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Erdogan B, Ata N, Caglayan M, Gözükara MG, Gemcioglu E, Sokmen FC, Yilmaz N, Celik O, Ayvali MO, Ulgu MM, Birinci S. Association between hyponatremia, inflammation, and mortality in patients undergoing peritoneal dialysis: A nationwide observations. Ther Apher Dial 2024; 28:265-271. [PMID: 38093682 DOI: 10.1111/1744-9987.14092] [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] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 10/26/2023] [Accepted: 11/17/2023] [Indexed: 01/23/2024]
Abstract
INTRODUCTION Hyponatremia is the most common electrolyte disorder often present in peritoneal dialysis (PD) patients. The aim of this retrospective study was to investigate the effect of hyponatremia on mortality in patients undergoing PD. METHODS The health records of adult individuals with an inserted PD catheter identified via the centralized national e-health database were used. RESULTS The mean age of the 846 patients included in the study was 52.48 years (±14.6). The mean sodium level was 136.51 mEq/L. Sodium levels <137 mEq/L were associated with higher death risk independent of comorbidities. There was a 0.821 times less reduction in mortality for each mEq /L increase in serum sodium. CONCLUSION Our study provides evidence that monitoring and adjusting serum sodium levels is crucial in managing PD patients with hyponatremia, as low serum sodium level was found to be a significant and independent predictor of mortality.
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Affiliation(s)
- Bulent Erdogan
- Department of Nephrology, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Naim Ata
- Republic of Turkey Ministry of Health, Ankara, Turkey
| | - Murat Caglayan
- Department of Medical Biochemistry, Etlik City Hospital, Ankara, Turkey
| | - Melih Gaffar Gözükara
- Department of Public Health, Ankara Yıldırım Beyazıt University-Faculty of Medicine, Ankara, Turkey
| | - Emin Gemcioglu
- Department of Internal Medicine, Ankara Etlik City Hospital, Ankara, Turkey
| | - Fevzi Coskun Sokmen
- Department of Internal Medicine, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Nuray Yilmaz
- Department of Internal Medicine, Ankara City Hospital, Cankaya, Turkey
| | - Osman Celik
- Republic of Turkey Ministry of Health, Ankara, Turkey
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Hacioglu MB, Erdogan B, Bardakcı M, Algın E, Gulbagcı B, Hacibekiroglu I, Hamdard J, Olmez OF, Akkus H, Oksuzoglu B, Goksu SS, Dae SA, Sumbul AT, Ugraklı M, Karaagac M, Sahin E, Cabuk D, Ozer O, Yavuzsen T, Arıkan R, Köstek O, Atcı MM, Sakin A, Deligonul A, Bayır D, Dincer M, Unsal O, Yazıcı O, Zeynelgil E, Gulmez A, Harputluoglu H, Erol C, Sendur MAN, Aytekin A, Akagunduz B, Oner I, Er O, Oztosun B, Gumus M, Biricik FS, Aykan MB, Karadurmus N, Degerli E, Demirci NS, Turkmen E, Şakalar T, Secmeler S, Tanrıverdi O, Alkan A, Kemal Y, Cil I, Unal C, Iriagaç Y, Alan O, Balli S, Urun Y, Ozcan E, Turhal NS, Cicin I. Major and minor salivary gland cancers: A multicenter retrospective study. Head Neck 2023. [PMID: 37084179 DOI: 10.1002/hed.27376] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 03/15/2023] [Accepted: 04/10/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND Most of the studies on salivary gland cancers are limited for various reasons such as being single-center, small number of patients, including only major or minor SGCs, or only including epidemiological data. METHODS A total of 37 medical oncology clinics from different regions of Turkey participated in this retrospective-multicenter study. The analyzed data included clinical and demographical features, primary treatment, metastasis localizations, and treatments and includes certain pathologic features. RESULTS The study included data from a total of 443 SGCs. 56.7% was in major salivary glands and 43.3% was in minor salivary glands. Distant metastasis in the major SGCs was statistically significantly more common than in the minor SGCs, locoregional recurrence was statistically significantly more common in the minor SGCs than in the major SGCs (p = 0.003). CONCLUSIONS Epidemiological information, metastasis and recurrence patterns, treatment modalities, and survival analysis of the patients over 20 years of follow-up are presented.
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Affiliation(s)
| | - Bulent Erdogan
- Department of Medical Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey
| | - Murat Bardakcı
- Department of Medical Oncology, Ankara City Hospital, Ankara, Turkey
| | - Efnan Algın
- Department of Medical Oncology, Ankara City Hospital, Ankara, Turkey
| | - Burcu Gulbagcı
- Department of Medical Oncology, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | - Ilhan Hacibekiroglu
- Department of Medical Oncology, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | - Jamshid Hamdard
- Department of Medical Oncology, Faculty of Medicine, Medipol University, İstanbul, Turkey
| | - Omer Fatih Olmez
- Department of Medical Oncology, Faculty of Medicine, Medipol University, İstanbul, Turkey
| | - Hadi Akkus
- Department of Medical Oncology, Dr. Abdurrahman Yurtaslan Ankara Oncology Education and Research Hospital, Ankara, Turkey
| | - Berna Oksuzoglu
- Department of Medical Oncology, Dr. Abdurrahman Yurtaslan Ankara Oncology Education and Research Hospital, Ankara, Turkey
| | - Sema Sezgin Goksu
- Department of Medical Oncology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Shute Ailia Dae
- Department of Medical Oncology, Faculty of Adana Medicine, Baskent University, Adana, Turkey
| | - Ahmet Taner Sumbul
- Department of Medical Oncology, Faculty of Adana Medicine, Baskent University, Adana, Turkey
| | - Muzaffer Ugraklı
- Department of Medical Oncology, Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Mustafa Karaagac
- Department of Medical Oncology, Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Elif Sahin
- Department of Medical Oncology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Devrim Cabuk
- Department of Medical Oncology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Ozden Ozer
- Department of Medical Oncology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Tugba Yavuzsen
- Department of Medical Oncology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Rukiye Arıkan
- Department of Medical Oncology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Osman Köstek
- Department of Medical Oncology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Muhammed Mustafa Atcı
- Department of Medical Oncology, Prof. Dr. Cemil Tascıoglu City Hospital, Istanbul, Turkey
| | - Abdullah Sakin
- Department of Medical Oncology, Prof. Dr. Cemil Tascıoglu City Hospital, Istanbul, Turkey
| | - Adem Deligonul
- Department of Medical Oncology, Faculty of Medicine, Uludag University, Bursa, Turkey
| | - Duygu Bayır
- Department of Medical Oncology, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Murat Dincer
- Department of Medical Oncology, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Oktay Unsal
- Department of Medical Oncology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Ozan Yazıcı
- Department of Medical Oncology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Esra Zeynelgil
- Department of Medical Oncology, Diskapi Yıldırım Beyazıt Education and Research Hospital, Ankara, Turkey
| | - Ahmet Gulmez
- Department of Medical Oncology, Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Hakan Harputluoglu
- Department of Medical Oncology, Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Cihan Erol
- Department of Medical Oncology, Faculty of Medicine, Ankara Yıldırım Beyazit University, Ankara, Turkey
| | - Mehmet Ali Nahit Sendur
- Department of Medical Oncology, Faculty of Medicine, Ankara Yıldırım Beyazit University, Ankara, Turkey
| | - Aydin Aytekin
- Department of Medical Oncology, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Baran Akagunduz
- Department of Medical Oncology, Mengucek Gazi Education and Research Hospital, Erzincan Binali Yıldırım University, Erzincan, Turkey
| | - Irem Oner
- Department of Medical Oncology, Konya City Hospital, Konya, Turkey
| | - Ozlem Er
- Department of Medical Oncology, Maslak Hospital, Acıbadem MAA University, Istanbul, Turkey
| | - Bugra Oztosun
- Department of Medical Oncology, Goztepe Education and Research Hospital, Medeniyet University, Istanbul, Turkey
| | - Mahmut Gumus
- Department of Medical Oncology, Goztepe Education and Research Hospital, Medeniyet University, Istanbul, Turkey
| | | | - Musa Baris Aykan
- Department of Medical Oncology, Ankara Gulhane Education and Research Hospital, Ankara, Turkey
| | - Nuri Karadurmus
- Department of Medical Oncology, Ankara Gulhane Education and Research Hospital, Ankara, Turkey
| | - Ezgi Degerli
- Department of Medical Oncology, Faculty of Medicine, Cerrahpasa University, Istanbul, Turkey
| | - Nebi Serkan Demirci
- Department of Medical Oncology, Faculty of Medicine, Cerrahpasa University, Istanbul, Turkey
| | - Esma Turkmen
- Department of Medical Oncology, Derince Education and Research Hospital, Kocaeli, Turkey
| | - Teoman Şakalar
- Department of Medical Oncology, Kahramanmaras Necip Fazıl City Hospital, Kahramanmaras, Turkey
| | - Saban Secmeler
- Department of Medical Oncology, Sanlıurfa Mehmet Akif İnan Education and Research Hospital, Şanlıurfa, Turkey
| | - Ozgur Tanrıverdi
- Department of Medical Oncology, Faculty of Medicine, Mugla Sıtkı Kocman University, Mugla, Turkey
| | - Ali Alkan
- Department of Medical Oncology, Faculty of Medicine, Mugla Sıtkı Kocman University, Mugla, Turkey
| | - Yasemin Kemal
- Department of Medical Oncology, Faculty of Medicine, Altınbas University, Samsun, Turkey
| | - Ibrahim Cil
- Department of Medical Oncology, Istanbul Umraniye Education and Research Hospital, Istanbul, Turkey
| | - Caglar Unal
- Department of Medical Oncology, Gayrettepe Florence Nightingale Hospital, Istanbul Bilim University, Istanbul, Turkey
| | - Yakup Iriagaç
- Department of Medical Oncology, Faculty of Medicine, Tekirdag Namık Kemal University, Tekirdag, Turkey
| | - Ozkan Alan
- Department of Medical Oncology, Tekirdag City Hospital, Tekirdag, Turkey
| | - Sevinc Balli
- Department of Medical Oncology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Yuksel Urun
- Department of Medical Oncology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Erkan Ozcan
- Department of Medical Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey
| | | | - Irfan Cicin
- Department of Medical Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey
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Erdogan B, Ozcan E, Gokmen I, Gokyer A, Kucukarda A, Kostek O, Hacioglu MB, Uzunoglu S, Cicin I. Relationship between prognostic nutritional index and neutrophil lymphocyte ratio with overall survival in patients with metastatic colorectal cancer receiving regorafenib. J Cancer Res Ther 2023; 19:762-767. [PMID: 37470607 DOI: 10.4103/jcrt.jcrt_1620_21] [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] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Aim In this study, we aimed to analyze the effect of prognostic nutritional index and neutrophile lymphocyte ratio on the overall survival (OS) in patients treated with regorafenib. Materials and Methods Metastatic colorectal cancer (CRC) patients who treated with regorafenib between 2016 and 2020 in a single center were evaluated retrospectively. ROC analysis was used for neutrophile lymphocyte ratio (NLR's) and prognostic nutritional index (PNI's) optimum cut-off value. The relationship between OS with PNI and NLR was investigated. Results Fifty-two patient's data were analyzed. The median age was 57 years, 22 (41.5%) of the patients were female. The optimal cut-off value of PNI for OS was 45.7 according to ROC curve analysis. The median NLR value was accepted as 2.7. Median OS was 8.3 months. Patients who have high PNI value than 45.7 had longer OS (12.09 months vs. 6.31 months hazard ratio [HR]: 0.37 95% confidence interval [CI]: 0.19-0.73 P = 0.003) and there was a tendency for longer OS with low NLR value then median (12.05 months vs. 6.14 months HR: 0.54 95% CI: 0.29-1.23 P = 0.057). Primary tumor resected patients had longer OS than nonresected patients (12.05 months vs. 6.30 months HR: 0.34 95% CI: 0.17-0.66 P = 0.001). In multivariate analysis, high PNI value more than 45.7 (HR: 0.40 95% CI: 0.18-0.88 P = 0.02) and resection of the primary tumor (HR: 0.40 95% CI: 0.21-0.80 P = 0.01) were the only independent factors for longer OS. Conclusion Metastatic CRC patients with high pretreatment PNI and primary tumor resected are more likely to have longer OS with regorafenib. PNI is more reliable index than NLR to predict OS in metastatic CRC patients treated with regorafenib.
