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Seber ES, Iriagac Y, Cavdar E, Karaboyun K, Avci O, Yolcu A, Gurdal SO, Oznur M, Ekinci F, Aytac A, Gulturk I, Yilmaz M, Sever N, Kapagan T, Ferhatoglu F, Kahvecioglu FA, Hacibekiroglu I. Efficacy of Neoadjuvant Chemotherapy in Lobular and Rare Subtypes of Breast Cancer. J Coll Physicians Surg Pak 2024; 34:37-41. [PMID: 38185958 DOI: 10.29271/jcpsp.2024.01.37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 11/01/2023] [Indexed: 01/09/2024]
Abstract
OBJECTIVE To determine the predictive factors for the pathological complete response (pCR) in patients with non-ductal invasive breast cancer (ND-BC) receiving neoadjuvant chemotherapy. STUDY DESIGN Observational study. Place and Duration of the Study: Departments of Medical Oncology, Tekirdag Namik Kemal University, Sirnak State Hospital, Aydin Adnan Menderes University, Marmara University, Bakirkoy Sadi Konuk Hospital, Basaksehir Cam and Sakura Hospital, Sakarya University, Balıkesir Ataturk Hospital, Turkiye, from April 2016 to December 2022. METHODOLOGY A total of 222 non-metastatic breast cancer patients who received neoadjuvant chemotherapy were included in this retrospective multicentric study. The clinicopathologic data were obtained from the hospitals' electronic-record-system. The logistic regression models were used to identify predictive factors for pCR. RESULTS One hundred and twenty-six patients (56.8%) had invasive lobular carcinoma and 28 patients (12.6%) had signet ring cell/mucinous carcinoma. A total of 45 patients (20.3%) achieved pCR. The pCR rate was 14.3% for lobular carcinoma and 17.9% for signet ring cell/mucinous carcinoma. The univariate analysis showed that estrogen receptor-negative tumours (p = 0.017), high Ki-67 (p = 0.008), high histologic grade (p<0.001), HER2+ expression (p<0.001), and non-lobular histologic type (p = 0.012) were predictive factors for pCR. The multivariate model revealed that HER2 expression (p<0.001) and Ki-67 (p = 0.005) were independent predictors. CONCLUSION Neoadjuvant chemotherapy demonstrated effectiveness in ND-BC patients, leading to favourable pCR rates and enabling breast-conserving surgery. Predictive markers for pCR varied depending on histologic types, with HER2 expression, ER status, Ki-67, and histologic grade showing significance in non-ductal subtypes, while HER2 status alone was predictive in lobular carcinoma. KEY WORDS Neoadjuvant chemotherapy, Non-ductal breast cancer, Lobular carcinoma.
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Affiliation(s)
- Erdogan Selcuk Seber
- Department of Medical Oncology, Faculty of Medicine, Tekirdag Namik Kemal University, Tekirdag, Turkiye
- Department of Medical Oncology, Aydin Adnan Menderes University, Aydin, Turkiye
- Department of Medical Oncology, Marmara University, Istanbul, Turkiye
- Department of Medical Oncology, Faculty of Medicine, Sakarya University, Sakarya, Turkiye
| | - Yakup Iriagac
- Department of Medical Oncology, Faculty of Medicine, Tekirdag Namik Kemal University, Tekirdag, Turkiye
- Department of Medical Oncology, Aydin Adnan Menderes University, Aydin, Turkiye
- Department of Medical Oncology, Marmara University, Istanbul, Turkiye
- Department of Medical Oncology, Faculty of Medicine, Sakarya University, Sakarya, Turkiye
| | - Eyyup Cavdar
- Department of Medical Oncology, Faculty of Medicine, Tekirdag Namik Kemal University, Tekirdag, Turkiye
- Department of Medical Oncology, Aydin Adnan Menderes University, Aydin, Turkiye
- Department of Medical Oncology, Marmara University, Istanbul, Turkiye
- Department of Medical Oncology, Faculty of Medicine, Sakarya University, Sakarya, Turkiye
| | - Kubilay Karaboyun
- Department of Medical Oncology, Faculty of Medicine, Tekirdag Namik Kemal University, Tekirdag, Turkiye
- Department of Medical Oncology, Aydin Adnan Menderes University, Aydin, Turkiye
- Department of Medical Oncology, Marmara University, Istanbul, Turkiye
- Department of Medical Oncology, Faculty of Medicine, Sakarya University, Sakarya, Turkiye
| | - Okan Avci
- Department of Medical Oncology, Faculty of Medicine, Tekirdag Namik Kemal University, Tekirdag, Turkiye
- Department of Medical Oncology, Aydin Adnan Menderes University, Aydin, Turkiye
- Department of Medical Oncology, Marmara University, Istanbul, Turkiye
- Department of Medical Oncology, Faculty of Medicine, Sakarya University, Sakarya, Turkiye
| | - Ahmet Yolcu
- Department of Radiation Oncology, Faculty of Medicine, Tekirdag Namik Kemal University, Tekirdag, Turkiye
- Department of Medical Oncology, Bakirkoy Sadi Konuk Training and Research Hospital, Istanbul, Turkiye
- Department of Medical Oncology, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkiye
- Department of Medical Oncology, Balikesir Ataturk City Hospital, Balikesir, Turkiye
| | - Sibel Ozkan Gurdal
- Department of Surgical Oncology, Faculty of Medicine, Tekirdag Namik Kemal University, Tekirdag, Turkiye
