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Öğe The case of gastric adenocarcinoma applying with malign Acanthosis Nigricans(Kare Publ, 2015) Oruc, Zeynep; Kaplan, Mehmet Ali; Urakci, Zuhat; Kucukoner, Mehmet; Avci, Yahya; Isikdogan, AbdurrahmanAchantosis Nigricans (AN) is a skin disorder characterised with hyperpigmented hyperkeratotic lesions. It occurs mostly in association with insulin resistance while it may also arise as a symptom of visceral malignancies. In the occurrence of AN considered as associated with malignancy, a detailed examination may be necessary to identify underlying malignancy. 85% of malign AN cases abdominal adenocarcinomas, and especially 60% of those are gastric adenocarcinomas. A 44-year-old male patient applied to our clinic with hyperpigmentation and hyperkeratosis, widespread body pain and weight loss within 3-4 months. Skin symptoms were reviewed as acanthosis nigricans. He had no endocrinological diseases such as DM or obesity. Due to ocurrence of many skin symptoms in accordance with acanthosis nigricans in a rapid growth on our patient, no findings of other AN causes, systemic symptoms such as the age of patient and weight loss, it is considered as malign AN.Öğe 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, MehmetThe 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.Öğe Comparison of Two Chemotherapy Regimens After First-Line Treatment for HER2-Negative Metastatic Gastric Cancer(Springernature, 2023) Urakci, Zuhat; Ebinc, Senar; Tunc, Sezai; Kalkan, Ziya; Oruc, Zeynep; Kucukoner, Mehmet; Kaplan, Muhammet AliAim: Metastatic stage gastric cancer is a disease with a poor prognosis and the likelihood of achieving a cure in these patients is low. Treatment response to subsequent-line treatments is poor. We aimed to investigate the effectiveness of the folinic acid, fluorouracil and irinotecan (FOLFIRI) and paclitaxel+carboplatin regimens, which are used in subsequent lines of therapy in advanced-stage gastric cancer.Materials and methods: This study included 40 patients who have metastatic stage gastric cancer and received FOLFIRI or paclitaxel+carboplatin therapy in subsequent lines of therapy between 2017 and 2022. The data of the patients were analyzed retrospectively.Results: At diagnosis median age was 51 (23-88) years. The tumor was localized in the gastroesophageal junction in eight (20%) patients and in other gastric locations in 32 (80%) patients. At diagnosis, 75% (n=30) of the patients presented with the disease in the metastatic stage, while 25% (n=10) presented with stage II -III disease. Regarding the treatments received in the second and further lines of therapy, 18 (45%) patients received paclitaxel+carboplatin and 22 (55%) patients received a FOLFIRI regimen. Of these treatments, 67.5% (n=27) were given as the second line and 32.5% (n=13) were given as third-line therapy. The objective response rate (ORR) was 45.5% in the FOLFIRI arm compared to 16.7% in the paclitaxel+carboplatin arm (p=0.05). Both treatment arms had a median progression-free survival (PFS) of three months (p=0.82). The median overall survival (OS) time was seven months in the FOLFIRI arm compared to eight months in the paclitaxel+carboplatin arm (p=0.71). Side effects were similar between both treatment arms.Conclusion: This study determined that FOLFIRI and paclitaxel+carboplatin treatments have similar OS, PFS, and side effect profiles in subsequent line treatment of gastric cancer. The FOLFIRI treatment regimen yielded a higher ORR.Öğe Effects of the changes between pre- and post-treatment 18F-FDG PET-CT volumetric parameters on overall survival in pleural mesothelioma(Via Medica, 2023) Tuzun, Faris; Ebinc, Senar; Kaplan, Muhammet Ali; Kaplan, Ihsan; Komek, Halil; Oruc, Zeynep; Tuzcu, Sadiye KemalIntroduction. This study aimed to examine the efficacy of positron emission tomography in fusion with computed tomography (PET-CT) parameters in predicting survival outcomes for patients with malignant pleural mesothelioma.Material and methods. This study retrospectively evaluated the data of 250 patients who were followed up after a diagnosis of malignant pleural mesothelioma. The relationship of pre-treatment [maximum standardized uptake value (SUVmax1), metabolic tumor volume (MTV1), total lesion glycolysis (TLG1), tumor/background (TBR1), pleural thickness1), post-treatment (SUVmax2, MTV2, TLG2, TBR2, pleural thickness2], and APET-CT parameters with survival was retrospectively evaluated in 36 patients whose pre-and post-treatment CT scan examinations were complete.Results. The median age of the patients was 57.5 years, ranging from 35 to 76. Median follow-up time was 16 months, with a range of 7 to 42 months. Median survival was calculated as 18.8 months for all patients. Based on the determined cut-off values, overall survival was determined as 29.9 months in patients with TLG2 <= 158 compared to 16 months in patients with TLG2 > 158 (p = 0.009) and as 30.9 months in patients with ATLG <= -62.58 compared to 16 months in patients with ATLG > -62.58 (p = 0.001). In addition, median overall survival (OS) was determined as 29.9 months in patients with MTV2 <= 63.9 compared to 16 months in patients with MTV2 > 63.9 (p = 0.007) and as 29.9 months in patients with AMTV <=-54.03 compared to 16 months in patients with AMTV > -54.03 (p = 0.002). When evaluated with respect to TBR2; median OS was 29.9 months in patients with TBR2 <= 1.84 compared to 16 months in patients with TBR2 > 1.84 (p = 0.039).Conclusions. Our research findings indicate a correlation between OS and volumetric PET-CT measures, specifically TLG and MTV.Öğe The efficacy and reliability of sequential adjuvant anthracycline-based chemotherapy and weekly paclitaxel regimen in human epidermal growth factor receptor 2 negative breast cancer: A retrospective analysis of a multicentre study(Imprimatur Publications, 2019) Kaplan, Muhammet Ali; Oruc, Zeynep; Gumus, Mahmut; Ozaydm, Sukru; Elkiran, Emin Tamer; Dine, Nur Sener; Sakin, AbdullahPurpose: To analyze the reliability and the effectiveness of chemotherapy and prognostic factors for survival in patients with HER2 (human epidermal growth receptor 2) negative early-stage breast cancer treated with adjuvant sequential anthracycline-based chemotherapy and paclitaxel. Methods: This analysis retrospectively evaluated the medical records of 756 HER2 negative early-stage breast cancel-patients who received adjuvant sequential anthracycline-based chemotherapy and weekly paclitaxel in 15 medical oncology centers in Turkey between 2008-2015. Estrogen receptor (ER), progesterone receptor (PR), HER2, age, tumor size and grade, nodal status, perineural and lymphatic invasion, disease-free survival (DFS) and overall survival (OS) were analyzed. Results: The median patient age was 50 years (22-82). Median follow up period was 46 months (13-82). The rates of recurrence and death detected in this period were 14.8% and 7.4%, respectively.Median OS and PFS were not reached in this period. Five-year DFS and OS rates were 87% and 89%, respectively. Age (OR:0.35, 95%CI 0.12-0.96, p=0.04), PR status (OR:.0.44, 95%CI 0.18-1, p=0.05), lymphatic invasion (OR:.2.6, 95%CI 0.97-7.4, p=0.05) were independent prognostic factors.Most common grade 3-4 toxicides were fatigue (6.7%), neutropenia (1.7%) and nausea (1.3%). Neutropenic fever developed in 1.8% o f the patients and peripheral neuropathy in 16.9%. Dose reduction was necessary for 10%of the patients due to grade 3-4 toxicity, whereas postponement of chemotherapy was neccessary for 7% of the patients. Conclusions: This multicentric retrospective study confirmed that sequential adjuvant therapy with anthracycline-based chemotherapy and paclitaxel for HER2 negative breast cancer is an effective and reliable regimen.Öğe Evaluation of Factors Influencing Survival in Metastatic Renal Cell Cancer(2021) Kaplan, Muhammet Ali; Oruc, Zeynep; Isikdogan, Abdurrahman; Ileri, Serdar; Ebinc, Senar; Urakci, Zuhat; Kucukoner, MehmetObjectives: The use of prognostic factors that can correctly predict the clinical outcomes of patients with mRCC has particular importance for individualized risk assessment. In this study, we aimed to address the prognostic factors in mRCC patients. Methods: Eighty-six patients who were diagnosed with de-novo metastatic renal cell cancer or developed metastasis during follow-up between January 2007-January 2020 were included and their files were retrospectively evaluated. From patient