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Affiliation(s)
- Bulent Erdogan
- Department of Internal Medicine, Division of Medical Oncology, Trakya University School of Medicine, Edirne, Turkey
| | - Erkan Ozcan
- Department of Internal Medicine, Division of Medical Oncology, Trakya University School of Medicine, Edirne, Turkey
| | - Ivo Gokmen
- Department of Internal Medicine, Division of Medical Oncology, Trakya University School of Medicine, Edirne, Turkey
| | - Ali Gokyer
- Department of Internal Medicine, Division of Medical Oncology, Trakya University School of Medicine, Edirne, Turkey
| | - Ahmet Kucukarda
- Department of Internal Medicine, Division of Medical Oncology, Trakya University School of Medicine, Edirne, Turkey
| | - Osman Kostek
- Department of Internal Medicine, Division of Medical Oncology, Trakya University School of Medicine, Edirne, Turkey
| | - Muhammet Bekir Hacioglu
- Department of Internal Medicine, Division of Medical Oncology, Trakya University School of Medicine, Edirne, Turkey
| | - Sernaz Uzunoglu
- Department of Internal Medicine, Division of Medical Oncology, Trakya University School of Medicine, Edirne, Turkey
| | - Irfan Cicin
- Department of Internal Medicine, Division of Medical Oncology, Trakya University School of Medicine, Edirne, Turkey
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Durmaz D, Anbarcioglu B, Bulut M, Erdogan B, Celik E, Akoglu H. The Critical Role of Therapeutic Plasma Exchange in the Treatment of MPO-ANCA Associated Crescentic IgA Nephropathy. Iran J Kidney Dis 2022; 1:63-65. [PMID: 35271501] [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] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 08/25/2021] [Indexed: 06/14/2023]
Abstract
Crescentic IgA nephropathy (IgAN) with the positivity for antineutrophilic cytoplasmic antibody (ANCA) is a novel and uncommon entity. The optimal management of this condition is not well-defined. We report a 49-years-old woman with complaints of skin rash and swelling of lower limbs. She had hematuria, proteinuria and, progressive renal impairment with positive myeloperoxidase (MPO)-ANCA test. A renal biopsy revealed MPO-ANCA-associated crescentic IgAN. Induction therapy was intravenous methylprednisolone, cyclophosphamide and, therapeutic plasma exchange (TPE). An unexpected disease flare-up was observed during induction immunosuppressive therapy which regressed after long-term TPE. The patient experienced a full renal recovery after treatment with long-term TPE, cyclophosphamide, and corticosteroids. DOI: 10.52547/ijkd.6490.
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Affiliation(s)
| | | | | | | | | | - Hadim Akoglu
- Department of Nephrology, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey.
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Erdogan B, Kostek O, Bekir Hacioglu M, Gokyer A, Kucukarda A, Ozcan E, Gokmen I, Uzunoglu S, Cicin I. Is early change in systemic inflammatory markers associated with treatment response in patients who received pazopanib? J BUON 2021; 26:2196-2201. [PMID: 34761635] [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] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE To demonstrate whether early changes in systemic inflammatory markers are related with pazopanib treatment response in soft tissue sarcoma and renal cell carcinoma. METHODS Forty-one patients with metastatic clear cell renal carcinoma (mRCC) (n=22) and advanced stage soft tissue sarcoma (STS) (n=19) were assessed. Systemic inflammatory markers such as neutrophils, lymphocytes, c-reactive protein (CRP), mean platelet volume (MPV), lactate dehydrogenase (LDH) and neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) at both baseline and 1-month of pazopanib treatment were obtained and their relation with the first radiological response about 3-months later after pazopanib treatment was evaluated. RESULTS Disease control rate (DCR) at the first initial radiological evaluation was 58.5 % for all, it was 77.3% for the RCC group and 36.8% in the STS group. Serum neutrophil, NLR and CRP levels were significantly decreased from baseline in RCC patients who had DCR with pazopanib treatment. Also, serum CRP levels after pazopanib treatment was significantly lower in RCC patients who had DCR (+) rather than those who progressed. CONCLUSIONS Early decline in serum CRP, neutrophil and NLR levels in RCC patients who received pazopanib at the first month was significantly associated with disease control, assuming a predictive role for the first radiological assessment. However, there was no significant association between change in serum inflammatory marker levels and disease control in STS patients.
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Affiliation(s)
- Bulent Erdogan
- Trakya University, School of Medicine, Department of Medical Oncology, Edirne, Turkey
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Engin Ozekin M, Gokyer A, Kucukarda A, Kostek O, Issever K, Erdogan B. The association between post-progression survival and clinical characteristics of patients with metastatic colon cancer: A single center experience. J BUON 2021; 26:1887-1892. [PMID: 34761596] [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] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE In this study, we aimed to determine the factors which affect post-progression survival (PPS) and overall survival (OS) in patients with metastatic colorectal cancer. METHODS 87 patients with metastatic colorectal cancer had been followed up with palliative care due to disease progression or ECOG performance status after receiving at least two cycles of chemotherapy. PPS was estimated as the time between the last progression date and last control or death date in patients who were followed up with palliative care. RESULTS 87 patients with metastatic colorectal cancer were included in the study. Evaluation with multivariate analysis of factors affecting PPS revealed a significantly longer PPS (10.8 weeks) in patients with ECOG score 0 or 1 than the PPS of patients with ECOG score 2-5 (3 weeks) (p=0.01). It was also found that PPS was 14.4 weeks in patients with CEA levels <5ng/ml,while it was 6.7 weeks in patients with CEA levels ≥5 ng/ml (p=0.001) and PPS was 13.7 weeks in patients with controlled disease after first-line chemotherapy while it was 8 weeks in patients with progression (p=0.03); both were statistically significant. No significant association was found between PPS and age, gender, tumor location, sites of metastasis, and RAS status. CONCLUSION ECOG performance status score of 0-1, CEA levels below 5 ng/ml, and disease control with first-line chemotherapy are related to longer PPS in patients with metastatic colorectal cancer.
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Affiliation(s)
- Mehmet Engin Ozekin
- Trakya University School of Medicine, Department of Internal Medicine, Edirne, Turkey
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Topal A, Sayın S, Gokyer A, Kucukarda A, Kostek O, Bekir Hacıoglu M, Uzunoglu S, Erdogan B, Cicin I. Real-life data on first-line Sunitinib and Pazopanib therapy in metastatic renal cell carcinoma patients: a single center experience. J BUON 2021; 26:1628-1634. [PMID: 34565028] [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] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE In this study, we aimed to compare the data of sunitinib and pazopanib used in the first-line treatment of metastatic renal cell carcinoma (RCC) cases and to evaluate the effective factors in terms of survival. METHODS The records of 125 patients with metastatic RCC admitted between January 2005 and February 2018 were retrospectively analyzed and 63 patients who received pazopanib or sunitinib were included in the study while 62 patients were excluded due to insufficient data. Clinical and histological characteristics, treatment responses, progression-free survival (PFS), and overall survival (OS) of the patients were compared. RESULTS Patients with metastatic RCC who received pazopanib or sunitinib as tyrosine kinase inhibitors (TKI) in first-line treatment were analyzed; 45 (71.4%) were male while 18 (28.6%) were female, and the median age was 60. 43 (68.3%) patients were treated with sunitinib and 20 (31.7%) with pazopanib. PFS of pazopanib and sunitinib were 10.6 and 7.2 months, respectively. Median OS was 14.5 months in patients receiving pazopanib and 13.6 months in those receiving sunitinib. There was no statistical difference in PFS and OS between both treatments. The median OS of clear-cell RCC was 15.2 months, while of non-clear-cell RCC was 7.7months. CONCLUSIONS High ECOG score, non-clear-cell histology, presence of liver metastasis in metastatic RCC patients were found to be associated with shorter OS and PFS. Sunitinib and pazopanib produced similar OS and PFS rates in first-line treatment of metastatic RCC.
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Affiliation(s)
- Alper Topal
- Trakya University School of Medicine, Department of Internal Medicine, Edirne, Turkey
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Kucukarda A, Gokyer A, Gokmen I, Bekir Hacioglu M, Kostek O, Kurt N, Karabulut D, Tuncbilek N, Uzunoglu S, Erdogan B, Cicin I. Skeletal muscle loss during anti-epidermal growth factor receptor therapy is an independent prognostic factor on non-small cell lung cancer patients survival. J BUON 2021; 26:853-860. [PMID: 34268945] [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] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE We aimed to assess whether skeletal muscle loss during EGFR thyrosine kinase inhibitor therapy of advance non-small cell lung cancer patients is an independent prognostic factor for progression-free survival (PFS) and overal survival (OS). METHODS A total of 45 patients who had computed tomography images were retrospectively evaluated at the diagnosis and during the treatment period before progression occurs. RESULTS During treatment 19 patients (42.2%) had skeletal muscle loss. Objective response rates in muscle loss group and muscle stable group were 36.8% and 73.0%, respectively (p<0.01). Median follow-up time was 18.9 months (14.8-32.1). Median PFS was 14.7 months (95% CI 12.1-17.3) in muscle stable group and 7.6 months (95% CI 6.7-8.5) in muscle loss group (p<0.01). Median OS was 18.3 months (95% CI 16.5-20.2) in muscle loss group while it was 30.1 months (95% CI 22.1-38.2) in muscle stable group (p<0.01). In multivariate analysis for both PFS and OS, skeletal muscle loss was an independent prognostic factor. Hazard ratios (HR) for PFS and OS were 12.2 (95% CI 4.3-34.4) and 3.51 (95% CI 1.41-8.73) respectively. CONCLUSION On CT imaging skeletal muscle loss before progression is an independent prognostic factor for both PFS and OS in advance non-small cell lung cancer patients who received EGFR tyrosine kinase inhibitor therapy.
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Affiliation(s)
- Ahmet Kucukarda
- 1Division of Medical Oncology, Department of Internal Medicine, Trakya University School of Medicine, Edirne, Turkey
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Gokyer A, Kucukarda A, Kostek O, Sayin S, Can N, Hacıoglu B, Erdogan B, Uzunoglu S, Cicin I. The relation between tissue galectin-3 level and platinum resistance in neoadjuvant bladder cancer treatment. J BUON 2021; 26:1034-1039. [PMID: 34268970] [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] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE This study aimed to reveal the relationship between the level of galectin-3 expression and the depth of response to neoadjuvant therapy in bladder tumor tissue with muscle invasion revealed by transurethral biopsy. METHODS The percentage of galectin-3 staining in transurethral biopsy tissue with muscle invasion was determined by immunohistochemistry. The patients were divided into two groups: the down-staging (+) group consisting of patients with pathological complete response or non-invasive bladder cancer, and the down-staging (-) group consisting of patients with stage 2 and above. RESULTS There were 11 patients in the down-staging (+) group and 12 patients in the down-staging (-) group. There was no significant difference between the two groups in terms of median age, gender, smoking, clinical stage at the time of diagnosis, distribution of carboplatin or cisplatin used as a platinum agent. Galectin-3 was positive in 2 patients (18.2%) in the group where down-staging was achieved with neoadjuvant therapy, while it was positive in 9 patients (75%) in the other group (p = 0.01). The median follow-up period of the patients was 31.6 months (95% CI 25.1-39.3). Overall survival was 43.4 months in the down-staging (+) group (95% CI 25.1-61.6) and 31.6 months in the down-staging (-) group (95% CI 12.7-50.6). Although there was a numerical difference, it did not reach statistical significance (p=0.37). CONCLUSION The rate of down-staging after platinum-based neoadjuvant chemotherapy is significantly higher in patients with low galectin-3 staining in transurethral bladder biopsy tissue.