| | - Meltem Oznur
- Department of Pathology, Faculty of Medicine, Tekirdag Namik Kemal University, Tekirdag, Turkiye
| | - Ferhat Ekinci
- Department of Medical Oncology, Sirnak State Hospital, Sirnak, Turkiye
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Demirci NS, Çavdar E, Erdem GU, Hatipoglu E, Celik E, Sezer S, Yolcu A, Dogan M, Seber ES. Is the serum level of survivin, an antiapoptotic protein, a potential predictive and prognostic biomarker in metastatic pancreatic cancer? Medicine (Baltimore) 2023; 102:e34014. [PMID: 37352081 PMCID: PMC10289789 DOI: 10.1097/md.0000000000034014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 05/15/2023] [Accepted: 05/25/2023] [Indexed: 06/25/2023] Open
Abstract
In the present study, we aimed to assess the association between the serum survivin level and overall survival and treatment response rates in metastatic pancreatic cancer (MPC). Serum samples were prospectively collected from 41 patients with newly diagnosed MPC patients and 41 healthy individuals (control group) to assess the survivin levels. The median survivin level was 136.2 ng/mL in patients with MPC and 52 ng/mL in healthy individuals (P = .028). Patients were divided into low- and high-survivin groups according to the baseline median survivin level. Patients with a high serum survivin level compared with a low serum survivin level had shorter median progression-free survival (2.39 vs 7.06 months; P = .008, respectively) and overall survival (3.74 vs 9.52 months; P = .026, respectively). Patients with higher serum survivin levels had significantly worse response rates (P = .007). The baseline high level of serum survivin in patients with MPC may be associated with treatment resistance and poor prognosis. A confirmation will be needed for these results in future large multicenter prospective studies.
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Affiliation(s)
- Nebi Serkan Demirci
- Department of Medical Oncology, Faculty of Medicine, Istanbul University-Cerrahpasa Cerrahpasa, Turkey
| | - Eyyüp Çavdar
- Department of Oncology, Faculty of Medicine, Tekirdag Namik Kemal University, Turkey
| | - Gokmen Umut Erdem
- Department of Medical Oncology, Başakşehir Çam and Sakura City Hospital, Turkey
| | - Engin Hatipoglu
- Department of General Surgery, Faculty of Medicine, Istanbul University-Cerrahpasa Cerrahpasa, Turkey
| | - Emir Celik
- Department of Medical Oncology, Haydarpaşa Numune Training and Research Hospital, University of Health Sciences, Turkey
| | - Sevilay Sezer
- Department of Biochemistry, Ministry of Health Ankara City Hospital, Turkey
| | - Ahmet Yolcu
- Department of Radiation Oncology, Tekirdag Namik Kemal University Faculty of Medicine, Turkey
| | - Mutlu Dogan
- Department of Medical Oncology, Ankara Oncology Training and Research Hospital, Turkey
| | - Erdogan Selcuk Seber
- Department of Oncology, Faculty of Medicine, Tekirdag Namik Kemal University, Turkey
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Berber T, Celik SE, Aksaray F, Yoney A, Harmanci K, Tambas M, Yılmaz BD, Numanoglu C, Yolcu A, Açan Hİ, Dinçer ST, Yıldırım BA. Radiosurgery effects and adverse effects in symptomatic eloquent brain-located Cavernomas. J Radiat Res 2023; 64:133-141. [PMID: 36208871 PMCID: PMC9855324 DOI: 10.1093/jrr/rrac056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 06/21/2022] [Indexed: 06/16/2023]
Abstract
In this study, the dose schedule efficacy, safety and late adverse effects of stereotactic radiosurgery (SRS) were evaluated for patients with symptomatic cavernomas who were not eligible for surgery and treated with SRS. Between January 2013 and December 2018, 53 patients with cavernomas were treated using SRS with the CyberKnife® system. Patients' diseases were deeply located or were in subcortical functional brain regions. In addition to bleeding, 23 (43.4%) patients had epilepsy, 12 (22.6%) had neurologic symptoms and 16 patients (30.2%) had severe headaches. The median volume was 741 (range, 421-1351) mm3, and the median dose was 15 (range, 14-16) Gy in one fraction. After treatment, six (50%) of 12 patients with neurologic deficits still had deficits. Rebleeding after treatment developed in only two (3.8%) patients. The drug was completely stopped in 14 (60.9%) out of 23 patients who received epilepsy treatment, and the dose of levetiracetam decreased from 2000 mg to 1000 mg in four (17.3%) of nine patients. Radiologically, complete response (CR) was observed in 13 (24.5%) patients, and partial responses (PR) were observed in 32 (60.2%) patients. Clinical response of CR was observed in 30 (56.6%) patients, PR was observed in 16 (30.2%), stable disease (SD) was observed in three (5.7%) and four (7.5%) patients progressed. In conclusion, SRS applied in the appropriate dose schedule may be an effective and reliable method in terms of symptom control and prevention of rebleeding, especially in patients with inoperable cavernomas.
