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Urakçı Z, Ebinç S, Oruc Z, Kalkan Z, Kaplan MA, Küçüköner M, Işıkdoğan A. Causes of liver test abnormalities in newly diagnosed cancer patients and the investigation of etiological factors. Postgrad Med 2024; 136:162-168. [PMID: 38331573 DOI: 10.1080/00325481.2024.2316571] [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: 04/17/2023] [Accepted: 01/31/2024] [Indexed: 02/10/2024]
Abstract
OBJECTIVES In this study, we aimed to investigate the causes of liver test abnormalities in newly diagnosed patients naive to anti-tumoral therapy. METHOD This study included a total of 490 patients with ALT levels > 5X ULN on liver function tests at the initial presentation to our clinic. Data from 247 (50.4%) patients diagnosed with cancer (cohort A) and 243 (49.6%) patients without cancer (cohort B) were compared with regard to the etiology of liver test abnormalities and the risk factors. RESULTS The most common etiological factor in cohort A was presence of liver metastasis (31.2%, n = 77). In the comparison of the two groups with regard to etiological factors; the rates of liver metastasis [31.2% vs 0%, (p < 0.001)], drug-induced liver toxicity [30/4% vs 19.8%, (p = 0.007)], pancreaticobiliary pathology [21.5% vs 14%, (p = 0.03)] and chronic viral hepatitis [14.2% vs 7.4%, (p = 0.02)] were higher in the cohort A. The rate of NAFLD was higher in the cohort B [6.9% vs 42.2% (p < 0.001). CONCLUSION In our study, the most common cause of liver test abnormalities was the presence of liver metastasis in cohort A and NAFLD in cohort B.
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Affiliation(s)
- Zuhat Urakçı
- Faculty of Medicine, Department of Medical Oncology, Dicle University, Diyarbakır, Turkey
| | - Senar Ebinç
- Faculty of Medicine, Department of Medical Oncology, Dicle University, Diyarbakır, Turkey
| | - Zeynep Oruc
- Faculty of Medicine, Department of Medical Oncology, Dicle University, Diyarbakır, Turkey
| | - Ziya Kalkan
- Faculty of Medicine, Department of Medical Oncology, Dicle University, Diyarbakır, Turkey
| | - Muhammet Ali Kaplan
- Faculty of Medicine, Department of Medical Oncology, Dicle University, Diyarbakır, Turkey
| | - Mehmet Küçüköner
- Faculty of Medicine, Department of Medical Oncology, Dicle University, Diyarbakır, Turkey
| | - Abdurrahman Işıkdoğan
- Faculty of Medicine, Department of Medical Oncology, Dicle University, Diyarbakır, Turkey
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2
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Güzel Y, Kömek H, Can C, Kaplan İ, Kepenek F, Ebinç S, Büyükdeniz MP, Gündoğan C, Oruç Z. Comparison of the role of 18 F-fluorodeoxyglucose PET/computed tomography and 68 Ga-labeled FAP inhibitor-04 PET/CT in patients with malignant mesothelioma. Nucl Med Commun 2023; 44:631-639. [PMID: 37114422 DOI: 10.1097/mnm.0000000000001702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
OBJECTIVE In this study, we aimed to compare the role of 68 Ga-labeled FAP inhibitor ( 68 Ga-FAPI)-04 PET/computed tomography (CT) and 18 F-fluorodeoxyglucose ( 18 F-FDG) PET/CT in the evaluation of primary tumor and metastases in patients diagnosed with malignant mesothelioma. MATERIALS AND METHODS Our prospective study included 21 patients with histopathological diagnosis of malignant mesothelioma who underwent both 68 Ga-FAPI-04 PET/CT and 18 F-FDG PET/CT imaging between April 2022 and September 2022. Maximum standardized uptake value (SUVmax), metabolic tumor volume, total lesion glycolysis, tumor-to-background ratio (TBR) and highest SUVpeak (HPeak) values and lesion numbers were calculated from primary and metastatic lesions on FDG and FAPI PET/CT images. Findings obtained from FAPI and FDG PET/CT were compared. RESULTS More lesions were detected in 68 Ga-FAPI-04 PET/CT compared to 18 F-FDG PET/CT in primary tumor and lymph node metastases. Statistically significantly higher SUVmax and TBR values were found with FAPI PET/CT (primary lesion SUVmax and TBR, P = 0.001 and P < 0.001, respectively; lymph node SUVmax and TBR, P = 0.016 and P = 0.005, respectively). With FAPI PET/CT, upstage was observed according to tumor-node-metastasis staging in a total of seven patients including three patients with pleural origin, three patients with peritoneal origin and one patient with pericardial origin. CONCLUSION In addition to the stage change with 68 Ga-FAPI-04 PET/CT in malignant mesothelioma patients, a statistically significant superiority was observed in SUVmax, TBR and volumetric parameters in primary tumors and metastases.
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Affiliation(s)
- Yunus Güzel
- Department of Nuclear Medicine, Saglik Bilimleri University Diyarbakir Gazi Yasargil Training and Research Hospital
| | - Halil Kömek
- Department of Nuclear Medicine, Saglik Bilimleri University Diyarbakir Gazi Yasargil Training and Research Hospital
| | - Canan Can
- Department of Nuclear Medicine, Saglik Bilimleri University Diyarbakir Gazi Yasargil Training and Research Hospital
| | - İhsan Kaplan
- Department of Nuclear Medicine, Saglik Bilimleri University Diyarbakir Gazi Yasargil Training and Research Hospital
| | - Ferat Kepenek
- Department of Nuclear Medicine, Saglik Bilimleri University Diyarbakir Gazi Yasargil Training and Research Hospital
| | - Senar Ebinç
- Department of Medical Oncology, Saglik Bilimleri University Diyarbakir Gazi Yasargil Training and Research Hospital
| | | | - Cihan Gündoğan
- Department of Nuclear Medicine, Saglik Bilimleri University Diyarbakir Gazi Yasargil Training and Research Hospital
| | - Zeynep Oruç
- Department of Medical Oncology, Dicle University Faculty of Medicine, Diyarbakir, Turkey
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Urakçı Z, Ebinç S, Tunç S, Kalkan Z, Oruç Z, Küçüköner M, Kaplan MA, Isikdogan A. Comparison of Two Chemotherapy Regimens After First-Line Treatment for HER2-Negative Metastatic Gastric Cancer. Cureus 2023; 15:e38837. [PMID: 37303360 PMCID: PMC10256246 DOI: 10.7759/cureus.38837] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2023] [Indexed: 06/13/2023] Open
Abstract
AIM Metastatic stage gastric cancer is a disease with a poor prognosis and the likelihood of achieving a cure in these patients is low. Treatment response to subsequent-line treatments is poor. We aimed to investigate the effectiveness of the folinic acid, fluorouracil and irinotecan (FOLFIRI) and paclitaxel+carboplatin regimens, which are used in subsequent lines of therapy in advanced-stage gastric cancer. MATERIALS AND METHODS This study included 40 patients who have metastatic stage gastric cancer and received FOLFIRI or paclitaxel+carboplatin therapy in subsequent lines of therapy between 2017 and 2022. The data of the patients were analyzed retrospectively. RESULTS At diagnosis median age was 51 (23-88) years. The tumor was localized in the gastroesophageal junction in eight (20%) patients and in other gastric locations in 32 (80%) patients. At diagnosis, 75% (n=30) of the patients presented with the disease in the metastatic stage, while 25% (n=10) presented with stage II-III disease. Regarding the treatments received in the second and further lines of therapy, 18 (45%) patients received paclitaxel+carboplatin and 22 (55%) patients received a FOLFIRI regimen. Of these treatments, 67.5% (n=27) were given as the second line and 32.5% (n=13) were given as third-line therapy. The objective response rate (ORR) was 45.5% in the FOLFIRI arm compared to 16.7% in the paclitaxel+carboplatin arm (p=0.05). Both treatment arms had a median progression-free survival (PFS) of three months (p=0.82). The median overall survival (OS) time was seven months in the FOLFIRI arm compared to eight months in the paclitaxel+carboplatin arm (p=0.71). Side effects were similar between both treatment arms. CONCLUSION This study determined that FOLFIRI and paclitaxel+carboplatin treatments have similar OS, PFS, and side effect profiles in subsequent line treatment of gastric cancer. The FOLFIRI treatment regimen yielded a higher ORR.