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Affiliation(s)
- Ali Gokyer
- Trakya University School of Medicine, Department of Internal Medicine, Division of Medical Oncology, Edirne, Turkey
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Affiliation(s)
- N. Özlem
- Departments of General Surgery, Dr. Muhittin Ülker Emergency Aid and Traumatology Hospital, Ankara, Turkey
| | - B. Erdogan
- Departments of General Surgery, Dr. Muhittin Ülker Emergency Aid and Traumatology Hospital, Ankara, Turkey
| | - S. Gültekin
- Departments of General Surgery, Dr. Muhittin Ülker Emergency Aid and Traumatology Hospital, Ankara, Turkey
| | - S. Dedeoglu
- Departments of Pathology, Dr. Muhittin Ülker Emergency Aid and Traumatology Hospital, Ankara, Turkey
| | - A. Aydin
- Departments of General Surgery, Dr. Muhittin Ülker Emergency Aid and Traumatology Hospital, Ankara, Turkey
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Bekir Hacioglu M, Kostek O, Karabulut S, Tastekin D, Sezgin Goksu S, Alandag C, Akagunduz B, Bilgetekin I, Caner B, Bilgehan Sahin A, Yildiz B, Kose F, Kaplan MA, Gulmez A, Dogan E, Can Guven D, Gurbuz M, Ergun Y, Karaagac M, Gokcen Demiray A, Turker S, Sakalar T, Ozkul O, Telli TA, Sahin S, Kilickap S, Bilici A, Erdogan B, Cicin I. Efficacy of regorafenib in the second-and third-line setting for patients with advanced hepatocellular carcinoma: A real life data of multicenter study from Turkey. J BUON 2020; 25:1897-1903. [PMID: 33099930 DOI: pmid/33099930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE After failure of the first-line sorafenib treatment in advanced or metastatic stage hepatocellular carcinoma (HCC), regorafenib is one of the newly-approved targeted agents. We aimed to evaluate the efficacy of regorafenib in patients with advanced HCC treated in the second- or third-line setting. METHODS In this retrospective and multicenter study, advanced HCC patients not eligible for local therapies, who received a second- or third-line regorafenib therapy after progression on the first-line sorafenib or sequential therapy with chemotherapy (CT) followed by sorafenib, were included. RESULTS In the first-line setting, 28 (28.9%) patients received CT and 69 (71.1%) patients received sorafenib. There were 24 (24.7%) patients who were intolerant to sorafenib. Disease control rate (DCR) was 53.6% for all patients treated with regorafenib, 62.3% in patients who received regorafenib in the second-line, and 32.1% for those receiving regorafenib in the third-line (p=0.007). Median progression-free survival (PFS) and overall survival (OS) were 5.6 (range; 4.3-6.9) and 8.8 (range, 6.3-11.3) months for all patients treated with regorafenib vs. 7.1 months and 10.3 months for patients who received regorafenib in the second-line vs. 5.1 and 8.7 months for patients who received regorafenib in the third-line, respectively; however, there was no statistically significant difference (pPFS=0.22 and pOS=0.85). CONCLUSION Although receiving CT as a first-line therapy in advanced HCC patients did not affect the survival rates of subsequent regorafenib therapy, it might diminish the DCR of regorafenib.
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Erdogan B, Is M, Aker FV, Emon ST, Engin T, Akar EA, Sayman E, Somay H. Preventative effect of diclofenac sodium and/or diltiazem in rats with epidural fibrosis. ACTA ACUST UNITED AC 2019; 120:813-818. [PMID: 31747760 DOI: 10.4149/bll_2019_135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Spinal epidural fibrosis is commonly seen after laminectomy. There is not yet proven any agent preventing fibrosis in clinical usage. We used diclofenac sodium and diltiazem, which are fibrosis inhibitors. METHODS AND MATERIALS 40 rats were divided into four groups of equal numbers: control, diclofenac sodium, diltiazem, and diclofenac sodium + diltiazem. Laminectomies were performed at L5 and L6. After a 4 week period, the rats were decapitated and the vertebral column blocks were removed for histopathologic examination. Fibrosis percentage, spread of fibrous regions, and fibroblast numbers were evaluated in each group and compared between the groups. RESULTS The distribution of epidural fibrosis density, percentage of fibrosis, and distribution of fibroblasts in the diclofenac sodium + diltiazem group were significantly lower than in the other groups. The fibroblast numbers of the diltiazem, and diclofenac sodium + diltiazem groups were significantly lower than in the other groups. CONCLUSION Diclofenac sodium + diltiazem used together provided better outcomes because each of them prevented fibrosis via different ways, probably through synergistic action (Tab. 5, Fig. 3, Ref. 43).
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Bekir Hacioglu M, Kostek O, Kurt N, Kucukarda A, Gokyer A, Ustabasioglu FE, Karatas F, Tuncbilek N, Uzunoglu S, Bilici A, Cicin I, Erdogan B. Comparison of skeletal muscle mass loss in patients with metastatic colorectal cancer treated with regorafenib or TAS-102. J BUON 2019; 24:2198-2204. [PMID: 31786894] [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] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
PURPOSE To assess whether regorafenib and TAS-102 treatments are associated with a change in Skeletal Muscle Area (SMA) as well as to compare Skeletal Muscle Mass (SMM) loss levels between regorafenib and TAS-102 treatments and prognostic significance in the patients with metastatic colorectal cancer (mCRC). METHODS A total of 36 mCRC patients, who received regorafenib or TAS-102 in the third-line and subsequent settings were assessed in the analysis. SMM changes were assessed with CT scans findings, and they were categorized into two groups as SMM-loss (SMM decrease ≥2%) and SMM-stable (SMM change <2%). RESULTS The SMM change after regorafenib therapy was significantly worse compared with TAS-102 therapy (p=0.001). The median overall survival (OS) was longer in SMM-stable group than in SMM-loss group (12.8 months; 95%CI:9.8-15.7) vs. 6.4 months; 95%CI:5.2-7.7, respectively;p=0.04). Cox regression analysis showed that SMM loss was independent prognostic indicator for OS (HR, 2.87; 95%CI: 1.07-7.42, p=0.03). CONCLUSION Although patients who received regorafenib had more SMM loss than those who received TAS-102, there was no difference in OS between drugs.
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Korucu FC, Senyigit E, Köstek O, Demircan NC, Erdogan B, Uzunoglu S, Cicin I. A retrospective study on potential drug interactions: A single center experience. Journal of Oncological Sciences 2018. [DOI: 10.1016/j.jons.2018.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Kostek O, Yilmaz E, Bekir Hacıoglu M, Erdogan B, Kodaz H, Turkmen Bekmez E, Hacibekiroglu I, Uzunoglu S, Tuncbilek N, Cicin I. Value of MRI apparent diffusion coefficient for assessment of response to sorafenib in hepatocellular carcinoma. J BUON 2018; 23:979-984. [PMID: 30358202] [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] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
PURPOSE Efficient and adequate evaluation of therapeutic response in hepatocellular carcinoma (HCC) is an evolving field. We aimed to evaluate apparent diffusion coefficient (ADC) values in the prediction of response to sorafenib and prognosis in patients with advanced HCC. METHODS Baseline magnetic resonance (MR) imaging was performed before treatment. After sorafenib started, clinical and radiological response were evaluated at approximately 3 months later. ADC measurements were performed by a 12- year experienced radiologist who evaluated MR before and after sorafenib therapy. RESULTS A total of 17 patients (median age 60 years, range 51-66 and M/F ratio=3.25/1) were analyzed. A significant increase in ADC levels in responders was observed 3 months after sorafenib therapy. Baseline and post-sorafenib ADC values were not significantly associated with mortality (hazard ratio/HR baseline ADC=1.003, p=0.98) and after sorafenib (HR 0.480, p=0.48, respectively). CONCLUSION Advanced HCC patients with a favorable response to sorafenib had a significant increase in ADC value at the first radiological evaluation. The predictive and prognostic role of ADC for overall survival is still unknown and further research is needed to investigate any possible association.
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Affiliation(s)
- Osman Kostek
- Trakya University, School of Medicine, Department of Medical Oncology, Edirne, Turkey
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Hacioglu BM, Kodaz H, Erdogan B, Cinkaya A, Tastekin E, Hacibekiroglu I, Turkmen E, Kostek O, Genc E, Uzunoglu S, Cicin I. K-RAS and N-RAS mutations in testicular germ cell tumors. Bosn J Basic Med Sci 2017; 17:159-163. [PMID: 28426398 DOI: 10.17305/bjbms.2017.1764] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 02/09/2017] [Accepted: 02/09/2017] [Indexed: 12/28/2022] Open
Abstract
Testicular cancer is a relatively rare tumor type, accounting for approximately 1% of all cancers in men. However, among men aged between 15 and 40 years, testicular cancer is the most commonly diagnosed malignancy. Testicular germ cell tumors (TGCTs) are classified as seminoma and non-seminoma. The RAS oncogene controls several cellular functions, including cell proliferation, apoptosis, migration, and differentiation. Thus, RAS signaling is important for normal germ cell development. Mutations of the Kirsten RAS (K-RAS) gene are present in over 20% of all cancers. RAS gene mutations have also been reported in TGCTs. We investigated K-RAS and N-RAS mutations in seminoma and non-seminoma TGCT patients. A total of 24 (55%) pure seminoma cases and 19 (45%) non-seminoma cases were included in the study. K-RAS and N-RAS analyses were performed in our molecular pathology laboratory, using K-RAS and N-RAS Pyro Kit 24 V1 (Qiagen). In total, a RAS mutation was present in 12 patients (27%): 7 seminoma (29%) and 5 non-seminoma cases (26%) [p = 0.55]. A K-RAS mutation was present in 4 pure seminoma tumors (16%) and 3 non-seminoma tumors (15%) [p = 0.63], and an N-RAS mutation was observed in 4 seminoma tumors (16%) and 3 non-seminoma tumors (15%) [p = 0.63]. Both, K-RAS and N-RAS mutations were present in two patients: one with seminoma tumor and the other with non-seminoma tumor. To date, no approved targeted therapy is available for the treatment of TGCTs. The analysis of K-RAS and N-RAS mutations in these tumors may provide more treatment options, especially in platinum-resistant tumors.
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Muhammet Hacioglu B, Kostek O, Erdogan B, Uzunoglu S, Cicin I. Targeted therapy with anaplastic lymphoma kinase inhibitors in non-small cell lung cancer even with brain metastasis. J BUON 2017; 22:586-591. [PMID: 28730760] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The incidence of brain metastases has increased as a result of improved systemic disease control and advances in imaging. Brain metastasis can occur approximately in 25-40% of the patients with non-small cell lung cancer (NSCLC) and it is a frequent cause of death. Stereotactic radiosurgery, whole-brain radiotherapy (WBRT) or surgical resection are the local treatment modalities for brain metastases which are feasible either alone, in combination, or as sequential treatments. Resistance to systemic therapy for brain metastasis poses significant clinical problems. In anaplastic lymphoma kinase (ALK)-positive NSCLC patients; ALK inhibitors may provide a new treatment option for brain metastasis and could improve overall survival (OS). Even in patients with crizotinib-resistant disease, second generation ALK inhibitors display prominent clinical activity. There is rapidly emerging preclinical and clinical data showing improvement in this issue. In this article we reviewed the latest literature data concerning the brain metastases and intracranial efficacy of ALK inhibitors in patients with ALK-positive NSCLC.