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Affiliation(s)
- Tanju Berber
- Corresponding author. Department of Radiation Oncology and Radiosurgery, Okmeydani Training And Research Hospital, Kaptan Pasa, SSK Okmeydani Hst. No: 25, 34384 Sisli/Istanbul, Turkey. Tel: +905324111202;
| | - Suat Erol Celik
- Department of Neurosurgery, Okmeydani Training And Research Hospital, Istanbul, Turkey
| | - Ferdi Aksaray
- Department of Radiation Oncology and Radiosurgery, Okmeydani Training And Research Hospital, Istanbul, Turkey
| | - Adnan Yoney
- Department of Internal Medicine, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
| | - Kemal Harmanci
- Department of Radiology, Okmeydani Training And Research Hospital, Istanbul, Turkey
| | - Makbule Tambas
- Department of Radiation Oncology and Radiosurgery, Okmeydani Training And Research Hospital, Istanbul, Turkey
| | - Binnur Dönmez Yılmaz
- Department of Radiation Oncology and Radiosurgery, Okmeydani Training And Research Hospital, Istanbul, Turkey
| | - Cakir Numanoglu
- Department of Radiation Oncology and Radiosurgery, Okmeydani Training And Research Hospital, Istanbul, Turkey
| | - Ahmet Yolcu
- Department of Radiation Oncology, Namık Kemal University Medical Faculty of Medicine, Tekirdag, Turkey
| | - Hilal İrem Açan
- Department of Radiation Oncology and Radiosurgery, Okmeydani Training And Research Hospital, Istanbul, Turkey
| | - Selvi Tabak Dinçer
- Department of Radiation Oncology and Radiosurgery, Okmeydani Training And Research Hospital, Istanbul, Turkey
| | - Berna Akkuş Yıldırım
- Department of Radiation Oncology and Radiosurgery, Okmeydani Training And Research Hospital, Istanbul, Turkey
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Şeber ES, İriagac Y, Çavdar E, Karaboyun K, Avcı O, Yolcu A, Gürdal SÖ, Öznur M. A logarithmic model for hormone receptor-positive and breast cancer patients treated with neoadjuvant chemotherapy. Rev Assoc Med Bras (1992) 2023; 69:434-439. [PMID: 36921198 PMCID: PMC10004284 DOI: 10.1590/1806-9282.20221255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 12/20/2022] [Indexed: 03/12/2023]
Abstract
OBJECTIVE The aim of this study was to investigate the predictive importance of the previously validated log(ER)*log(PgR)/Ki-67 predictive model in a larger patient population. METHODS Patients with hormone receptor positive/HER-2 negative and clinical node positive before chemotherapy were included. Log(ER)*log(PgR)/Ki-67 values of the patients were determined, and the ideal cutoff value was calculated using a receiver operating characteristic curve analysis. It was analyzed with a logistic regression model along with other clinical and pathological characteristics. RESULTS A total of 181 patients were included in the study. The ideal cutoff value for pathological response was 0.12 (area under the curve=0.585, p=0.032). In the univariate analysis, no statistical correlation was observed between luminal subtype (p=0.294), histological type (p=0.238), clinical t-stage (p=0.927), progesterone receptor level (p=0.261), Ki-67 cutoff value (p=0.425), and pathological complete response. There was a positive relationship between numerical increase in age and residual disease. As the grade of the patients increased, the probability of residual disease decreased. Patients with log(ER)*log(PgR)/Ki-67 above 0.12 had an approximately threefold increased risk of residual disease when compared to patients with 0.12 and below (odds ratio: 3.17, 95% confidence interval: 1.48-6.75, p=0.003). When age, grade, and logarithmic formula were assessed together, the logarithmic formula maintained its statistical significance (odds ratio: 2.47, 95% confidence interval: 1.07-5.69, p=0.034). CONCLUSION In hormone receptor-positive breast cancer patients receiving neoadjuvant chemotherapy, the logarithmic model has been shown in a larger patient population to be an inexpensive, easy, and rapidly applicable predictive marker that can be used to predict response.