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Affiliation(s)
- Zuhat Urakçı
- Department of Medical Oncology, Dicle University Faculty of Medicine, Diyarbakır, TUR
| | - Senar Ebinç
- Department of Medical Oncology, Gazi Yasargil Training and Research Hospital, Diyarbakır, TUR
| | - Sezai Tunç
- Department of Medical Oncology, Dicle University Faculty of Medicine, Diyarbakır, TUR
| | - Ziya Kalkan
- Department of Medical Oncology, Dicle University Faculty of Medicine, Diyarbakır, TUR
| | - Zeynep Oruç
- Department of Medical Oncology, Dicle University Faculty of Medicine, Diyarbakır, TUR
| | - Mehmet Küçüköner
- Department of Medical Oncology, Dicle University Faculty of Medicine, Diyarbakır, TUR
| | - Muhammet Ali Kaplan
- Department of Medical Oncology, Dicle University Faculty of Medicine, Diyarbakır, TUR
| | - Abdurrahman Isikdogan
- Department of Medical Oncology, Dicle University Faculty of Medicine, Diyarbakır, TUR
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4
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Kutluk T, Sahin B, Kirazli M, Ahmed F, Aydin S, Yesil Çinkir H, Sezgin G, Bayram I, Ebinç S, Isikdogan A, Sasmaz I, Okan V, Ilhan G, Ören AC, Akbayram S, Harputluoglu H, Ural C, Ayyildiz O, Aktas G, Uçar MA, Güvenç B, Köse D, Acipayam C, Güncan S, Erçolak V, Berber I, Akdeniz A, Akyay A, Üzel VH, Söker M, Sengelen M, Yalçin S, Sullivan R. Clinical Characteristics and Outcomes of Cancer Cases Among Syrian Refugees From Southern Turkey. JAMA Netw Open 2023; 6:e2312903. [PMID: 37219908 DOI: 10.1001/jamanetworkopen.2023.12903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/24/2023] Open
Abstract
Importance Cancer was a common noncommunicable disease in Syria before the present conflict and is now a major disease burden among 3.6 million Syrian refugees in Turkey. Data to inform health care practice are needed. Objective To explore sociodemographic characteristics, clinical characteristics, and treatment outcomes of Syrian patients with cancer residing in the southern border provinces of Turkey hosting more than 50% of refugees. Design, Setting, and Participants This was a retrospective hospital-based cross-sectional study. The study sample consisted of all adult and children Syrian refugees diagnosed and/or treated for cancer between January 1, 2011, and December 31, 2020, in hematology-oncology departments of 8 university hospitals in the Southern province of Turkey. Data were analyzed from May 1, 2022, to September 30, 2022. Main Outcomes and Measures Demographic characteristics (date of birth, sex, and residence), date of first cancer-related symptom, date and place of diagnosis, disease status at first presentation, treatment modalities, date and status at last hospital visit, and date of death. The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision and International Classification of Childhood Cancers, Third Edition, were used for the classification of cancer. The Surveillance, Epidemiology, and End Results system was applied for staging. The diagnostic interval was defined as the number of days from first symptoms until the diagnosis. Treatment abandonment was documented if the patient did not attend the clinic within 4 weeks of a prescribed appointment throughout the treatment. Results A total of 1114 Syrian adult and 421 Syrian children with cancer were included. The median age at diagnosis was 48.2 (IQR, 34.2-59.4) years for adults and 5.7 (IQR, 3.1-10.7) years for children. The median diagnostic interval was 66 (IQR, 26.5-114.3) days for adults and 28 (IQR, 14.0-69.0) days for children. Breast cancer (154 [13.8%]), leukemia and multiple myeloma (147 [13.2%]), and lymphoma (141 [12.7%]) were common among adults, and leukemias (180 [42.8%]), lymphomas (66 [15.7%]), and central nervous system neoplasms (40 [9.5%]) were common among children. The median follow-up time was 37.5 (IQR, 32.6-42.3) months for adults and 25.4 (IQR, 20.9-29.9) months for children. The 5-year survival rate was 17.5% in adults and 29.7% in children. Conclusions and Relevance Despite universal health coverage and investment in the health care system, low survival rates were reported in this study for both adults and children with cancer. These findings suggest that cancer care in refugees requires novel planning within national cancer control programs with global cooperation.