files; demographic characteristics [age, gender, EGOC PS (Eastern Cooperative Oncology Group perfor- mance status), tumor localization, tumor size, metastasis status, metastatic sites], histopathological characteristics and laboratory tests (hemoglobin, serum albumin, lactate dehydrogenase), treatments they received were recorded. Results: Factors determined to be significant in univariate analysis were assessed using multivariate analysis and the results identified a tumor size larger than 6 cm (p= 0.032), ECOG PS ?2 (p< 0.001), a hemoglobin level below 13 gr/dl (p= 0.016) and a serum albumin level below 3.6 gr/dl (p= 0.006) as independent unfavorable prognostic factors associ- ated with overall survival. Conclusion: Our study determined tumor size>6cm, hemoglobin ?13gr/dL, serum albumin ?3,6 gr/dL and ECOG PS ?2 as factors influencing the prognosis unfavorably in mRCC patients.Öğe Evaluation of the effectiveness and tolerability of sunitinib and pazopanib in the first line treatment of metastatic renal cell carcinoma(Via Medica, 2022) Ebinc, Senar; Kalkan, Ziya; Oruc, Zeynep; Urakci, Zuhat; Kucukoner, Mehmet; Kaplan, Muhammet Ali; Isikdogan, AbdurrahmanIntroduction. It is known that sunitinib and pazopanib are effective in the first-line and subsequent treatment of metastatic renal cell carcinoma (mRCC). This study aims to investigate the effectiveness and tolerability of sunitinib and pazopanib in the first-line treatment of mRCC. Material and metbods. This study included 78 patients followed up in our clinic due to a diagnosis of mRCC, who received pazopanib or sunitinib treatment between 2006 and 2020. Along with clinical and laboratory findings, survival times obtained with each treatment and medication side effects were assessed. Sunitinib and pazopanib were compared in terms of effectiveness (ORR, PFS and OS) and tolerability. Results. The patients' median age at diagnosis was 55 years (25-81). In the first-line treatment, 54 patients (69.2%) received sunitinib and 24 (30.8%) received pazopanib. The comparison of sunitinib and pazopanib yielded an ORR of 66.7% vs. 45.8% (p = 0.08), PFS of 24 months vs. 19 months (p = 0.66) and OS of 27 months vs. 30 months (p = 0.73), respectively. The most common side effect was hypothyroidism in those on sunitinib (25.9%) and nausea-vomiting in those on pazopanib (41.7%). In our study, hemoglobin >= 13 g/dL, an ECOG PS of 0-1 and the occurrence of hypothyroidism as a medication side effect were found to be predictive factors of PFS for both agents. An International Metastatic RCC Database Consortium score corresponding to the poor risk group was associated with a poor PFS. Conclusions. This study, which provides current real-world data, confirms that sunitinib and pazopanib have similar effectiveness and side-effect profiles in the first-line treatment of mRCC.Öğe Factors influencing HER2 discordance in nonmetastatic breast cancer and the role of neoadjuvant therapy(Future Medicine Ltd, 2022) Ebinc, Senar; Oruc, Zeynep; Sezgin, Yasin; Karhan, Ogur; Bilen, Erkan; Yerlikaya, Halis; Kalkan, ZiyaPlain language summary HER2 is an important and targetable molecule in breast cancer. In the early stages of breast cancer, a treatment modality called neoadjuvant therapy, which now includes anti-HER2 therapies, is administered before surgery in order to achieve disease regression and make the patient suitable for a more minor operation. In breast cancer, HER2 status may be positive in the initial biopsy specimen and negative in the surgical specimen. HER2 status plays an important role in treatment decisions. In this study, we investigated the factors causing HER2 status to change in early-stage breast cancer. This study has a retrospective design and includes 400 female patients with early-stage breast cancer. The results of the study identified the factors causing HER2 status to change to negative as receipt of neoadjuvant therapy, small tumor size and younger age. Objective: The rates of and the factors influencing HER2 discordance in patients receiving neoadjuvant therapy for breast cancer are investigated. Methods: This study retrospectively examines the rates of HER2 and hormone receptor discordance between the biopsy and postoperative resection specimens of 400 female early-stage breast cancer patients. Results: One hundred and thirty-three (33.3%) patients had received neoadjuvant therapy. The rate of HER2 discordance between biopsy and resection specimens was 1.7% in the control group and 5.3% in the neoadjuvant therapy group (p = 0.018). The rate of HER2 discordance was higher in younger patients and in patients with T1 tumors in the neoadjuvant therapy group. Conclusion: Neoadjuvant therapy, age <40 years and smaller tumor size were independent risk factors for HER2 discordance.