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Uzunoglu S, Erdogan B, Kodaz H, Cinkaya A, Turkmen E, Hacibekiroglu I, Sari A, Ozen A, Usta U, Cicin I. Unknown primary adenocarcinomas: a single-center experience. Bosn J Basic Med Sci 2016; 16:292-297. [PMID: 27455119 DOI: 10.17305/bjbms.2016.1495] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 07/13/2016] [Accepted: 07/13/2016] [Indexed: 12/12/2022] Open
Abstract
This study aimed to elucidate the clinical and prognostic characteristics of a homogeneous group of patients with cancer of unknown primary (CUP). Between 1999 and 2014, CUP was diagnosed in 159 (1.3%) of 11,742 cancer patients at Trakya University Hospital (Edirne, Turkey). Ninety-seven (61%) of the 159 patients were retrospectively reviewed. Among these, 61 (62.8%) patients with adenocarcinoma were included in this study. The most frequently predicted primary tumor site was the lung (37.7%), and 59% of the patients were smokers. There was a significant relationship between smoking and the lung as a potential primary cancer site (p = 0.042). The most frequent site of metastasis was the liver (60.7%). The median number of metastases per patient was two, but patients with liver metastases had a median of five metastases. The overall median survival time was 7 months. Median survival was significantly longer in patients with a predicted primary site than in patients without the predicted site (7 vs. 6 months, respectively; p = 0.038). When the patients with predicted ovarian and peritoneal tumors were excluded from the comparison, the statistical p value was still close to significant (p = 0.07). Multivariate analysis revealed that smoking, liver metastasis, serum alkaline phosphatase ≥92 U/L, and progression in response to chemotherapy were independent predictors of a poor prognosis. The present study identified several independent prognostic factors in patients with unknown primary adenocarcinomas who received chemotherapy. Smoking, the presence of liver metastasis, and response to chemotherapy were independent risk factors for both progression-free and overall survival.
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Affiliation(s)
- Sernaz Uzunoglu
- Department of Medical Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey.
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Erdogan B, Kodaz H, Karabulut S, Cinkaya A, Tozkir H, Tanriverdi O, Cabuk D, Hacioglu MB, Turkmen E, Hacibekiroglu I, Uzunoglu S, Cicin I. Impact of active smoking on survival of patients with metastatic lung adenocarcinoma harboring an epidermal growth factor receptor (EGFR) mutation. Bosn J Basic Med Sci 2016; 16:280-285. [PMID: 27371767 DOI: 10.17305/bjbms.2016.1380] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 06/15/2016] [Accepted: 06/16/2016] [Indexed: 11/16/2022] Open
Abstract
Lung cancer in smokers and non-smokers demonstrates distinct genetic profiles, and cigarette smoking affects epidermal growth factor receptor (EGFR) function and causes secondary EGFR tyrosine kinase resistance. We evaluated the effect of active smoking in patients with metastatic lung adenocarcinoma. A total of 132 metastatic lung adenocarcinoma patients, diagnosed between 2008 and 2013, with known EGFR mutation status, were evaluated retrospectively. Among these patients, 40 had an activating EGFR mutation. Patients who continued smoking during the treatment were defined as active smokers. Former smokers and never smokers were together defined as non-smokers. The outcomes of the treatment in relation to the EGFR mutation and smoking status were evaluated. The median follow-up time was 10.5 months. The overall response rate for the first-line therapy was significantly higher among the EGFR-mutant patients (p = 0.01), however, smoking status had no impact on the response rate (p = 0.1). The EGFR-mutant active smokers progressed earlier than the non-smokers (p < 0.01). The overall survival (OS) of the non-smokers and patients treated with erlotinib was significantly longer (p = 0.02 and p = 0.01, respectively). Smoking status did not affect the OS in EGFR wild type tumors (p = 0.49) but EGFR-mutant non-smokers had a longer OS than the active smokers (p = 0.01).The active smokers treated with erlotinib had poorer survival than the non-smokers (p = 0.03). Multivariate analysis of EGFR-mutant patients showed that erlotinib treatment at any line and non-smoking were independent prognostic factors for the OS (p = 0.04 and p = 0.01, respectively). Smoking during treatment is a negative prognostic factor in metastatic lung adenocarcinoma with an EGFR mutation.
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Affiliation(s)
- Bulent Erdogan
- Department of Medical Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey.
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Hacioglu BM, Kostek O, Erdogan B, Kodaz H, Hacibekiroglu I, Turkmen E, Uzunoglu S, Cicin I. Durable response with medroxiprogesterone acetate in metastatic renal cell carcinoma: Case report. Journal of Oncological Sciences 2016. [DOI: 10.1016/j.jons.2016.10.003] [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: 10/20/2022] Open
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Tural D, Karaca M, Hacioglu B, Bilgetekin I, Bilgin B, Kocoglu H, Ozet G, Erdogan B, Sendur MAN, Aytekin A, Benekli M, Ozet A. Receptor discordance after neoadjuvant chemotherapy and its impact on disease-free survival. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.e12518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Deniz Tural
- Akdeniz Univ Medical Scholl, Konyoulte, Turkey
| | | | - Bekir Hacioglu
- Diskapi Yildirim Beyazit Research Hospital, Ankara, Turkey
| | | | | | | | | | | | - Mehmet Ali Nahit Sendur
- Department of Medical Oncology, Yildirim Beyazit University Faculty of Medicine, Ankara, Turkey
| | - Aydin Aytekin
- Gazi University Faculty of Medicine, Medical Oncology Department, Ankara, Turkey
| | - Mustafa Benekli
- Department of Medical Oncology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Ahmet Ozet
- Department of Medical Oncology, Gazi University Faculty of Medicine, Ankara, Turkey
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Cemil B, Gokce EC, Kahveci R, Gokce A, Aksoy N, Sargon MF, Erdogan B, Kosem B. Aged Garlic Extract Attenuates Neuronal Injury in a Rat Model of Spinal Cord Ischemia/Reperfusion Injury. J Med Food 2016; 19:601-6. [PMID: 27183321 DOI: 10.1089/jmf.2016.0018] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Garlic has been used as a food as well as a component of traditional medicine. Aged garlic extract (AGE) is claimed to promote human health through antioxidant/anti-inflammatory activities with neuroprotective effects. We evaluated the possible beneficial effect of AGE neurologically, pathologically, ultrastructurally, and biochemically in a spinal cord ischemia-reperfusion (I/R) model of rats. Twenty-four Sprague-Dawley rats were divided into three groups: sham (no I/R), I/R, and AGE (I/R+AGE); each group consisted of eight animals. Animals were evaluated neurologically with the Basso, Beattie, and Bresnahan (BBB) scoring system. The spinal cord tissue samples were harvested for pathological and ultrastructural examinations. Oxidative products (Malondialdehyde, nitric oxide), antioxidant enzymes (superoxide dismutase, catalase, glutathione peroxidase), inflammatory cytokines (tissue tumor necrosis factor alpha, interleukin-1), and caspase-3 activity were analyzed. The AGE group had significantly higher BBB scores than the I/R group. Pathologically, AGE group revealed reduced degree of ischemia and spinal cord edema. Ultrastructural results also showed preservation of tissue structure in the AGE group. Oxidative product levels of the I/R group were significantly higher than both the other groups, and antioxidant enzyme levels of AGE group were significantly higher than the I/R group. There was also significant difference between the sham and AGE groups in terms of total antioxidant enzyme levels. Furthermore, AGE treatment significantly reduced the inflammatory cytokines and caspase-3 activity than the I/R group. This study demonstrates the considerable neuroprotective effect of AGE on the neurological, pathological, ultrastructural, and biochemical status of rats with I/R-induced spinal cord injury.
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Affiliation(s)
- Berker Cemil
- 1 Department of Neurosurgery, Turgut Ozal University Faculty of Medicine , Emek, Ankara, Turkey
| | - Emre Cemal Gokce
- 1 Department of Neurosurgery, Turgut Ozal University Faculty of Medicine , Emek, Ankara, Turkey
| | - Ramazan Kahveci
- 2 Department of Neurosurgery, Ministry of Health Kirikkale Yuksek Ihtisas State Hospital , Kirikkale, Turkey
| | - Aysun Gokce
- 3 Department of Pathology, Ministry of Health, Diskapi Yildirim Beyazit Education and Research Hospital , Ankara, Turkey
| | - Nurkan Aksoy
- 4 Department of Biochemistry, Faculty of Medicine, Kirikkale University , Kirikkale, Turkey
| | - Mustafa Fevzi Sargon
- 5 Department of Anatomy, Hacettepe University Faculty of Medicine , Ankara, Turkey
| | - Bulent Erdogan
- 1 Department of Neurosurgery, Turgut Ozal University Faculty of Medicine , Emek, Ankara, Turkey
| | - Bahadir Kosem
- 6 Department of Anesthesiology, Turgut Ozal University Faculty of Medicine , Emek, Ankara, Turkey
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Kodaz H, Bekir Hacioglu M, Elpen Kodaz C, Cinkaya A, Erdogan B, Cicin I. Endometrial carcinoma and paraneoplastic immune thrombocytopenia. Journal of Oncological Science 2016. [DOI: 10.1016/j.jons.2016.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Turkmen E, Erdogan B, Kodaz H, Hacibekiroglu I, Onal Y, Uzunoglu S, Kilic N, Cicin I. Post progression survival analysis of metastatic gastric and gastroesophageal junction cancer patients after second-line treatment. Acta Gastroenterol Belg 2016; 79:211-215. [PMID: 27382940] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
PURPOSE The aim of this study was to define the factors that -affect response and post-progression survival of metastatic gastric cancer (MGC) and gastroesophageal junction cancer (GEJ) -patients treated with second-line chemotherapy. METHODS We retrospectively reviewed the data of 59 patients with MGC or GEJ adenocarcinoma who received second-line treatment. RESULTS The median age was 54 years old (26-77). Response to second-line treatment was strongly associated with disease control with first-line treatment (p < 0.01). Median progression-free survival (PFS), overall survival (OS) and post-progression survival (PPS) were 3.2 (95% CI : 2.63-3.80), 6.5 (95% CI : 3.78-9.35) and 2.7 months (95% CI : 1.89-3.68), respectively. PFS (r = 0.55, p < 0.01) and PPS (r = 0.89, p < 0.01) were correlated with OS. Response to second-line treatment was independently related to PFS (HR : 0.12 95%CI : 0.53-0.26, p < 0.001). Having an ECOG 0 performance status (HR : 0.42 ; 95%CI : 0.21-0.86, p = 0.02) and response to second-line therapy (HR : 0.47 ; 95%CI : 0.25-0.85, p = 0.01) were independently associated with OS. CONCLUSION PPS and PFS were correlated with OS after second-line treatment of MGC. Response to second-line treatment prolonged OS by increasing PFS, and having an ECOG 0 PS prolonged OS by increasing PPS.