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Affiliation(s)
- Tezer Kutluk
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine and Cancer Institute, Ankara, Turkey
| | - Berksoy Sahin
- Department of Medical Oncology, Çukurova University, Adana, Turkey
| | - Meral Kirazli
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine and Cancer Institute, Ankara, Turkey
| | - Fahad Ahmed
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine and Cancer Institute, Ankara, Turkey
- Now with Department of Public Health, Yıldırım Beyazıt University, Ankara, Turkey
| | - Sinem Aydin
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine and Cancer Institute, Ankara, Turkey
| | | | - Gülay Sezgin
- Department of Pediatric Hematology-Oncology, Çukurova University, Adana, Turkey
| | - Ibrahim Bayram
- Department of Pediatric Hematology-Oncology, Çukurova University, Adana, Turkey
| | - Senar Ebinç
- Department of Medical Oncology, Dicle University, Diyarbakır, Turkey
| | | | - Ilgen Sasmaz
- Department of Pediatric Hematology, Çukurova University, Adana, Turkey
| | - Vahap Okan
- Department of Hematology, Gaziantep University, Gaziantep, Turkey
| | - Gül Ilhan
- Department of Hematology, Mustafa Kemal University, Hatay, Turkey
| | - Ayse Ceyda Ören
- Department of Pediatric Hematology-Oncology, Gaziantep University, Gaziantep, Turkey
| | - Sinan Akbayram
- Department of Pediatric Hematology-Oncology, Gaziantep University, Gaziantep, Turkey
| | | | - Cihan Ural
- Department of Hematology, Dicle University, Diyarbakır, Turkey
| | - Orhan Ayyildiz
- Department of Hematology, Dicle University, Diyarbakır, Turkey
| | - Gökmen Aktas
- Department of Medical Oncology, Sütçü İmam University, Kahramanmaraş, Turkey
- Now at Medicalpoint Gaziantep Hospital, Gaziantep, Turkey
| | - Mehmet Ali Uçar
- Department of Hematology, Çukurova University, Adana, Turkey
| | - Birol Güvenç
- Department of Hematology, Çukurova University, Adana, Turkey
| | - Dogan Köse
- Department of Pediatric Oncology, Harran University, Şanlıurfa, Turkey
- Now at Emsey Hospital, İstanbul Turkey
| | - Can Acipayam
- Department of Pediatric Hematology-Oncology, Sütçü İmam University, Kahramanmaraş, Turkey
| | - Sabri Güncan
- Department of Medical Oncology, Mersin University, Mersin, Turkey
| | - Vehbi Erçolak
- Department of Medical Oncology, Mersin University, Mersin, Turkey
| | - Ilhami Berber
- Department of Hematology, İnönü University, Malatya, Turkey
| | - Aydan Akdeniz
- Department of Hematology, Mersin University, Mersin, Turkey
| | - Arzu Akyay
- Department of Pediatric Hematology-Oncology, İnönü University, Malatya, Turkey
| | - Veysiye Hülya Üzel
- Department of Pediatric Hematology-Oncology, Dicle University, Diyarbakır, Turkey
| | - Murat Söker
- Department of Pediatric Hematology-Oncology, Dicle University, Diyarbakır, Turkey
| | - Meltem Sengelen
- Department of Public Health, Hacettepe University, Ankara, Turkey
| | - Suayib Yalçin
- Department of Medical Oncology, Hacettepe University, Ankara, Turkey
| | - Richard Sullivan
- King's College London, Institute of Cancer Policy, Conflict & Health Research Group, London, United Kingdom
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5
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Karacin C, Oksuzoglu B, Demirci A, Keskinkılıç M, Baytemür NK, Yılmaz F, Selvi O, Erdem D, Avşar E, Paksoy N, Demir N, Göksu SS, Türker S, Bayram E, Çelebi A, Yılmaz H, Kuzu ÖF, Kahraman S, Gökmen İ, Sakin A, Alkan A, Nayır E, Uğraklı M, Acar Ö, Ertürk İ, Demir H, Aslan F, Sönmez Ö, Korkmaz T, Celayir ÖM, Karadağ İ, Kayıkçıoğlu E, Şakalar T, Öktem İN, Eren T, Erul E, Mocan EE, Kalkan Z, Yıldırım N, Ergün Y, Akagündüz B, Karakaya S, Kut E, Teker F, Demirel BÇ, Karaboyun K, Almuradova E, Ünal OÜ, Oyman A, Işık D, Okutur K, Öztosun B, Gülbağcı BB, Kalender ME, Şahin E, Seyyar M, Özdemir Ö, Selçukbiricik F, Kanıtez M, Dede İ, Gümüş M, Gökmen E, Yaren A, Menekşe S, Ebinç S, Aksoy S, İmamoğlu Gİ, Altınbaş M, Çetin B, Uluç BO, Er Ö, Karadurmuş N, Erdoğan AP, Artaç M, Tanrıverdi Ö, Çiçin İ, Şendur MAN, Oktay E, Bayoğlu İV, Paydaş S, Aydıner A, Salim DK, Geredeli Ç, Yavuzşen T, Doğan M, Hacıbekiroğlu İ. Correction: Efficacy of subsequent treatments in patients with hormone-positive advanced breast cancer who had disease progression under CDK 4/6 inhibitor therapy. BMC Cancer 2023; 23:192. [PMID: 36849943 PMCID: PMC9969671 DOI: 10.1186/s12885-023-10662-3] [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: 03/01/2023] Open
Affiliation(s)
- Cengiz Karacin
- Department of Medical Oncology, UHS Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey.
