectable by the monoclonal antibody technique used. All ER-positive tumor samples were from female patients; all tumors from males were negative for ER staining. Female predominance of meningiomas as the most common primary intracranial neoplasm strongly suggests that sex hormones may affect meningioma growth. This study found that PR status was a prognostic factor in our meningioma series, as were gender and age.