Öğe Factors influencing the prognosis in Braf wild-type metastatic malignant melanoma and the role of novel inflammation indices(Galenos Publ House, 2023) Ebinc, Senar; Kalkan, Ziya; Oruc, Zeynep; Sezgin, Yasin; Urakci, Zuhat; Kucukoner, Mehmet; Kaplan, Muhammet AliBackground and Design: This study aims to investigate the prognostic factors in BRAF wild-type metastatic cutaneous melanoma and the prognostic role of inflammation indices.Materials and Methods: Metastatic BRAF wild-type cutaneous melanoma patients who presented to our clinic between 2011 and 2021 were enrolled. To investigate their prognostic roles, age, gender, performance status, first immunotherapy regimen received by the patient, metastatic sites, and seven inflammation indices [C-reactive protein (CRP)/albumin ratio (CAR), neutrophil lymphocyte ratio (NLR), prognostic nutritional index (PNI), platelet lymphocyte ratio (PLR), systemic immune-inflammation index (SII) and advanced lung cancer inflammation index (ALI) and hemoglobin, albumin levels, lymphocyte and platelet counts (HALP)] were studied.Results: Fourty-seven patients, consisting of 22 (46.8%) females and 25 (53.2%) males, were included in this study. Mean patient age was 54 (18-88) years. In our study, there were 16 (34%) patients with liver metastasis, 17 (36.2%) patients with lung metastasis, and 9 (19.1%) patients with brain metastasis. As immunotherapy, 34 (72.3%) patients had received Nivolumab, while 13 (27.7%) patients had received Ipilimumab therapy. When the relationships of the prognostic variables with overall survival were inspected in univariate and multivariate analyses, brain metastasis was found to be an independent prognostic factor (p=0.02). Lung metastasis approached the threshold of statistical significance in univariate analysis (p=0.09) and liver metastasis in multivariate analysis (p=0.07). The seven inflammation indices examined in the analyses [CAR, NLR, PNI, PLR, SII ALI and HALP] were found to have no prognostic role in both univariate and multivariate analyses.Conclusion: Our study determined that brain metastasis is an independent poor prognostic factor in BRAF wild-type metastatic melanoma. Prognostic roles of the CAR, NLR, PNI, PLR, SII ALI and HALP indices could not be demonstrated.Öğe Investigation of Factors Influencing the Prognosis in Prostate Cancer Patients with Isolated Bone Metastasis(Galenos Publ House, 2022) Ebinc, Senar; Oruc, Zeynep; Urakci, Zuhat; Kaplan, Muhammet Ali; Kucukoner, Mehmet; Isikdogan, AbdurrahmanObjective: Bone metastases, which show a milder course compared with visceral disease, are among the most common metastatic sites in prostate cancer. In the present study, we aimed to investigate the prognostic factors that influence the survival time in the castration-sensitive phase in patients diagnosed with prostate adenocarcinoma with isolated bone metastasis.Materials and Methods: The prognostic effects of the clinical (performance status, number of bone metastases) and laboratory parameters of a total of 217 patients, of whom the data could be accessed, on survival in the castration-sensitive phase were evaluated.Results: Of the 217 patients included in our study, 144 (66.4%) were metastatic at presentation. The mean age of the patients was 68.4 (42-88) years. The mean follow-up duration was 44 months. Of our 217 patients, 125 (57.6%) were included in the castration-sensitive group and 92 (42.4%) in the castration-resistant group. In multivariate analyses; lactate dehydrogenase, alkaline phosphatase (ALP) levels and the number of bone metastases were independent prognostic factors with a strong correlation with time to castration-resistant prostate cancer. The evaluation of