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Affiliation(s)
- Esma Turkmen
- Department of Medical Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey
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Ozcelik M, Guclu C, Bermede O, Baytas V, Altay N, Karahan MA, Erdogan B, Can O. The administration sequence of propofol and remifentanil does not affect the ED50 and ED95 of rocuronium in rapid sequence induction of anesthesia: a double-blind randomized controlled trial. Eur Rev Med Pharmacol Sci 2016; 20:1479-1489. [PMID: 27160118] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE The topic of drug administration sequence in rapid sequence induction (RSI) is still an object of interest in terms of rocuronium effectiveness. The aim of this prospective, randomized trial was to evaluate the effect of administration sequence of propofol and remifentanil on ED50 and ED95 of rocuronium in a RSI model. PATIENTS AND METHODS Eighty-four patients were randomized into Group Remifentanil (Group R, n = 43), where induction of general anesthesia started with remifentanil (2 µg/kg) and followed by propofol (2 mg/kg) and rocuronium administrations; and Group Propofol (Group P, n = 41), where induction of general anesthesia started with propofol and followed by remifentanil and rocuronium. First patients in each group were paralyzed by 0.8 mg/kg rocuronium. In case of acceptable intubation as evaluated according to the criteria described by Viby-Mogensen et al, rocuronium dose was decreased by 0.1 mg/kg for the next patient; otherwise, rocuronium dose was increased by 0.1 mg/kg. After three crossover points, increments or decrements in rocuronium dosage were set to 0.05 mg/kg. The process was repeated until a total of ten crossover points were obtained. RESULTS The ED50 and ED95 doses of rocuronium were similar in Group R (0.182 mg/kg, and 0.244 mg/kg, respectively) and Group P (0.121 mg/kg, and 0.243 mg/kg, respectively) according to 95% CI of the estimates. There was no statistically significant difference in terms of clinically acceptable intubation conditions between the two groups (56.1% in Group R vs. 59% in Group P, p = 0.795). CONCLUSIONS The choice of administration sequence of propofol and remifentanil does not have an impact on estimated ED50 and ED95 of rocuronium in providing acceptable intubation conditions in the RSI technique.
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Affiliation(s)
- M Ozcelik
- Department of Anesthesiology and Intensive Care Medicine, Ankara University Faculty of Medicine, Ankara, Turkey.
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Gokce EC, Kahveci R, Gokce A, Sargon MF, Kisa U, Aksoy N, Cemil B, Erdogan B. Curcumin Attenuates Inflammation, Oxidative Stress, and Ultrastructural Damage Induced by Spinal Cord Ischemia-Reperfusion Injury in Rats. J Stroke Cerebrovasc Dis 2016; 25:1196-1207. [PMID: 26935117 DOI: 10.1016/j.jstrokecerebrovasdis.2016.01.008] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Revised: 10/25/2015] [Accepted: 01/02/2016] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVES Curcumin is a molecule found in turmeric root that possesses anti-inflammatory and antioxidant properties and has been widely used to treat neurodegenerative diseases. We investigated whether curcumin stimulates the neurorepair process and improves locomotor function in a rat model of spinal cord ischemia-reperfusion injury. METHODS Thirty-two Wistar albino rats (190-220 g) were randomly allocated into 4 groups of 8 rats each: 1 sham-operated group and 3 ischemia-reperfusion injury groups that received intraperitoneal injections of saline vehicle, methylprednisolone (MP, 30 mg/kg following induction of ischemia-reperfusion [IR] injury), or curcumin (200 mg/kg for 7 days before induction of IR injury). Spinal cord IR injury was induced by occlusion of the abdominal aorta for 30 minutes. After 24 hours of reperfusion, locomotor function was assessed using the Basso, Beattie, and Bresnahan scale. All animals were sacrificed. Spinal cord tissues were harvested to evaluate histopathological and ultrastructural alterations and to analyze levels of malondialdehyde, tumor necrosis factor-alpha, interleukin-1 beta, nitric oxide, and caspase-3, as well as enzyme activities of superoxide dismutase and glutathione peroxidase. RESULTS Intraperitoneal administration of curcumin significantly reduced inflammatory cytokine expression, attenuated oxidative stress and lipid peroxidation, prevented apoptosis, and increased antioxidant defense mechanism activity in comparison to treatment with MP or saline. Histopathological and ultrastructural abnormalities were significantly reduced in curcumin-treated rats compared to the MP- and saline-treated groups. Furthermore, curcumin significantly improved locomotor function. CONCLUSIONS Curcumin treatment preserves neuronal viability against inflammation, oxidative stress, and apoptosis associated with ischemia-reperfusion injury.
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Affiliation(s)
- Emre Cemal Gokce
- Department of Neurosurgery, Turgut Ozal University Faculty of Medicine, Ankara, Turkey.
| | - Ramazan Kahveci
- Department of Neurosurgery, Ministry of Health Kirikkale Yuksek Ihtisas State Hospital, Kirikkale, Turkey
| | - Aysun Gokce
- Department of Pathology, Ministry of Health, Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey
| | | | - Ucler Kisa
- Department of Biochemistry, Kirikkale University Faculty of Medicine, Kirikkale, Turkey
| | - Nurkan Aksoy
- Department of Biochemistry, Kirikkale University Faculty of Medicine, Kirikkale, Turkey
| | - Berker Cemil
- Department of Neurosurgery, Turgut Ozal University Faculty of Medicine, Ankara, Turkey
| | - Bulent Erdogan
- Department of Neurosurgery, Turgut Ozal University Faculty of Medicine, Ankara, Turkey
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Hacibekiroglu I, Kodaz H, Erdogan B, Turkmen E, Esenkaya A, Uzunoglu S, Cicin I. Comparative analysis of the efficacy and safety of oxaliplatin plus 5-fluorouracil/leucovorin (modified FOLFOX6) with advanced gastric cancer patients having a good or poor performance status. Asian Pac J Cancer Prev 2016; 16:2355-9. [PMID: 25824764 DOI: 10.7314/apjcp.2015.16.6.2355] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Combination chemotherapy of 5 fluorouracil (5-FU) and leucovorin (LV) with oxaliplatin, mainly FOLFOX regimens, has shown considerable antitumor activity and a tolerable toxicity profile in gastric cancer. The goal of this study was to retrospectively compare the efficacy and toxicity of modified FOLFOX-6 (mFOLFOX6) regimen in advanced gastric cancer (AGC) patients with good and poor performance status (PS). MATERIALS AND METHODS AGC patients receiving the mFOLFOX6 regimen including oxaliplatin 85 mg/m2, bolus of 5-FU 400 mg/m2 and LV 400 mg/m2 on the first day, followed by 2400mg/m2 of 5- FU as a continious infusion over 46 hour for first-line treatment were eligible for the study. RESULTS A total 58 patients with a median age of 59.5 (32-81) were included. The median follow up of the study was 9.2 months. Thirty patients (51.7%) with an ECOG PS 0-1 were assigned to the good PS arm, while 28 patients (48.3%) with ECOG PS 2 were in the poor PS arm. Overall response rates were 36.6 and 28.8%, respectively (p=0.91). Median PFS was 6.7 and 6.3 months in good PS and poor PS arms (p=0.50) and median OS was 9.6 and 10.4 months (p=0.55). As compared with good PS arm, poor PS arm was associated with more grade 3-4 neutropenia and anemia. Dose reduction and dose delays were also significantly higher. CONCLUSIONS In this study, mFOLFOX6 was similarly effective in both arms. Although hematologic toxicity was significantly higher in patients with poor PS, it remained manageable. Our results suggest that this regimen may be an effective treatment option for AGC patients with poor PS.
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Affiliation(s)
- Ilhan Hacibekiroglu
- Department of Medical Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey E-mail :
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Kazanci B, Ozdogan S, Kahveci R, Gokce EC, Yigitkanli K, Gokce A, Erdogan B. Neuroprotective effects of pregabalin against spinal cord ischemia-reperfusion injury in rats. Turk Neurosurg 2016; 27:952-961. [DOI: 10.5137/1019-5149.jtn.17959-16.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Gokce EC, Kahveci R, Atanur OM, Gürer B, Aksoy N, Gokce A, Sargon MF, Cemil B, Erdogan B, Kahveci O. Neuroprotective effects of Ganoderma lucidum polysaccharides against traumatic spinal cord injury in rats. Injury 2015; 46:2146-55. [PMID: 26298021 DOI: 10.1016/j.injury.2015.08.017] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 07/29/2015] [Accepted: 08/05/2015] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Ganoderma lucidum (G. lucidum) is a mushroom belonging to the polyporaceae family of Basidiomycota and has widely been used as a traditional medicine for thousands of years. G. lucidum has never been studied in traumatic spinal cord injury. The aim of this study is to investigate whether G. lucidum polysaccharides (GLPS) can protect the spinal cord after experimental spinal cord injury. MATERIALS AND METHODS Rats were randomized into five groups of eight animals each: control, sham, trauma, GLPS, and methylprednisolone. In the control group, no surgical intervention was performed. In the sham group, only a laminectomy was performed. In all the other groups, the spinal cord trauma model was created by the occlusion of the spinal cord with an aneurysm clip. In the spinal cord tissue, caspase-3 activity, tumour necrosis factor-alpha levels, myeloperoxidase activity, malondialdehyde levels, nitric oxide levels, and superoxide dismutase levels were analysed. Histopathological and ultrastructural evaluations were also performed. Neurological evaluation was performed using the Basso, Beattie, and Bresnahan locomotor scale and the inclined-plane test. RESULTS After traumatic spinal cord injury, increases in caspase-3 activity, tumour necrosis factor-alpha levels, myeloperoxidase activity, malondialdehyde levels, and nitric oxide levels were detected. After the administration of GLPS, decreases were observed in tissue caspase-3 activity, tumour necrosis factor-alpha levels, myeloperoxidase activity, malondialdehyde levels, and nitric oxide levels. Furthermore, GLPS treatment showed improved results in histopathological scores, ultrastructural scores, and functional tests. CONCLUSIONS Biochemical, histopathological, and ultrastructural analyses and functional tests reveal that GLPS exhibits meaningful neuroprotective effects against spinal cord injury.
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Affiliation(s)
- Emre Cemal Gokce
- Department of Neurosurgery, Turgut Ozal University, Emek, Ankara, Turkey
| | - Ramazan Kahveci
- Department of Neurosurgery, Ministry of Health, Kirikkale Yuksek Ihtisas State Hospital, Kirikkale, Turkey
| | - Osman Malik Atanur
- International Centre for Hydrogen Energy Technologies (UNIDO-ICHET), Cevizlibag, Zeytinburnu 34015, Istanbul, Turkey
| | - Bora Gürer
- Department of Neurosurgery, Ministry of Health, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey.
| | - Nurkan Aksoy
- Department of Biochemistry, Kirikkale University, Kirikkale, Turkey
| | - Aysun Gokce
- Department of Pathology, Ministry of Health, Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey
| | | | - Berker Cemil
- Department of Neurosurgery, Turgut Ozal University, Emek, Ankara, Turkey
| | - Bulent Erdogan
- Department of Neurosurgery, Turgut Ozal University, Emek, Ankara, Turkey
| | - Ozan Kahveci
- Department of Emergency Medicine, Bulent Ecevit University, Zonguldak, Turkey
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Kali A, Yayar O, Erdogan B, Eser B, Buyukbakkal M, Ercan Z, Merhametsiz O, Haspulat A, Gök Oğuz E, Canbakan B, Ayli MD. Is hepcidin-25 a predictor of atherosclerosis in hemodialysis patients? Hemodial Int 2015; 20:191-7. [PMID: 26374145 DOI: 10.1111/hdi.12355] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Atherosclerotic cardiovascular disease is an important cause of mortality and morbidity in hemodialysis patients. Iron accumulation in arterial wall macrophages is increased in atherosclerotic lesions. Hepcidin is a key hepatic hormone regulating iron balance. It inhibits iron release from macrophages and iron absorption from enterocytes by binding and inactivating the cellular iron exporter ferroportin. The aim of this study is to investigate the relation of hepcidin-25, iron parameters, and atherosclerosis measured by carotid intima media thickness (CIMT) in hemodialysis patients. Eighty-two hemodialysis patients were enrolled in this cross-sectional study. Predialysis blood samples were centrifuged at 1500 g and 4°C for 10 minutes and stored at -80°C for the measurement of hepcidin-25. DRG hepcidin enzyme-linked immunosorbent assay kit was used for the measurement of hepcidin-25. Ultrasonographical B-mode imaging of bilateral carotid arteries was performed with a high-resolution real-time ultrasonography (Mindray DC7). Mean age of the study population was 57.90 ± 16.08 years and 43.9% were men. Total study population was grouped into two according to median value of hepcidin-25. There was no difference between groups with respect to age, dialysis vintage, and C-reactive protein. CIMT was found to be statistically significantly higher in low hepcidin-25 group. In correlation analysis, CIMT was found to be correlated with age (P < 0.01, R = 0.33) and hepcidin-25 (P < 0.01, R = 0.46). In linear regression analysis, age (β = 0.31) and hepcidin-25 (β = 0.44) were found to be the determinants of CIMT in hemodialysis patients. Our results implicate that hepcidin may take part in pathophysiology of atherosclerosis and cardiovascular disease in hemodialysis patients.