| | - Berna Oksuzoglu
- grid.413794.cDepartment of Medical Oncology, UHS Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Ayşe Demirci
- grid.49746.380000 0001 0682 3030Department of Medical Oncology, Sakarya University, Sakarya, Turkey
| | - Merve Keskinkılıç
- grid.21200.310000 0001 2183 9022Department of Medical Oncology, Dokuz Eylül University, İzmir, Turkey
| | | | - Funda Yılmaz
- grid.413794.cDepartment of Medical Oncology, UHS Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Oğuzhan Selvi
- Department of Medical Oncology, Okmeydanı Prof. Dr. Cemil Taşcıoğlu City Hospital, Istanbul, Turkey
| | - Dilek Erdem
- Department of Medical Oncology, VM Medical Park Hospital, Samsun, Turkey
| | - Esin Avşar
- grid.413819.60000 0004 0471 9397Department of Medical Oncology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Nail Paksoy
- grid.9601.e0000 0001 2166 6619Department of Medical Oncology, Istanbul University Instıtue of Oncology, Istanbul, Turkey
| | - Necla Demir
- grid.413290.d0000 0004 0643 2189Department of Medical Oncology, Acıbadem Hospital, Kayseri, Turkey
| | - Sema Sezgin Göksu
- grid.29906.34Department of Medical Oncology, Akdeniz University, Antalya, Turkey
| | - Sema Türker
- Department of Medical Oncology, Zonguldak Hospital, Zonguldak, Turkey
| | - Ertuğrul Bayram
- grid.98622.370000 0001 2271 3229Department of Medical Oncology, Çukurova University, Adana, Turkey
| | - Abdüssamet Çelebi
- grid.414850.c0000 0004 0642 8921Department of Medical Oncology, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey
| | - Hatice Yılmaz
- grid.34517.340000 0004 0595 4313Department of Medical Oncology, Adnan Menderes University, Aydın, Turkey
| | - Ömer Faruk Kuzu
- grid.512925.80000 0004 7592 6297Department of Medical Oncology, Ankara City Hospital, Ankara, Turkey
| | - Seda Kahraman
- grid.512925.80000 0004 7592 6297Department of Medical Oncology, Ankara City Hospital, Ankara, Turkey
| | - İvo Gökmen
- grid.411693.80000 0001 2342 6459Department of Medical Oncology, Trakya University, Edirne, Turkey
| | - Abdullah Sakin
- grid.411781.a0000 0004 0471 9346Department of Medical Oncology, Istanbul Medipol University Bahçelievler Hospital, Istanbul, Turkey
| | - Ali Alkan
- grid.411861.b0000 0001 0703 3794Department of Medical Oncology, Muğla Sıtkı Koçman University, Muğla, Turkey
| | - Erdinç Nayır
- Mersin Medical Park Hospital, Department of Medical Oncology, Mersin, Turkey
| | - Muzafer Uğraklı
- grid.411124.30000 0004 1769 6008Department of Medical Oncology, Necmettin Erbakan University, Konya, Turkey
| | - Ömer Acar
- grid.411688.20000 0004 0595 6052Department of Medical Oncology, Celal Bayar University, Manisa, Turkey
| | - İsmail Ertürk
- Department of Medical Oncology, Gülhane Training and Research Hospital, Ankara, Turkey
| | - Hacer Demir
- Department of Medical Oncology, Afyonkarahisar Health Sciences University Hospital, Afyonkarahisar, Turkey
| | - Ferit Aslan
- Department of Medical Oncology, Ankara Medical Park Hospital, Ankara, Turkey
| | - Özlem Sönmez
- grid.411117.30000 0004 0369 7552Department of Medical Oncology, Acıbadem University Maslak Hospital, Istanbul, Turkey
| | - Taner Korkmaz
- grid.411117.30000 0004 0369 7552Department of Medical Oncology, Acıbadem University Maslak Hospital, Istanbul, Turkey
| | - Özde Melisa Celayir
- grid.411117.30000 0004 0369 7552Department of Medical Oncology, Acıbadem University Maslak Hospital, Istanbul, Turkey
| | - İbrahim Karadağ
- grid.440466.40000 0004 0369 655XDepartment of Medical Oncology, Hitit University Hospital, Çorum, Turkey
| | - Erkan Kayıkçıoğlu
- grid.45978.37Department of Medical Oncology, Süleyman Demirel University Hospital, Isparta, Turkey
| | - Teoman Şakalar
- Department of Medical Oncology, Kahramanmaraş Necip Fazıl City Hospital, Kahramanmaraş, Turkey
| | - İlker Nihat Öktem
- Department of Medical Oncology, Ersin Arslan Training and Research Hospital, Gaziantep, Turkey
| | - Tülay Eren
- grid.413698.10000 0004 0419 0366Department of Medical Oncology, UHS Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Enes Erul
- grid.14442.370000 0001 2342 7339Department of Medical Oncology, Hacettepe University Instıtue of Oncology, Ankara, Turkey
| | - Eda Eylemer Mocan
- grid.7256.60000000109409118Department of Medical Oncology, Ankara University, Ankara, Turkey
| | - Ziya Kalkan
- grid.411690.b0000 0001 1456 5625Department of Medical Oncology, Dicle University, Diyarbakır, Turkey
| | - Nilgün Yıldırım
- grid.411320.50000 0004 0574 1529Department of Medical Oncology, Fırat University, Elazığ, Turkey
| | - Yakup Ergün
- Batman Training and Research Hospital, Batman, Turkey
| | - Baran Akagündüz
- grid.412176.70000 0001 1498 7262Department of Medical Oncology, Erzincan Binali Yıldırım University, Erzincan, Turkey
| | - Serdar Karakaya
- Department of Medical Oncology, Atatürk Pulmonary Diseases Hospital, Ankara, Turkey
| | - Engin Kut
- Department of Medical Oncology, Manisa City Hospital, Manisa, Turkey
| | - Fatih Teker
- grid.411549.c0000000107049315Department of Medical Oncology, Gaziantep University, Gaziantep, Turkey
| | - Burçin Çakan Demirel
- grid.411742.50000 0001 1498 3798Department of Medical Oncology, Pamukkale University, Denizli, Turkey
| | - Kubilay Karaboyun
- grid.412006.10000 0004 0369 8053Department of Medical Oncology, Namık Kemal University, Tekirdağ, Turkey
| | - Elvina Almuradova
- grid.8302.90000 0001 1092 2592Department of Medical Oncology, Ege University, İzmir, Turkey
| | - Olçun Ümit Ünal
- grid.414882.30000 0004 0643 0132UHS İzmir Tepecik Training and Research Hospital, İzmir, Turkey
| | - Abdilkerim Oyman
- grid.417018.b0000 0004 0419 1887Department of Medical Oncology, Ümraniye Training and Research Hospital, Istanbul, Turkey
| | - Deniz Işık
- Kocaeli Medical Park, Department of Medical Oncology, Kocaeli, Turkey
| | - Kerem Okutur
- grid.414854.8Department of Medical Oncology, Bahçelievler Memorial Hospital, Istanbul, Turkey
| | - Buğra Öztosun
- grid.411776.20000 0004 0454 921XDepartment of Medical Oncology, Istanbul Medeniyet University, Istanbul, Turkey
| | - Burcu Belen Gülbağcı
- grid.49746.380000 0001 0682 3030Department of Medical Oncology, Sakarya University, Sakarya, Turkey
| | | | - Elif Şahin
- grid.411105.00000 0001 0691 9040Department of Medical Oncology, Kocaeli University, Kocaeli, Turkey
| | - Mustafa Seyyar
- grid.411105.00000 0001 0691 9040Department of Medical Oncology, Kocaeli University, Kocaeli, Turkey
| | - Özlem Özdemir
- grid.414879.70000 0004 0415 690Xİzmir Bozyaka Training and Research Hospital, İzmir, Turkey
| | - Fatih Selçukbiricik
- grid.15876.3d0000000106887552Department of Medical Oncology, Koç University, Istanbul, Turkey
| | - Metin Kanıtez
- grid.413690.90000 0000 8653 4054Department of Medical Oncology, American Hospital, Istanbul, Turkey
| | - İsa Dede