these three parameters within the framework of a prognostic index and subsequent risk stratification revealed median progression-free survival times of 91, 36, 20 and 12 months for the very low-risk, low-risk, intermediate-risk and high-risk groups, respectively.Conclusion: Lactate dehydrogenase, ALP levels and the number of bone metastases were determined as strong and useful prognostic factors in predicting time to inÖğe Is eribulin treatment prognostic factor in patients with metastatic breast cancer treated with this drug? Retrospective analysis of a multicentre study(Imprimatur Publications, 2019) Oruc, Zeynep; Kaplan, Muhammet Ali; Geredeli, Caglayan; Sari, Nilgun Yildirim; Ozaslan, Ersin; Aytekin, Aydin; Elkiran, Emin TamerPurpose: This study aimed to analyze prognostic factors for survival and the reliability and the effectiveness of eribulin therapy in metastatic breast cancer (MBC) patients. Methods: A total of 80 patients treated with eribulin in 12 medical oncology centers in Turkey between 2013-2017 were retrospectively evaluated. Sixteen potential prognostic variables were assessed for analysis. Results: The patients had received a median of 5 prior chemotherapy regimens and a median of 3 eribulin cycles for MBC. Median progression-free survival (PFS) was 5.5 months (95% Cl: 4.1-7.8) and median overall survival (OS) was 11 months (95 % Cl: 6-15). Multivariate analysis showed that eribulin treatment line was shown to have independent prognostic significance for PFS. PFS difference was demostrated in patients who received 3 chemotherapy lines for advanced disease compared to those who had more than 3 chemotherapy lines [median PFS; 3 lines: 8.6 months (6.2-11) and >3 lines: 4.6 months (3.7-4.6) p=0.00]. The clinical benefit rate (CBR) was 52.5 and 35% in patients treated with three lines and with >3 previous chemotherapeutic regimens. Most common toxicities were neutropenia (62.5%), fatigue (52.5%), alopecia (50%) and nausea (37.5%). Conclusions: Eribulin treatment line was identified as indepedent prognostic factor for PFS in MBC patients.Öğe Is eribulin treatment prognostic factor in patients with metastatic breast cancer treated with this drug? Retrospective analysis of a multicentre study(Imprimatur Publications, 2020) Oruc, Zeynep; Kaplan, Muhammet Ali; Geredeli, Caglayan; Sari, Nilgun Yildirim; Ozaslan, Ersin; Aytekin, Aydin; Elkiran, Emin TamerPurpose: This study aimed to analyze prognostic factors for survival and the reliability and the effectiveness of eribulin therapy in metastatic breast cancer (MBC) patients. Methods: A total of 80 patients treated with eribulin in 12 medical oncology centers in Turkey between 2013-2017 were retrospectively evaluated. Sixteen potential prognostic variables were assessed for analysis. Results: The patients had received a median of 5 prior chemotherapy regimens and a median of 3 eribulin cycles for MBC. Median progression free survival (PFS) was 5.5 months (95% CI: 4.1-7.8) and median overall survival (OS) was 11 months (95 % CI: 6-15). Multivariate analysis showed that eribulin treatment line was shown to have independent prognostic significance for PFS. PFS difference was demostrated in patients who received 3 chemotherapy lines for advanced disease compared to those who had more than 3 chemotherapy lines [median PFS; 3 lines: 8.6 months (6.2-11) and >3 lines: 4.6 months (3.7-16) p=0.00]. The clinical benefit rate (CBR) was 52.5 and 35% in patients treated with three lines and with >3 previous chemotherapeutic regimens. Most common toxicities were neutropenia (62.5%), fatigue (52.5%), alopecia (50%) and nausea (37.5%). Conclusions: Eribulin treatment line was identified as indepedent prognostic factor for PFS in MBC patients.Öğe Is fat mass more effective than body mass index (BMI) to predict toxicity in early breast cancer patients treated with doxorubicin and cyclophosphamide?