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Affiliation(s)
- Alaaddin Kali
- Department of Nephrology, Diskapi Yildirim Beyazid Research and Training Hospital, Ankara, Turkey
| | - Ozlem Yayar
- Department of Nephrology, Diskapi Yildirim Beyazid Research and Training Hospital, Ankara, Turkey
| | - Bulent Erdogan
- Department of Nephrology, Diskapi Yildirim Beyazid Research and Training Hospital, Ankara, Turkey
| | - Baris Eser
- Department of Nephrology, Diskapi Yildirim Beyazid Research and Training Hospital, Ankara, Turkey
| | - Mehmet Buyukbakkal
- Department of Nephrology, Diskapi Yildirim Beyazid Research and Training Hospital, Ankara, Turkey
| | - Zafer Ercan
- Department of Nephrology, Diskapi Yildirim Beyazid Research and Training Hospital, Ankara, Turkey
| | - Ozgur Merhametsiz
- Department of Nephrology, Diskapi Yildirim Beyazid Research and Training Hospital, Ankara, Turkey
| | - Ayhan Haspulat
- Department of Nephrology, Diskapi Yildirim Beyazid Research and Training Hospital, Ankara, Turkey
| | - Ebru Gök Oğuz
- Department of Nephrology, Diskapi Yildirim Beyazid Research and Training Hospital, Ankara, Turkey
| | - Basol Canbakan
- Department of Nephrology, Diskapi Yildirim Beyazid Research and Training Hospital, Ankara, Turkey
| | - Mehmet D Ayli
- Department of Nephrology, Diskapi Yildirim Beyazid Research and Training Hospital, Ankara, Turkey
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Eser B, Yayar O, Buyukbakkal M, Erdogan B, Ercan Z, Merhametsiz O, haspulat A, Oğuz EG, Dogan İ, Canbakan B, Ayli MD. Fibroblast growth factor is associated to left ventricular mass index, anemia and low values of transferrin saturation. Nefrologia 2015; 35:465-72. [DOI: 10.1016/j.nefro.2015.06.025] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 06/16/2015] [Accepted: 06/17/2015] [Indexed: 01/09/2023] Open
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Hacibekiroglu I, Kodaz H, Erdogan B, Turkmen E, Esenkaya A, Onal Y, Uzunoglu S, Cicin I. Comparative analysis of the efficacy and safety of modified FOLFOX-6 and DCF regimens as first-line treatment in advanced gastric cancer. Mol Clin Oncol 2015; 3:1160-1164. [PMID: 26623070 DOI: 10.3892/mco.2015.592] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 06/09/2015] [Indexed: 12/16/2022] Open
Abstract
The aim of this study was to retrospectively compare the efficacy and toxicity of the oxaliplatin + 5-fluorouracil (5-FU) + leucovorin (LV) regimen [modified (m)FOLFOX-6] with that of the docetaxel + cisplatin + 5-FU regimen (DCF) in patients with advanced gastric cancer (AGC). A total of 72 patients received DCF (75 mg/m2 docetaxel and 75 mg/m2 cisplatin on day 1 and 750 mg/m2 5-FU on days 1-5) every 21 days, whereas 54 patients received mFOLFOX-6 (85 mg/m2 oxaliplatin and 400 mg/m2 LV as a 2-h infusion, followed by a 5-FU bolus of 400 mg/m2 and 2,400 mg/m2 5-FU as a 46-h continuous infusion) every 14 days. In the DCF arm, 55 (76.4%) of the patients received prophylactic granulocyte colony-stimulating factor (G-CSF), 48-72 h following completion of chemotherapy. The median follow-up of the study was 12.1 months. The overall response rate (ORR) was 37.0% for mFOLFOX-6 and 40.3% for DCF (P=0.72). The median time to progression was 6.5 and 6.2 months in the mFOLFOX-6 and DCF arms, respectively (P=0.70). The median overall survival was 11.4 and 13.5 months in the mFOLFOX-6 and DCF arms, respectively (P=0.72). The rates of hematological toxicity did not differ between the two arms. However, in the subgroup analysis, grade 3-4 neutropenia and febrile neutropenia were significantly more common among patients who had not received G-CSF prophylaxis in the DCF arm. The incidence of grade 3-4 nausea/vomiting and diarrhea were significantly higher in the DCF arm. In conclusion, the present study demonstrated that the efficacy of the mFOLFOX-6 regimen was comparable to that of the DCF regimen in AGC patients. In addition, the benefit of G-CSF prophylaxis in conjunction with the DCF regimen was demonstrated.
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Affiliation(s)
- Ilhan Hacibekiroglu
- Department of Medical Oncology, Faculty of Medicine, Trakya University, 22030 Edirne, Turkey
| | - Hilmi Kodaz
- Department of Medical Oncology, Faculty of Medicine, Trakya University, 22030 Edirne, Turkey
| | - Bulent Erdogan
- Department of Medical Oncology, Faculty of Medicine, Trakya University, 22030 Edirne, Turkey
| | - Esma Turkmen
- Department of Medical Oncology, Faculty of Medicine, Trakya University, 22030 Edirne, Turkey
| | - Asim Esenkaya
- Department of Radiology, Faculty of Medicine, Trakya University, 22030 Edirne, Turkey
| | - Yilmaz Onal
- Department of Internal Medicine, Faculty of Medicine, Trakya University, 22030 Edirne, Turkey
| | - Sernaz Uzunoglu
- Department of Medical Oncology, Faculty of Medicine, Trakya University, 22030 Edirne, Turkey
| | - Irfan Cicin
- Department of Medical Oncology, Faculty of Medicine, Trakya University, 22030 Edirne, Turkey
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Kodaz H, Erdogan B, Hacibekiroglu I, Turkmen E, Tozkir H, Albayrak D, Uzunoglu S, Cicin I. Primary Tumor Resection Offers Higher Survival Advantage in KRAS Mutant Metastatic Colorectal Cancer Patients. Hepatogastroenterology 2015; 62:876-879. [PMID: 26902020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND/AIMS Colorectal cancer is the fourth most common cancer diagnosed in the United States, and the third most common cause of death from cancer. Approximately 20% of the patients with colorectal cancer have distant metastasis during diagnosis. Primary tumor resection is controversial in unresectable metastatic colorectal cancer (CRC). We studied the survival effect of primary tumor resection in unresectable metastatic CRC according to kirsten ras (KRAS) mutation status. METHODOLOGY Seventy eight CRC cases with unresectable metastasis were included in the study. The KRAS status was known in all patients. 34 patients had undergone primary tumor resection before 1st chemotherapy. RESULTS ThE median time from primary tumor resection to first chemotherapy was 6 (3-17) weeks. The survival was better in the unresectable metastatic colon patients with resected primary tumor, but it was statistically non-significant (P = 0.07). The median OS was similar (P = 0.91) in the KRAS wild patients with or without primary tumor resection. The median OS was 28 months in KRAS mutant patients with primary tumor resection, 14 months in KRAS mutant patients without primary tumor resection (P = 0.002). CONCLUSION Primary tumor resection offers survival advantage in KRAS mutant patients, but randomized prospective studies are required.
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Yayar O, Eser B, Buyukbakkal M, Erdogan B, Ercan Z, Merhametsiz O, Haspulat A, Kali A, Yildirim T, Canbakan B, Ayli MD. Do elevated plasma S100A12 levels predict atherosclerosis in peritoneal dialysis patients? Ren Fail 2015; 37:845-50. [PMID: 26016405 DOI: 10.3109/0886022x.2015.1033633] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AIM Atherosclerotic cardiovascular disease is one of the major causes of mortality and morbidity in peritoneal dialysis (PD) patients. S100A12 is an endogenous receptor ligand of advanced glycation end-products. It was shown to contribute to the development of atherosclerosis in animal models. The aim of this study was to evaluate the relationship between S100A12 levels and carotid atherosclerosis in PD patients. METHODS A cross-sectional study was performed in 56 PD patients and 20 control subjects. Plasma S100A12 levels were measured from all participants beside routine laboratory evaluation. All subjects underwent high-resolution B-mode ultrasonography to determine carotid intima media thickness (CIMT). S100A12 levels were compared between patient and control groups. Correlation analyses of S100A12 with other laboratory values and CIMT were also performed. RESULTS Plasma S100A12 levels were higher in PD patients compared with control subjects (129.5 ± 167.2 ng/mL vs. 48.5 ± 30.3 ng/mL, respectively, p < 0.001). In the patient group, CIMT was found to be positively correlated with age (r = 0.354; p = 0.007), CRP level (r = 0.269; p = 0.045), and S100A12 (r = 0.293; p = 0.028) level while it was found to be negatively correlated with hemoglobin concentration (r = -0.264; p = 0.049). In the linear regression analysis, the model, including CRP, S100A12, age, and Hgb, was found to be significant (F: 4.177, p: 0.005). When the parameters are analyzed age and S100A12 were found to be independent determinants of CIMT (β = 0.308, p = 0.018 and β = 0.248, p = 0.049, respectively). CONCLUSIONS This study suggests that an elevated plasma S100A12 level was closely associated with atherosclerosis. With aging elevated plasma S100A12 may show a powerful proatherogenic potential in patients undergoing PD.
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Affiliation(s)
- Ozlem Yayar
- a Nephrology Department , Diskapi Yildirim Beyazid Research and Training Hospital , Ankara , Turkey
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Abstract
AIM Astrocytes and extracellular matrix molecules have important roles in regulating synaptic functions between neurons in the central nervous system. However, under pathological conditions, these constituents are activated to form glial scar that is thought to be harmful for neuronal regeneration. The aim of this study was to evaluate the expression pattern of ADAMTS1, -4, -5 and -9 in IL-1 stimulated astrocyte cultures obtained from postnatal day zero mouse brains. MATERIAL AND METHODS Real time PCR analyses were performed. RESULTS An overexpression of ADAMTS1, -4, -5 and -9 at the 3-h time point after IL-1 stimulation was found. IL-1 stimulation induced aggrecaneses and this effect was time dependent. Maximum increase was detected at 3-h (six fold increase). Interestingly the expression of ADAMTS1 and -4 appeared to be at the highest expression level but the ADAMTS5 and ADAMTS9 expression level was much weaker (three times and two times respectively). CONCLUSION To the best of our knowledge, this is the first report demonstrating induction of ADAMTS in IL-1 induced astrocytes. Aggrecanases may play a role in tissue destruction in the progression of central nervous system (CNS) injury and they are differentially expressed in mouse CNS, suggesting a critical role in the pathogenesis of CNS injury. This can be a very crucial aetiologic factor for some neuropsychiatric disorders.