- grid.14352.310000 0001 0680 7823Department of Medical Oncology, Mustafa Kemal University, Hatay, Turkey
| | - Mahmut Gümüş
- grid.411776.20000 0004 0454 921XDepartment of Medical Oncology, Istanbul Medeniyet University, Istanbul, Turkey
| | - Erhan Gökmen
- grid.8302.90000 0001 1092 2592Department of Medical Oncology, Ege University, İzmir, Turkey
| | - Arzu Yaren
- grid.411742.50000 0001 1498 3798Department of Medical Oncology, Pamukkale University, Denizli, Turkey
| | - Serkan Menekşe
- Department of Medical Oncology, Manisa City Hospital, Manisa, Turkey
| | - Senar Ebinç
- grid.411690.b0000 0001 1456 5625Department of Medical Oncology, Dicle University, Diyarbakır, Turkey
| | - Sercan Aksoy
- grid.14442.370000 0001 2342 7339Department of Medical Oncology, Hacettepe University Instıtue of Oncology, Ankara, Turkey
| | - Gökşen İnanç İmamoğlu
- grid.413698.10000 0004 0419 0366Department of Medical Oncology, UHS Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Mustafa Altınbaş
- grid.413698.10000 0004 0419 0366Department of Medical Oncology, UHS Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Bülent Çetin
- grid.45978.37Department of Medical Oncology, Süleyman Demirel University Hospital, Isparta, Turkey
| | - Başak Oyan Uluç
- grid.411117.30000 0004 0369 7552Department of Medical Oncology, Acıbadem University Maslak Hospital, Istanbul, Turkey
| | - Özlem Er
- grid.411117.30000 0004 0369 7552Department of Medical Oncology, Acıbadem University Maslak Hospital, Istanbul, Turkey
| | - Nuri Karadurmuş
- Department of Medical Oncology, Gülhane Training and Research Hospital, Ankara, Turkey
| | - Atike Pınar Erdoğan
- grid.411688.20000 0004 0595 6052Department of Medical Oncology, Celal Bayar University, Manisa, Turkey
| | - Mehmet Artaç
- grid.411124.30000 0004 1769 6008Department of Medical Oncology, Necmettin Erbakan University, Konya, Turkey
| | - Özgür Tanrıverdi
- grid.411861.b0000 0001 0703 3794Department of Medical Oncology, Muğla Sıtkı Koçman University, Muğla, Turkey
| | - İrfan Çiçin
- grid.411693.80000 0001 2342 6459Department of Medical Oncology, Trakya University, Edirne, Turkey
| | - Mehmet Ali Nahit Şendur
- grid.512925.80000 0004 7592 6297Department of Medical Oncology, Ankara City Hospital, Ankara, Turkey
| | - Esin Oktay
- grid.34517.340000 0004 0595 4313Department of Medical Oncology, Adnan Menderes University, Aydın, Turkey
| | - İbrahim Vedat Bayoğlu
- grid.414850.c0000 0004 0642 8921Department of Medical Oncology, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey
| | - Semra Paydaş
- grid.98622.370000 0001 2271 3229Department of Medical Oncology, Çukurova University, Adana, Turkey
| | - Adnan Aydıner
- grid.9601.e0000 0001 2166 6619Department of Medical Oncology, Istanbul University Instıtue of Oncology, Istanbul, Turkey
| | - Derya Kıvrak Salim
- grid.413819.60000 0004 0471 9397Department of Medical Oncology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Çağlayan Geredeli
- Department of Medical Oncology, Okmeydanı Prof. Dr. Cemil Taşcıoğlu City Hospital, Istanbul, Turkey
| | - Tuğba Yavuzşen
- grid.21200.310000 0001 2183 9022Department of Medical Oncology, Dokuz Eylül University, İzmir, Turkey
| | - Mutlu Doğan
- grid.413794.cDepartment of Medical Oncology, UHS Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - İlhan Hacıbekiroğlu
- grid.49746.380000 0001 0682 3030Department of Medical Oncology, Sakarya University, Sakarya, Turkey
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6
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Karacin C, Oksuzoglu B, Demirci A, Keskinkılıç M, Baytemür NK, Yılmaz F, Selvi O, Erdem D, Avşar E, Paksoy N, Demir N, Göksu SS, Türker S, Bayram E, Çelebi A, Yılmaz H, Kuzu ÖF, Kahraman S, Gökmen İ, Sakin A, Alkan A, Nayır E, Uğraklı M, Acar Ö, Ertürk İ, Demir H, Aslan F, Sönmez Ö, Korkmaz T, Celayir ÖM, Karadağ İ, Kayıkçıoğlu E, Şakalar T, Öktem İN, Eren T, Urul E, Mocan EE, Kalkan Z, Yıldırım N, Ergün Y, Akagündüz B, Karakaya S, Kut E, Teker F, Demirel BÇ, Karaboyun K, Almuradova E, Ünal OÜ, Oyman A, Işık D, Okutur K, Öztosun B, Gülbağcı BB, Kalender ME, Şahin E, Seyyar M, Özdemir Ö, Selçukbiricik F, Kanıtez M, Dede İ, Gümüş M, Gökmen E, Yaren A, Menekşe S, Ebinç S, Aksoy S, İmamoğlu Gİ, Altınbaş M, Çetin B, Uluç BO, Er Ö, Karadurmuş N, Erdoğan AP, Artaç M, Tanrıverdi Ö, Çiçin İ, Şendur MAN, Oktay E, Bayoğlu İV, Paydaş S, Aydıner A, Salim DK, Geredeli Ç, Yavuzşen T, Doğan M, Hacıbekiroğlu İ. Efficacy of subsequent treatments in patients with hormone-positive advanced breast cancer who had disease progression under CDK 4/6 inhibitor therapy. BMC Cancer 2023; 23:136. [PMID: 36765293 PMCID: PMC9912535 DOI: 10.1186/s12885-023-10609-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 02/03/2023] [Indexed: 02/12/2023] Open
Abstract
BACKGROUND There is no standard treatment recommended at category 1 level in international guidelines for subsequent therapy after cyclin-dependent kinase 4/6 inhibitor (CDK4/6) based therapy. We aimed to evaluate which subsequent treatment oncologists prefer in patients with disease progression under CDKi. In addition, we aimed to show the effectiveness of systemic treatments after CDKi and whether there is a survival difference between hormonal treatments (monotherapy vs. mTOR-based). METHODS A total of 609 patients from 53 centers were included in the study. Progression-free-survivals (PFS) of subsequent treatments (chemotherapy (CT, n:434) or endocrine therapy (ET, n:175)) after CDKi were calculated. Patients were evaluated in three groups as those who received CDKi in first-line (group A, n:202), second-line (group B, n: 153) and ≥ 3rd-line (group C, n: 254). PFS was compared according to the use of ET and CT. In addition, ET was compared as monotherapy versus everolimus-based combination therapy. RESULTS The median duration of CDKi in the ET arms of Group A, B, and C was 17.0, 11.0, and 8.5 months in respectively; it was 9.0, 7.0, and 5.0 months in the CT arm. Median PFS after CDKi was 9.5 (5.0-14.0) months in the ET arm of group A, and 5.3 (3.9-6.8) months in the CT arm (p = 0.073). It was 6.7 (5.8-7.7) months in the ET arm of group B, and 5.7 (4.6-6.7) months in the CT arm (p = 0.311). It was 5.3 (2.5-8.0) months in the ET arm of group C and 4.0 (3.5-4.6) months in the CT arm (p = 0.434). Patients who received ET after CDKi were compared as those who received everolimus-based combination therapy versus those who received monotherapy ET: the median PFS in group A, B, and C was 11.0 vs. 5.9 (p = 0.047), 6.7 vs. 5.0 (p = 0.164), 6.7 vs. 3.9 (p = 0.763) months. CONCLUSION Physicians preferred CT rather than ET in patients with early progression under CDKi. It has been shown that subsequent ET after CDKi can be as effective as CT. It was also observed that better PFS could be achieved with the subsequent everolimus-based treatments after first-line CDKi compared to monotherapy ET.