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Affiliation(s)
- Erdoğan Selçuk Şeber
- Tekirdağ Namık Kemal University, Faculty of Medicine, Department of Medical Oncology - Tekirdag, Turkey
| | - Yakup İriagac
- Tekirdağ Namık Kemal University, Faculty of Medicine, Department of Medical Oncology - Tekirdag, Turkey
| | - Eyyup Çavdar
- Tekirdağ Namık Kemal University, Faculty of Medicine, Department of Medical Oncology - Tekirdag, Turkey
| | - Kubilay Karaboyun
- Tekirdağ Namık Kemal University, Faculty of Medicine, Department of Medical Oncology - Tekirdag, Turkey
| | - Okan Avcı
- Tekirdağ Namık Kemal University, Faculty of Medicine, Department of Medical Oncology - Tekirdag, Turkey
| | - Ahmet Yolcu
- Tekirdağ Namık Kemal University, Faculty of Medicine, Department of Radiation Oncology - Tekirdag, Turkey
| | - Sibel Özkan Gürdal
- Tekirdağ Namık Kemal University, Faculty of Medicine, Department of Surgical Oncology - Tekirdag, Turkey
| | - Meltem Öznur
- Tekirdağ Namık Kemal University, Faculty of Medicine, Department of Pathology - Tekirdag, Turkey
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Yetisyigit T, Seber S, Yolcu A. CRP/albumin ratio can be a predictor of response to neoadjuvant chemoradiotherapy (CRT) in rectal cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy151.300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Karabey MS, Yirmibeşoğlu Erkal E, Yolcu A, Bakkal BH, Ay Ö, Aksu MG, Sarper EB, Erkal HŞ. Radiation therapy for biliary tract tumors: the joint experience of three centers. Turk J Med Sci 2017; 47:412-416. [PMID: 28425273 DOI: 10.3906/sag-1511-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 07/07/2016] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND/AIM This study presents the joint experience of three centers in the treatment of patients with biliary tract tumors with radiation therapy (RT). MATERIALS AND METHODS The records of 27 patients were retrospectively reviewed. All of the patients who had undergone surgical resection received postoperative adjuvant RT, whereas all of the patients who had not undergone a surgical resection received RT with palliative intent. Twenty patients with adequate performance status were treated with RT and chemotherapy, while the remaining seven patients were treated with RT alone. RESULTS Follow-up ranged from 1 to 44 months. Local control was not achieved in 10 out of 11 patients who had received RT with palliative intent. Systemic failure was observed in eight patients at 5 to 16 months. Fifteen patients died due to disease-related causes at 1 to 22 months. At 2 years, overall survival was 33% and disease-free survival was 19%. A surgical resection with curative intent predicted improved local failure-free survival and improved disease-free survival. CONCLUSION Since local recurrence is still the leading cause of failure following postoperative RT and the outcome following palliative RT is far from satisfactory, the indications, the target volume, and the doses for RT should be reconsidered.
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Affiliation(s)
- Mehmet Sinan Karabey
- Department of Radiation Oncology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Eda Yirmibeşoğlu Erkal
- Department of Radiation Oncology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Ahmet Yolcu
- Department of Radiation Oncology, Faculty of Medicine, Selçuk University, Konya, Turkey
| | - Bekir Hakan Bakkal
- Department of Radiation Oncology, Faculty of Medicine, Bülent Ecevit University, Zonguldak, Turkey
| | - Özlem Ay
- Department of Radiation Oncology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Maksut Görkem Aksu
- Department of Radiation Oncology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Emine Binnaz Sarper
- Department of Radiation Oncology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Haldun Şükrü Erkal
- Department of Radiation Oncology, Faculty of Medicine, Sakarya University, Sakarya, Turkey
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