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Affiliation(s)
- Osman Abali
- Istanbul Univetsity, School of Medicine, Department of Child and Adolescent Psychiatry, Istanbul, Turkey
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Hacibekiroglu I, Kodaz H, Erdogan B, Turkmen E, Ozcelik M, Esenkaya A, Saygi HM, Uzunoglu S, Cicin I. Erratum to: Single-agent bevacizumab is an effective treatment in recurrent glioblastoma. Med Oncol 2015; 32:119. [DOI: 10.1007/s12032-015-0482-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Erdogan B, Cicin I. Denosumab - a Monoclonal Antibody, not a Radionuclide. Asian Pac J Cancer Prev 2015; 16:2103. [DOI: 10.7314/apjcp.2015.16.5.2103] [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: 11/10/2022] Open
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Hacibekiroglu I, Kodaz H, Erdogan B, Turkmen E, Ozcelik M, Esenkaya A, Saygi HM, Uzunoglu S, Cicin I. Single-agent bevacizumab is an effective treatment in recurrent glioblastoma. Med Oncol 2015; 32:460. [PMID: 25572814 DOI: 10.1007/s12032-014-0460-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 12/15/2014] [Indexed: 12/14/2022]
Abstract
The aim of this study was to evaluate the efficiency and safety of single-agent bevacizumab therapy for recurrent glioblastoma multiforme (GBM). We identified patients with histologically confirmed glioblastoma and World Health Organization Grade III glioma who were previously treated with temozolomide plus radiotherapy and received 10 mg/kg bevacizumab intravenous infusion every 2 weeks until disease progression for recurrent disease. A total 24 patients included to this study. Twenty-two patients had GBM, and two patients had WHO grade III glioma. No complete response was observed, five patients (20.8 %) had partial response, nine patients (37.5 %) had stable diseases, and ten patients (41.7 %) had progressive diseases. The overall response rate was 20.8 %. The 6-month PFS rate (PFS6) and median PFS were determined as 37.5 % and 4.1 months, respectively. Median OS was 6.4 months. Performance status of 17 (70.8 %) patients was improved following bevacizumab regimen. Univariate analysis showed that improvement in performance status (IPS) following bevacizumab therapy was a significant predictor of both PFS (p < 0.001) and OS (p < 0.020). Bevacizumab-related adverse effects were observed in 13 (54.1 %) patients. Grade 3-4 toxicity was observed in 4 (16.6 %) patients. Therapy interruptions were experienced in two patients due to adverse effects. Single-agent bevacizumab is an effective and safe treatment alternative in recurrent GBM. IPS following bevacizumab therapy was a significant predictor of both PFS and OS.
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Affiliation(s)
- Ilhan Hacibekiroglu
- Department of Medical Oncology, Faculty of Medicine, Trakya University, 22030, Edirne, Turkey,
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Berk V, Kaplan MA, Tonyali O, Buyukberber S, Balakan O, Ozkan M, Demirci U, Ozturk T, Bilici A, Tastekin D, Ozdemir N, Unal OU, Oflazoglu U, Turkmen E, Erdogan B, Uyeturk U, Oksuzoglu B, Cinkir HY, Yasar N, Gumus M. Efficiency and side effects of sorafenib therapy for advanced hepatocellular carcinoma: a retrospective study by the anatolian society of medical oncology. Asian Pac J Cancer Prev 2015; 14:7367-9. [PMID: 24460304 DOI: 10.7314/apjcp.2013.14.12.7367] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Inoperable and metastatic hepatocellular carcinoma (HCC) is associated with a poor prognosis and low chemotherapeutic efficiency. Sorafenib is an oral multi-kinase inhibitor exerting its effects via the RAF/ MEK/ERK pathway, vascular endothelial growth factor receptor (VEGFR) and platelet derived growth factor receptor beta (PDGFR-β) tyrosine kinases. Randomized studies have shown a significant contribution of sorafenib to life expectancy and quality of life of cancer patients. The aim of the present study is to evaluate the efficacy and side effects of sorafenib therapy in Turkey. MATERIALS AND METHODS Data for 103 patients (82 males, 21 females) receiving sorafenib therapy in 13 centers from February 2008 to December 2012 were evaluated. Median age was 61 years and median ECOG performance status was 1 (range: 0-2). 60 patients (58%) had hepatitis B, 15 patients (15%) had hepatitis C infection and 12 patients (12%) had a history of alcohol consumption. All of the patients had Child scores meeting the utilization permit of the drug in our country (Child A). RESULTS A total of 571 cycles of sorafenib therapy were administered with a median of four per patient. Among the evaluable cases, there was partial response in 15 (15%), stable disease in 52 (50%), and progressive disease in 36 (35%). Median progression-free survival was 18 weeks and median overall survival was 48 weeks. The dose was reduced only in 6 patients and discontinued in 2 patients due to grade 3-4 toxicity, 18 patients (17%) suffering hand-foot syndrome, 7 (7%) diarrhea, and 2 (2%) vomiting. CONCLUSIONS This retrospective study demonstrated better efficacy of sorafenib therapy in patients with advanced HCC compared to the literature while progression-free survival and overall survival findings were comparable. The side effect rates indicate that the drug was tolerated well. In conclusion, among the available treatment options, sorafenib is an efficient and tolerable agent in patients with inoperable or metastatic HCC.
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Affiliation(s)
- Veli Berk
- Department of Medical Oncology, Erciyes University Faculty of Medicine, Turkey E-mail :
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Kodaz H, Erdogan B, Hacibekiroglu I, Turkmen E, Gurkan H, Albayrak D, Tastekin E, Uzunoglu S, Cicin I. Impact of bevacizumab on survival outcomes in primary tumor resected metastatic colorectal cancer. Med Oncol 2014; 32:441. [PMID: 25502088 DOI: 10.1007/s12032-014-0441-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Accepted: 12/05/2014] [Indexed: 12/16/2022]
Abstract
We have studied the efficacy of bevacizumab in colorectal cancer with unresectable metastasis patients who had undergone resection of primary tumor. The patients with unresectable metastasis during diagnosis who had undergone resection of primary tumor without chemotherapy and the patients without resection of primary tumor were included. Among patients who had met the inclusion criteria, 46 patients with resection of primary tumor and 47 without resection of primary tumor were included in the study. A total of 93 unresectable metastatic colorectal cancer patients were included in the study. Median PFS was 9 months (95 % CI 7.37-10.62) in patients with resected primary tumor and bevacizumab containing first-line chemotherapy combination. Median PFS was 10 months (95 % CI 8.06-11.93) in patients without bevacizumab (P = 0.66) Median OS was 25 months (95 % CI 17.92-32.07) in patients with resected primary tumor and bevacizumab containing first-line chemotherapy combination. Median OS was 16 months (95 % CI 9.71-22.28) in patients without bevacizumab (P = 0.36) Median OS was 16 months (95 % CI 13.06-8.939) in patients without resected primary tumor and bevacizumab containing first-line chemotherapy combination. Median OS was 9 months (95 % CI 1.48-16.51) in patients without bevacizumab (P = 0.012). Bevacizumab seems ineffective in mCRC patients with resected primary tumor. An increase in number of retrospective literature data and randomized, prospective studies is required about this subject.
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Affiliation(s)
- Hilmi Kodaz
- Department of Medical Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey,
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Abstract
Breast cancer bone metastasis causing severe morbidity is commonly encountered in daily clinical practice. It causes pain, pathologic fractures, spinal cord and other nerve compression syndromes and life threatening hypercalcemia. Breast cancer metastasizes to bone through complicated steps in which numerous molecules play roles. Metastatic cells disrupt normal bone turnover and create a vicious cycle to which treatment efforts should be directed. Bisphosphonates have been used safely for more than two decades. As a group they delay time to first skeletal related event and reduce pain, but do not prevent development of bone metastasis in patients with no bone metastasis, and also do not prolong survival. The receptor activator for nuclear factor κB ligand inhibitor denosumab delays time to first skeletal related event and reduces the skeletal morbidity rate. Radionuclides are another treatment option for bone pain. New targeted therapies and radionuclides are still under investigation. In this review we will focus on mechanisms of bone metastasis and its medical treatment in breast cancer patients.
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Affiliation(s)
- Bulent Erdogan
- Departments of Medical Oncology, Agri State Hospital, Turkey E-mail :
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Kodaz H, Hacibekiroglu I, Erdogan B, Turkmen E, Tozkir H, Albayrak D, Uzunoglu S, Cicin I. Association between specific KRAS mutations and the clinicopathological characteristics of colorectal tumors. Mol Clin Oncol 2014; 3:179-184. [PMID: 25469291 DOI: 10.3892/mco.2014.448] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Accepted: 10/10/2014] [Indexed: 12/14/2022] Open
Abstract
The aim of this study was to investigate the clinicopathological characteristics and distribution by tumor localization of KRAS point mutations in metastatic colorectal cancer. A total of 189 patients diagnosed with colorectal cancer between 2007 and 2014, who were either metastatic at the time of diagnosis or developed metastasis subsequently, were included in this study. KRAS mutation analysis was performed in the primary tumor tissues and KRAS mutations were identified in 47.6% of the patients. There was a high frequency of the p.G13D point mutation in left-colon tumors (P=0.011), while the p.G12D point mutation was more frequent in right-colon tumors (P=0.004). KRAS wild-type frequency (P=0.02) was higher among patients aged <40 years. A comparison of codon 12 and 13 mutations revealed that codon 12 mutations were more common in the >50-year-old group (P=0.03) and codon 13 mutations were more common in the <70-year-old group (P=0.04). KRAS wild-type tumors were localized in the right colon (P=0.005) and tumors with the p.G13D point mutation (P=0.018) were diagnosed at non-metastatic stages. In conclusion, KRAS point mutations in colorectal cancer exhibited a heterogeneous distribution in terms of tumor localization. In addition, the p.G13D point mutation was found to differ from other mutations in several aspects.