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Affiliation(s)
- Cengiz Karacin
- Department of Medical Oncology, UHS Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey.
| | - Berna Oksuzoglu
- grid.413794.cDepartment of Medical Oncology, UHS Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Ayşe Demirci
- grid.49746.380000 0001 0682 3030Department of Medical Oncology, Sakarya University, Sakarya, Turkey
| | - Merve Keskinkılıç
- grid.21200.310000 0001 2183 9022Department of Medical Oncology, Dokuz Eylül University, İzmir, Turkey
| | | | - Funda Yılmaz
- grid.413794.cDepartment of Medical Oncology, UHS Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Oğuzhan Selvi
- Department of Medical Oncology, Okmeydanı Prof. Dr. Cemil Taşcıoğlu City Hospital, Istanbul, Turkey
| | - Dilek Erdem
- Department of Medical Oncology, VM Medical Park Hospital, Samsun, Turkey
| | - Esin Avşar
- grid.413819.60000 0004 0471 9397Department of Medical Oncology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Nail Paksoy
- grid.9601.e0000 0001 2166 6619Department of Medical Oncology, Istanbul University Instıtue of Oncology, Istanbul, Turkey
| | - Necla Demir
- grid.413290.d0000 0004 0643 2189Department of Medical Oncology, Acıbadem Hospital, Kayseri, Turkey
| | - Sema Sezgin Göksu
- grid.29906.34Department of Medical Oncology, Akdeniz University, Antalya, Turkey
| | - Sema Türker
- Department of Medical Oncology, Zonguldak Hospital, Zonguldak, Turkey
| | - Ertuğrul Bayram
- grid.98622.370000 0001 2271 3229Department of Medical Oncology, Çukurova University, Adana, Turkey
| | - Abdüssamet Çelebi
- grid.414850.c0000 0004 0642 8921Department of Medical Oncology, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey
| | - Hatice Yılmaz
- grid.34517.340000 0004 0595 4313Department of Medical Oncology, Adnan Menderes University, Aydın, Turkey
| | - Ömer Faruk Kuzu
- grid.512925.80000 0004 7592 6297Department of Medical Oncology, Ankara City Hospital, Ankara, Turkey
| | - Seda Kahraman
- grid.512925.80000 0004 7592 6297Department of Medical Oncology, Ankara City Hospital, Ankara, Turkey
| | - İvo Gökmen
- grid.411693.80000 0001 2342 6459Department of Medical Oncology, Trakya University, Edirne, Turkey
| | - Abdullah Sakin
- grid.411781.a0000 0004 0471 9346Department of Medical Oncology, Istanbul Medipol University Bahçelievler Hospital, Istanbul, Turkey
| | - Ali Alkan
- grid.411861.b0000 0001 0703 3794Department of Medical Oncology, Muğla Sıtkı Koçman University, Muğla, Turkey
| | - Erdinç Nayır
- Mersin Medical Park Hospital, Department of Medical Oncology, Mersin, Turkey
| | - Muzaffer Uğraklı
- grid.411124.30000 0004 1769 6008Department of Medical Oncology, Necmettin Erbakan University, Konya, Turkey
| | - Ömer Acar
- grid.411688.20000 0004 0595 6052Department of Medical Oncology, Celal Bayar University, Manisa, Turkey
| | - İsmail Ertürk
- Department of Medical Oncology, Gülhane Training and Research Hospital, Ankara, Turkey
| | - Hacer Demir
- Department of Medical Oncology, Afyonkarahisar Health Sciences University Hospital, Afyonkarahisar, Turkey
| | - Ferit Aslan
- Department of Medical Oncology, Ankara Medical Park Hospital, Ankara, Turkey
| | - Özlem Sönmez
- grid.411117.30000 0004 0369 7552Department of Medical Oncology, Acıbadem University Maslak Hospital, Istanbul, Turkey
| | - Taner Korkmaz
- grid.411117.30000 0004 0369 7552Department of Medical Oncology, Acıbadem University Maslak Hospital, Istanbul, Turkey
| | - Özde Melisa Celayir
- grid.411117.30000 0004 0369 7552Department of Medical Oncology, Acıbadem University Maslak Hospital, Istanbul, Turkey
| | - İbrahim Karadağ
- grid.440466.40000 0004 0369 655XDepartment of Medical Oncology, Hitit University Hospital, Çorum, Turkey
| | - Erkan Kayıkçıoğlu
- grid.45978.37Department of Medical Oncology, Süleyman Demirel University Hospital, Isparta, Turkey
| | - Teoman Şakalar
- Department of Medical Oncology, Kahramanmaraş Necip Fazıl City Hospital, Kahramanmaraş, Turkey
| | - İlker Nihat Öktem
- Department of Medical Oncology, Ersin Arslan Training and Research Hospital, Gaziantep, Turkey
| | - Tülay Eren
- grid.413698.10000 0004 0419 0366Department of Medical Oncology, UHS Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Enes Urul
- grid.14442.370000 0001 2342 7339Department of Medical Oncology, Hacettepe University Instıtue of Oncology, Ankara, Turkey
| | - Eda Eylemer Mocan
- grid.7256.60000000109409118Department of Medical Oncology, Ankara University, Ankara, Turkey
| | - Ziya Kalkan
- grid.411690.b0000 0001 1456 5625Department of Medical Oncology, Dicle University, Diyarbakır, Turkey
| | - Nilgün Yıldırım
- grid.411320.50000 0004 0574 1529Department of Medical Oncology, Fırat University, Elazığ, Turkey
| | - Yakup Ergün
- Batman Training and Research Hospital, Batman, Turkey
| | - Baran Akagündüz
- grid.412176.70000 0001 1498 7262Department of Medical Oncology, Erzincan Binali Yıldırım University, Erzincan, Turkey
| | - Serdar Karakaya
- Department of Medical Oncology, Atatürk Pulmonary Diseases Hospital, Ankara, Turkey
| | - Engin Kut
- Department of Medical Oncology, Manisa City Hospital, Manisa, Turkey
| | - Fatih Teker
- grid.411549.c0000000107049315Department of Medical Oncology, Gaziantep University, Gaziantep, Turkey
| | - Burçin Çakan Demirel
- grid.411742.50000 0001 1498 3798Department of Medical Oncology, Pamukkale University, Denizli, Turkey
| | - Kubilay Karaboyun
- grid.412006.10000 0004 0369 8053Department of Medical Oncology, Namık Kemal University, Tekirdağ, Turkey
| | - Elvina Almuradova
- grid.8302.90000 0001 1092 2592Department of Medical Oncology, Ege University, İzmir, Turkey
| | - Olçun Ümit Ünal
- grid.414882.30000 0004 0643 0132UHS İzmir Tepecik Training and Research Hospital, İzmir, Turkey
| | - Abdilkerim Oyman
- grid.417018.b0000 0004 0419 1887Department of Medical Oncology, Ümraniye Training and Research Hospital, Istanbul, Turkey
| | - Deniz Işık
- Kocaeli Medical Park, Department of Medical Oncology, Kocaeli, Turkey
| | - Kerem Okutur
- grid.414854.8Department of Medical Oncology, Bahçelievler Memorial Hospital, Istanbul, Turkey
| | - Buğra Öztosun
- grid.411776.20000 0004 0454 921XDepartment of Medical Oncology, Istanbul Medeniyet University, Istanbul, Turkey
| | - Burcu Belen Gülbağcı
- grid.49746.380000 0001 0682 3030Department of Medical Oncology, Sakarya University, Sakarya, Turkey
| | | | - Elif Şahin