(Amer Assoc Cancer Research, 2018) Kaplan, Muhammet Ali; Kavak, Hemrin; Urakci, Zuhat; Nas, Necip; Oruc, Zeynep; Yerlikaya, Halis; Akdeniz, Nadiye[Abstract Not Available]Öğe Nasal septum perforation in the patients with advanced breast cancer due to the treatment of lapatinib+capecitabine(Kare Publ, 2015) Oruc, Zeynep; Kucukoner, Mehmet; Urakci, Zuhat; Kaplan, M. Ali; Solmaz, Ihsan; Isikdogan, AbdurrahmanNasal septum perforation is a rare complication that can occur due to certain antineoplastic agents, especially antiangiogenic agents such as bevacizumab. There has been no case of nasal perforation case due to the treatment of lapatinib+capecitabine so far. Our case is nasal septum perforation occuring with the 38-year-old patient diagnosed with premenopausal advanced breast cancer during the treatment of lapatinib+capecitabine. It occured as epistaxis in the 30th month of patient's treatment. In the anterior rhinoscopy, nasal septum perforation was diagnosed. The patient had no nasal irritant or cocaine, or no trauma story. Although it is a rare complication, perforation due to lapatinib+capecitabine should be considered in the advanced breast cancer patients with the treatment of lapatinib+capecitabine when nasal symptoms (epistaxis, nasal congestion, local pain, irritation, rhinorrhea) occur.Öğe Neoadjuvant Therapy and Factors Influencing Survival in Locally Advanced Non-Small Cell Lung Cancer(Springernature, 2023) Ebinc, Senar; Oruc, Zeynep; Kalkan, Ziya; Teke, Fatma; Onat, Serdar; Urakci, Zuhat; Kaplan, Muhammet AliAim: We aimed to investigate the effectiveness of neoadjuvant therapy (NAT) and clinicopathological characteristics in locally advanced non-small cell lung cancer (NSCLC) (IIIA-IIIB), as well as the influence of the post-NAT treatment modalities on survival. Materials and methods: This study included patients who presented to the Dicle University Medical Oncology Clinic and received NAT for a diagnosis of locally advanced NSCLC between 2004 and 2020. Clinicopathological and radiological data of the 57 patients whose data could be retrieved from the hospital archive system were retrospectively reviewed. Patients' overall survival (OS) and failure-free survival (FFS) times and the factors influencing these times were evaluated. Results: This study included a total of 57 patients consisting of five (8.8%) females and 52 (91.2%) males. The median patient age at diagnosis was 58 (30-75) years. All patients had received four courses of chemotherapy during the neoadjuvant period. When the factors influencing OS were evaluated, the post-NAT modality was found to have a statistically significant effect on survival. FFS times were 12, 13, and 16 months in the chemotherapy, chemoradiotherapy, and surgery arms, respectively (log-rank p=0.035). FFS was longer in those who underwent surgery (Hazard ratio (HR): 0.33, 95 % CI: 0.14-0.77, (p=0.01)). OS times were 20, 21, and 55 months in the chemotherapy, chemoradiotherapy, and surgery arms, respectively (log-rank p=0.05). OS was longer in the arm undergoing surgery compared to the other arms (HR: 0.36, 95% CI: 0.14-0.87, (p=0.02)). Five-year survival rates for the chemotherapy, chemoradiotherapy, and surgery arms were 14.3%, 21.4%, and 40%, respectively. Conclusions: This study shows that achieving an operable status is the most important indicator of survival and that patients undergoing surgery have a marked advantage in OS and FFS compared with patients receiving chemoradiotherapy or palliative chemotherapy.Öğe Non-Urothelial Bladder Cancer: Comparison of Clinicopathological and Prognostic Characteristics in Pure Adenocarcinoma and Non-Bilharzial Squamous Cell Carcinoma of the Bladder(Karger, 2018) Erdem, Gokmen U.; Dogan, Mutlu; Sakin, Abdullah; Oruc, Zeynep; Yaman, Emel; Cinkir, Havva Yesil; Uysal, MukreminObjectives: The clinicopathological characteristics, treatment modalities, and effects on the prognosis of pure squamous cell carcinoma (SqCC) and adenocarcinoma (AC) were evaluated. Materials and Methods: 86 patients with pure SqCC and AC bladder cancer were evaluated retrospectively. Results: Of the 86 patients, 51 had SqCC and 35 had AC. No differences in clinicopathological characteristics were observed between patients with AC and SqCC, except for the prevalence of T4 disease (28.6% vs. 51.0%, respectively). In multivariate analysis, older age, stage IV disease, and Eastern Cooperative Oncology Group (ECOG) performance status (> 2) were predictive of a poor overall survival (OS). The median OS was significantly longer for stage I-III patients (82.9 months) treated with surgery +/- chemotherapy (CT) +/- radiotherapy (RT) than for those treated with transurethral resection +/- CT +/- RT (24.3 months) (P = 0.007). The median OS of patients with SqCC and AC who were given platinum-based CT for metastasis was 7.7 and 30.3 months, respectively. Conclusions: Advanced age, stage IV disease, and poor ECOG performance status were factors associated with a poor prognosis. Surgery +/- CT +/- RT resulted in significantly better OS, except in stage IV disease. Patients with metastatic AC had better response rates with platinum- based CT. (c) 2018 S. Karger GmbH, FreiburgÖğe Survival outcomes of patients diagnosed with muscle-invasive bladder cancer who showed a response after neoadjuvant chemotherapy and refused radical cystectomy, and patients who had radical cystectomy or received chemoradiotherapy(Via Medica, 2023) Tunc, Sezai; Urakci, Zuhat; Ebinc, Senar; Ileri, Serdar; Kalkan, Ziya; Oruc, Zeynep; Kucukoner, MehmetIntroduction. We aimed to compare the survival results of patients with muscle-invasive bladder cancer who responded after neoadjuvant chemotherapy (NAC) and did not accept further treatment and those who underwent radical cystectomy or received chemoradiotherapy (CRT).Material and methods. The study included 53 patients with non-metastatic muscle-invasive bladder cancer who received NAC between 2009 and 2020. Clinical findings and post-NAC survival analysis were evaluated. Survival analyses of patients who underwent radical cystectomy (RC) after NAC, received CRT, and refused treatment were compared.Results. The median age at diagnosis was 61 (33-80) years. After NAC, 18 patients (34%) received CRT, 9 patients (17%) underwent RC, and 18 patients (34%) refused further treatment. Complete response (CR) was present in 10 (18.4%) patients, partial response (PR) in 35 (66%) patients, stable disease (SD) in 1 (1.9%) patient, and progression in 7 (13.2%) patients. Median overall survival (OS) was 78 months. Median OS was not reached in the RC arm; it was 97 months in the CRT arm and 78 months in the declined-treatment arm. There was no statistical difference between the arms (p = 0.94). Median disease-free survival (DFS) was 32 months. Median DFS in the RC arm was 30 months, in the CRT arm - 34 months, and 28 months in the declined-treatment arm after NAC. There was no statistically significant difference between the arms (p = 0.74).Conclusions. We did not find any difference in terms of OS and DFS between patients who after NAC underwent RC, CRT, or refused treatment.Öğe An update on the currently available and future chemotherapy for treating bone metastases in breast cancer patients(Taylor & Francis Ltd, 2018) Oruc, Zeynep; Kaplan, Muhammet Ali; Arslan, CagatayIntroduction: Bone metastases in breast cancer patients are a common clinical problem. Many factors influence the treatment decision, including tumor characteristics, previous treatment and tumor burden in the treatment of metastatic breast cancer. Areas covered: This present review summarizes the new treatment strategies and the chemotherapeutic agents currently available in the management of metastatic breast cancer with bone metastases. Expert opinion: Patients with bone metastases more often have hormone receptor-positive tumours. Although new treatment agents for metastatic breast cancer have been investigated, endocrine therapy is still considered as the treatment of choice for patients with bone metastases although chemotherapy still has an important place. In recent years, new chemotherapeutic agents such as etirinotecan and nab-paclitaxel have been established though there are few studies that have looked at particular types of metastases. In the last decade, therapies for bone metastasis resistant to endocrine therapy have predominantly focused on radiotherapy, surgical resection, chemotherapy, bone-targeting radiopharmaceuticals and targeted therapeutics. New targeted agents include: Src inhibitors, cathepsin K inhibitors, CXCR4 inhibitors, TGF-B blockade and integrin antagonists while drug delivery systems for chemotherapy have also been developed. These new treatment options could be future treatment options for bone metastatic disease if early promising results are confirmed by clinical trials.