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Affiliation(s)
- Hilmi Kodaz
- Departments of Medical Oncology, Faculty of Medicine, Trakya University, Edirne 22030, Turkey
| | - Ilhan Hacibekiroglu
- Departments of Medical Oncology, Faculty of Medicine, Trakya University, Edirne 22030, Turkey
| | - Bulent Erdogan
- Departments of Medical Oncology, Faculty of Medicine, Trakya University, Edirne 22030, Turkey
| | - Esma Turkmen
- Departments of Medical Oncology, Faculty of Medicine, Trakya University, Edirne 22030, Turkey
| | - Hilmi Tozkir
- Departments of Medical Genetics and Faculty of Medicine, Trakya University, Edirne 22030, Turkey
| | - Dogan Albayrak
- Departments of Medical Surgery, Faculty of Medicine, Trakya University, Edirne 22030, Turkey
| | - Sernaz Uzunoglu
- Departments of Medical Oncology, Faculty of Medicine, Trakya University, Edirne 22030, Turkey
| | - Irfan Cicin
- Departments of Medical Oncology, Faculty of Medicine, Trakya University, Edirne 22030, Turkey
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Wheeler DC, Abdalla S, Chertow G, Parfrey P, Herzog C, Mikolasevic I, Racki S, Lukenda V, Milic S, Devcic B, Orlic L, Suttorp MM, Hoekstra T, Ocak G, Van Diepen ATN, Ott I, Mittelman M, Rabelink TJ, Krediet RT, Dekker FW, Simone S, Dell'Oglio MPS, Ciccone M, Corciulo R, Castellano G, Balestra C, Grandaliano G, Gesualdo L, Pertosa G, Nishida M, Ando M, Karasawa K, Iwamoto Y, Tsuchiya K, Nitta K, Krzanowski M, Janda K, Gajda M, Dumnicka P, Fedak D, Lis G, Ja kowski P, Litwin JA, Su owicz W, Freitas GR, Silva VB, Abensur H, Luders C, Pereira BJ, Castro MC, Oliverira RB, Moyses RM, Elias RM, Silva BC, Tekce H, Ozturk S, Aktas G, Kin Tekce B, Erdem A, Ozyasar M, Taslamacioglu Duman T, Yazici M, Kirkpantur A, Balci MM, Turkvatan A, Afsar B, Alkis M, Mandiroglu F, Voroneanu L, Siriopol D, Nistor I, Apetrii M, Hogas S, Onofriescu M, Covic A, An WS, Kim SE, Son YK, Oh YJ, Gelev S, Toshev S, Trajceska L, Selim G, Dzekova P, Shikole A, Park J, Lee JS, Shin ES, Ann SH, Kim SJ, Chung HC, Janda K, Krzanowski M, Gajda M, Dumnicka P, Fedak D, Lis G, Litwin JA, Sulowicz W, Elewa U, Bichari W, Abo-Seif K, Seferi S, Rroji M, Likaj E, Spahia N, Barbullushi M, Thereska N, Kopecky CM, Genser B, Maerz W, Wanner C, Saemann MD, Weichhart T, Sezer S, Gurlek Demirci B, Tutal E, Bal Z, Erkmen Uyar M, Ozdemir Acar FN, Macunluoglu B, Atakan A, Ari Bakir E, Georgianos P, Sarafidis PA, Stamatiadis DN, Liakopoulos V, Zebekakis PE, Papagianni A, Lasaridis AN, Eftimovska - Otovic N, Babalj-Banskolieva E, Kostadinska-Bogdanoska S, Grozdanovski R, Aono M, Sato Y, El Amrani M, Asserraji M, Benyahia M, Lee YK, Choi SR, Cho A, Kim JK, Choi MJ, Kim SJ, Yoon JW, Koo JR, Kim HJ, Noh JW, Inagaki H, Yokota N, Sato Y, Chiyotanda S, Fukami K, Fujimoto S, Kendi Celebi Z, Kutlay S, Sengul S, Nergizoglu G, Erturk S, Ates K, Vishnevskii KA, Rumyantsev AS, Zemchenkov AY, Smirnov AV, Reinhardt B, Knaup R, Esteve Simo V, Carneiro Oliveira J, Moreno Guzman F, Fulquet Nicolas M, Pou Potau M, Saurina Sole A, Duarte Gallego V, Ramirez De Arellano Serna M, Turkmen K, Demirtas L, Akbas EM, Bakirci EM, Buyuklu M, Timuroglu A, Georgianos PI, Sarafidis PA, Karpetas A, Liakopoulos V, Stamatiadis DN, Papagianni A, Lasaridis AN, Taira T, Nohtomi K, Takemura T, Chiba T, Hirano T, Chang CT, Huang CC, Chen CJ, El Amrani M, Mohamed A, Benyahia M, Kanai H, Tamura Y, Kaizu Y, Kali A, Yayar O, Erdogan B, Eser B, Ercan Z, Buyukbakkal M, Merhametsiz O, Haspulat A, Yildirim T, Bozkurt B, Ayli MD, Bal Z, Erkmen Uyar M, Gokustun D, Gurlek Demirci B, Tutal E, Sezer S, Markaki A, Grammatikopoulou M, Fragkiadakis G, Stylianou K, Venyhaki M, Chatzi V, Selim G, Stojceva-Taneva O, Tozija L, Dzekova-Vidimliski P, Trajceska L, Gelev S, Petronievic Z, Sikole A, Moyseyenko V, Nykula T, Fernandes RT, Barreto DV, Rodrigues GGC, Misael A, Branco-Martins CT, Barreto FC, Yayar O, Ercan Z, Eser B, Merhametsiz O, Haspulat A, Buyukbakkal M, Erdogan B, Yildirim T, Bozkurt B, Ayli MD. DIALYSIS CARDIOVASCULAR COMPLICATIONS 1. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu155] [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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Erdogan B, Turkmen E, Uzunoglu S, Tanriverdi O, Cicin I. Performance status is an important prognostic factor in second line treatment of pancreaticobiliary adenocarcinoma. Hepatogastroenterology 2014; 60:1479-83. [PMID: 23933941 DOI: 10.5754/hge13269] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND/AIMS To define the factors related with disease control and survival in patients with pancreaticobiliary adenocarcinoma treated with second-line therapy. METHODOLOGY We retropectively reviewed the data of 39 pancreaticobiliary adenocarcinoma patients treated with second-line chemotherapy between 2000 and 2012. Age, gender, origin of tumor, location of tumor, stage at diagnosis, Eastern Cooperative Oncology Group (ECOG) performance status, progression site, progression free survival (PFS) for first-line therapy, disease control at first-line therapy and chemotherapy protocols are analyzed for disease control rate, PFS and overall survival (OS). RESULTS Disease control was recorded in 21 (53.8%) patients (20 stable disease, 1 partial response). Disease control rate was higher in patients with good performance status (p=0.03). Disease control at first-line therapy was not a predictor of disease control at second-line (p=0.6). Response to first-line therapy and other prognostic factors was not related with disease control. Progression free survival and OS was significantly longer in patients with good ECOG performance status (0-1) (p=0.01, p=0.006). Choice of chemotherapy (single agent or combination) and other factors did not have any impact on PFS and OS. In multivariate analysis; disease control was independent prognostic factor for both PFS and OS (p<0.001), (p<0.001). CONCLUSIONS Disease control and performance status are two important prognostic factors. Chemotherapy regimen has no impact on disease control and survival. Salvage chemotherapy can be considered for patients with good performance status whether they are resistant to first-line therapy or not.
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Gokce EC, Cemil B, Kirbas I, Bozkurt A, Erdogan B. A rare case of intracerebral hemorrhage due to arteriovenous malformation located at petrous portion of the temporal bone. Turk Neurosurg 2013; 23:811-4. [PMID: 24310469 DOI: 10.5137/1019-5149.jtn.6163-12.2] [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] [Indexed: 10/27/2022]
Abstract
Primary intraosseous arteriovenous malformations (AVM) are not infrequently encountered. We report a case of intraosseous arteriovenous malformation arising in the left temporal bone. A 51-year-old male patient presented with loss of conscious. Computerized tomography displayed hematoma measuring 4 cm in diameter in the left temporal lobe. Digital subtraction angiography (DSA) showed that a temporal bone AVM supplied by all the branches of the external carotid artery and vertebral artery. Many treatment modalities can be considered for preoperative steps and/or for definitive treatment. We preferred embolisation for this vascular pathology. To the best of our knowledge this represents the first case of an intraosseous arteriovenous malformation located in the temporal bone.
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Affiliation(s)
- Emre Cemal Gokce
- Turgut Ozal University, Faculty of Medicine, Department of Neurosurgery, Ankara, Turkey
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Cicin I, Erdogan B, Gulsen E, Uzunoglu S, Sut N, Turkmen E, Kodaz H, Ustundag S. Incidence of contrast-induced nephropathy in hospitalised patients with cancer. Eur Radiol 2013; 24:184-90. [PMID: 24220752 DOI: 10.1007/s00330-013-2996-6] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Revised: 07/26/2013] [Accepted: 07/30/2013] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To determine the frequency of and possible factors related to contrast-induced nephropathy (CIN) in hospitalised patients with cancer. METHODS Ninety adult patients were enrolled. Patients with risk factors for acute renal failure were excluded. Blood samples were examined the day before contrast-enhanced computed tomography (CT) and serially for 3 days thereafter. CIN was defined as an increase in serum creatinine (Cr) of 0.5 mg/dl or more, or elevation of Cr to 25 % over baseline. Relationships between CIN and possible risk factors were investigated. RESULTS CIN was detected in 18/90 (20 %) patients. CIN developed in 25.5 % patients who underwent chemotherapy and in 11 % patients who did not (P = 0.1). CIN more frequently developed in patients who had undergone CT within 45 days after the last chemotherapy (P = 0.005); it was also an independent risk factor (P = 0.017). CIN was significantly more after treatment with bevacizumab/irinotecan (P = 0.021) and in patients with hypertension (P = 0.044). CONCLUSIONS The incidence of CIN after CT in hospitalised oncological patients was 20 %. CIN developed 4.5-times more frequently in patients with cancer who had undergone recent chemotherapy. Hypertension and the combination of bevacizumab/irinotecan may be additional risk factors for CIN development. KEY POINTS • Contrast-induced nephropathy (CIN) is a concern for oncological patients undergoing CT. • CIN occurs more often when CT is performed <45 days after chemotherapy. • Hypertension and treatment with bevacizumab appear to be additional risk factors.
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Affiliation(s)
- Irfan Cicin
- Department of Medical Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey
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Cekinmez M, Sen O, Atalay B, Erdogan B, Bavbek M, Caner H, Ozen O, Altinors N. Effects of methyl prednisolone acetate, fibrin glue and combination of methyl prednisolone acetate and fibrin glue in prevention of epidural fibrosis in a rat model. Neurol Res 2013; 32:700-5. [DOI: 10.1179/016164110x12556180206239] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Cekinmez M, Erdogan B, Tufan K, Sarica FB, Ozen O, Caner H. Is topical tissue plasminogen activator application effective on prevention of post-laminectomy epidural fibrosis? An experimental study. Neurol Res 2013; 31:322-6. [DOI: 10.1179/174313208x332940] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Erdogan B, Aslan E, Bagis T, Gokcel A, Erkanli S, Bavbek M, Altinors N. Intima-media thickness of the carotid arteries is related to serum osteoprotegerin levels in healthy postmenopausal women. Neurol Res 2013; 26:658-61. [PMID: 15327755 DOI: 10.1179/016164104225014157] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Osteoprotegerin (OPG) regulates bone mass by inhibiting osteoclast differentiation and activation, and also plays a role in vascular calcification. The objective of this study was to evaluate the relationship between serum OPG levels, and carotid artery intima-media thickness (IMT) and carotid plaque formation in healthy postmenopausal women. We recruited 68 healthy postmenopausal women for the study. Carotid plaque presence and IMT were evaluated by high resolution B-mode ultrasound. IMT was positively correlated with presence of plaque, age, menopause age and OPG, and inversely correlated with Apolipoprotein A1 (Apo A1). Serum OPG level was positively correlated with IMT (r = 0.366; p < 0.003) and age (r = 0.324; p < 0.008), and negatively correlated with Apo A1 (r = -0.481; p < 0.0001). We did not observe any significant relation between plaque occurrence and levels of serum OPG. In regression analysis OPG (p < 0.02) and menopause age (p < 0.05) were independent risk factors for IMT, and age (p < 0.05) and IMT (p < 0.05) were independent risk factors for plaque formation. Although the role of OPG in the vascular biology is poorly understood, our results suggest that elevated levels of serum OPG is associated with IMT and may play a role in the pathogenesis of atherosclerotic disease.
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Affiliation(s)
- Bulent Erdogan
- Department of Neurosurgery, Baskent University School of Medicine, Adana, Turkey.
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Abstract
Lipoblastic, lipomatous or lipidized meningioma is an unusual extra-axial benign tumor. It shows benign clinical features and has a good prognosis after surgical excision. We present a 54-year-old woman with intracranial lipidized meningioma in the right temporal fossa, discuss the importance of the differential diagnosis among similar tumors and discuss the term 'Lipidized meningioma' in the light of the literature.
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Affiliation(s)
- F Bolat
- Department of Pathology, Baskent University Faculty of Medicine, Adana Teaching and Medical Research Center, Adana, Turkey.
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