- grid.411105.00000 0001 0691 9040Department of Medical Oncology, Kocaeli University, Kocaeli, Turkey
| | - Mustafa Seyyar
- grid.411105.00000 0001 0691 9040Department of Medical Oncology, Kocaeli University, Kocaeli, Turkey
| | - Özlem Özdemir
- grid.414879.70000 0004 0415 690Xİzmir Bozyaka Training and Research Hospital, İzmir, Turkey
| | - Fatih Selçukbiricik
- grid.15876.3d0000000106887552Department of Medical Oncology, Koç University, Istanbul, Turkey
| | - Metin Kanıtez
- grid.413690.90000 0000 8653 4054Department of Medical Oncology, American Hospital, Istanbul, Turkey
| | - İsa Dede
- grid.14352.310000 0001 0680 7823Department of Medical Oncology, Mustafa Kemal University, Hatay, Turkey
| | - Mahmut Gümüş
- grid.411776.20000 0004 0454 921XDepartment of Medical Oncology, Istanbul Medeniyet University, Istanbul, Turkey
| | - Erhan Gökmen
- grid.8302.90000 0001 1092 2592Department of Medical Oncology, Ege University, İzmir, Turkey
| | - Arzu Yaren
- grid.411742.50000 0001 1498 3798Department of Medical Oncology, Pamukkale University, Denizli, Turkey
| | - Serkan Menekşe
- Department of Medical Oncology, Manisa City Hospital, Manisa, Turkey
| | - Senar Ebinç
- grid.411690.b0000 0001 1456 5625Department of Medical Oncology, Dicle University, Diyarbakır, Turkey
| | - Sercan Aksoy
- grid.14442.370000 0001 2342 7339Department of Medical Oncology, Hacettepe University Instıtue of Oncology, Ankara, Turkey
| | - Gökşen İnanç İmamoğlu
- grid.413698.10000 0004 0419 0366Department of Medical Oncology, UHS Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Mustafa Altınbaş
- grid.413698.10000 0004 0419 0366Department of Medical Oncology, UHS Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Bülent Çetin
- grid.45978.37Department of Medical Oncology, Süleyman Demirel University Hospital, Isparta, Turkey
| | - Başak Oyan Uluç
- grid.411117.30000 0004 0369 7552Department of Medical Oncology, Acıbadem University Maslak Hospital, Istanbul, Turkey
| | - Özlem Er
- grid.411117.30000 0004 0369 7552Department of Medical Oncology, Acıbadem University Maslak Hospital, Istanbul, Turkey
| | - Nuri Karadurmuş
- Department of Medical Oncology, Gülhane Training and Research Hospital, Ankara, Turkey
| | - Atike Pınar Erdoğan
- grid.411688.20000 0004 0595 6052Department of Medical Oncology, Celal Bayar University, Manisa, Turkey
| | - Mehmet Artaç
- grid.411124.30000 0004 1769 6008Department of Medical Oncology, Necmettin Erbakan University, Konya, Turkey
| | - Özgür Tanrıverdi
- grid.411861.b0000 0001 0703 3794Department of Medical Oncology, Muğla Sıtkı Koçman University, Muğla, Turkey
| | - İrfan Çiçin
- grid.411693.80000 0001 2342 6459Department of Medical Oncology, Trakya University, Edirne, Turkey
| | - Mehmet Ali Nahit Şendur
- grid.512925.80000 0004 7592 6297Department of Medical Oncology, Ankara City Hospital, Ankara, Turkey
| | - Esin Oktay
- grid.34517.340000 0004 0595 4313Department of Medical Oncology, Adnan Menderes University, Aydın, Turkey
| | - İbrahim Vedat Bayoğlu
- grid.414850.c0000 0004 0642 8921Department of Medical Oncology, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey
| | - Semra Paydaş
- grid.98622.370000 0001 2271 3229Department of Medical Oncology, Çukurova University, Adana, Turkey
| | - Adnan Aydıner
- grid.9601.e0000 0001 2166 6619Department of Medical Oncology, Istanbul University Instıtue of Oncology, Istanbul, Turkey
| | - Derya Kıvrak Salim
- grid.413819.60000 0004 0471 9397Department of Medical Oncology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Çağlayan Geredeli
- Department of Medical Oncology, Okmeydanı Prof. Dr. Cemil Taşcıoğlu City Hospital, Istanbul, Turkey
| | - Tuğba Yavuzşen
- grid.21200.310000 0001 2183 9022Department of Medical Oncology, Dokuz Eylül University, İzmir, Turkey
| | - Mutlu Doğan
- grid.413794.cDepartment of Medical Oncology, UHS Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - İlhan Hacıbekiroğlu
- grid.49746.380000 0001 0682 3030Department of Medical Oncology, Sakarya University, Sakarya, Turkey
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7
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Kepenek F, Can C, Kömek H, Kaplan İ, Gündoğan C, Ebinç S, Güzel Y, Agüloglu N, Karaoglan H, Taşdemir B. Combination of [68Ga]Ga-PSMA PET/CT and [18F]FDG PET/CT in demonstrating dedifferentiation in castration-resistant prostate cancer. Médecine Nucléaire 2023. [DOI: 10.1016/j.mednuc.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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8
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Ebinç S, Güzel Y, Oruç Z, Kömek H, Kalkan Z, Can C, Taşdemir B, Urakçi Z, Kaplan MA, Küçüköner M, Işikdoğan A. 18 F-FDG PET/CT parameters for prediction of response to neoadjuvant therapy and prognosis in rectal cancer. Nucl Med Commun 2023; 44:81-90. [PMID: 36437550 DOI: 10.1097/mnm.0000000000001638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This study aims to investigate the role of F-18 fluorodeoxyglucose PET/computed tomography (18F-FDG PET/CT) parameters in the prediction of treatment response and the prognosis in locally advanced rectal cancer. METHODS We investigated the relationship of 18F-FDG PET/CT parameters [rectal metabolic tumor volume (MTV), rectal total lesion glycolysis (TLG), rectal standard uptake value (SUV) max, rectal highest peak SUV, lymph node MTV, lymph node TLG, lymph node highest peak SUV] with the pathological response and disease-free survival (DFS) in 60 patients who received neoadjuvant therapy for a diagnosis of locally advanced rectal cancer. Patients with a total score of 0 were assigned to the low-risk group, patients with a score of 1 were assigned to the intermediate-risk group and patients with a score of 2 were assigned to the high-risk group. RESULTS The multivariate analysis revealed that, from baseline PET CT parameters, lymph node highest peak SUV strongly predicted the pathological response at a cutoff value of 2.23. DFS was predicted by the lymph node highest peak SUV at a cutoff value of 3.13 and by the MTV value at a cutoff value of 27 cm 3 . The risk scoring performed with regard to rectal MTV and lymph node highest peak SUV values determined a median DFS of 19 months in patients with a risk score of 2, whereas the median DFS was not reached in patients with risk scores of 0 and 1 (P < 0.001). CONCLUSION This study determined that rectal MTV and lymph node highest peak SUV predicted the response to neoadjuvant therapy and DFS.
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Affiliation(s)
- Senar Ebinç
- Department of Medical Oncology, Gazi Yasargil Training and Research Hospital
| | - Yunus Güzel
- Department of Nuclear Medicine, Gazi Yasargil Training and Research Hospital
| | - Zeynep Oruç
- Department of Medical Oncology, Dicle University Faculty of Medicine
| | - Halil Kömek
- Department of Nuclear Medicine, Gazi Yasargil Training and Research Hospital
| | - Ziya Kalkan
- Department of Medical Oncology, Dicle University Faculty of Medicine
| | - Canan Can
- Department of Nuclear Medicine, Gazi Yasargil Training and Research Hospital
| | - Bekir Taşdemir
- Department of Nuclear Medicine, Dicle University Faculty of Medicine, Diyarbakir, Turkey
| | - Zuhat Urakçi
- Department of Medical Oncology, Dicle University Faculty of Medicine
| | | | - Mehmet Küçüköner
- Department of Medical Oncology, Dicle University Faculty of Medicine
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9
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Ebinç S, Oruç Z, Urakçi Z, Kalkan Z, Kaplan MA, Küçüköner M, Işikdoğan A. Evaluation of Factors Predicting the Effectiveness of Regorafenib in the Treatment of Metastatic Colorectal Cancer. Eurasian J Med 2022; 54:229-234. [PMID: 35950825 PMCID: PMC9797696 DOI: 10.5152/eurasianjmed.2022.21162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE Regorafenib is a multikinase inhibitor, the effectiveness of which was demonstrated in metastatic colorectal cancer. This study aimed to investigate the factors that could predict the effectiveness of regorafenib. MATERIALS AND METHODS This study retrospectively reviewed the clinical characteristics, tumor characteristics, and previous therapies in 62 patients who presented to our center between 2016 and 2020 and used regorafenib for metastatic colorectal cancer. The effects of the investigated variables on the response obtained with regorafenib use were evaluated. RESULTS This study included a total of 62 patients diagnosed with metastatic colorectal cancer, of whom 30 (48.4%) were males and 32 (51.6%) were females. Patients' median age at diagnosis was 49 years (18- 68). Regorafenib therapy yielded a disease control rate of 64% [complete response=0, partial response= 14 (28%), and stable disease=18 (36%)]. Objective response was obtained in 28% of patients [complete response=0 and partial response=14 (28%)]. Progression-free survival was 4 months. The evaluation of the effects of patients' age, sex, performance status, previous treatments, metastatic sites, and RAS mutation status on the disease control rate and progression-free survival did not determine any positive or negative effects on progression-free survival. However, left-sided tumors had a positive effect on disease control rate (69.8% vs. 28.6%, P=.029). and previous use of cetuximab had a negative effect on disease control rate [76.5% vs. 37.5% (P=.007)]. CONCLUSION In our study, tumor localization and previous cetuximab use were found to be correlated with the disease control rate in patients on regorafenib. However, the need for novel biomarkers that will predict the effectiveness of regorafenib in metastatic colorectal cancer treatment persists.
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10
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Ebinç S, Oruç Z, Sezgin Y, Karhan O, Bilen E, Yerlikaya H, Kalkan Z, Urakçı Z, Küçüköner M, Kaplan MA, Işikdoğan A. Factors influencing HER2 discordance in nonmetastatic breast cancer and the role of neoadjuvant therapy. Future Oncol 2022; 18:3399-3408. [PMID: 36069377 DOI: 10.2217/fon-2022-0198] [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] [Indexed: 11/21/2022] Open
Abstract
Objective: The rates of and the factors influencing HER2 discordance in patients receiving neoadjuvant therapy for breast cancer are investigated. Methods: This study retrospectively examines the rates of HER2 and hormone receptor discordance between the biopsy and postoperative resection specimens of 400 female early-stage breast cancer patients. Results: One hundred and thirty-three (33.3%) patients had received neoadjuvant therapy. The rate of HER2 discordance between biopsy and resection specimens was 1.7% in the control group and 5.3% in the neoadjuvant therapy group (p = 0.018). The rate of HER2 discordance was higher in younger patients and in patients with T1 tumors in the neoadjuvant therapy group. Conclusion: Neoadjuvant therapy, age <40 years and smaller tumor size were independent risk factors for HER2 discordance.
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Affiliation(s)
- Senar Ebinç
- Department of Medical Oncology, Diyarbakir Gazi Yasargil Training & Research Hospital, Diyarbakır, Turkey
| | - Zeynep Oruç
- Department of Medical Oncology, Dicle University Faculty of Medicine, Diyarbakır, Turkey
| | - Yasin Sezgin
- Department of Medical Oncology, Dicle University Faculty of Medicine, Diyarbakır, Turkey
| | - Oğur Karhan
- Department of Medical Oncology, Dicle University Faculty of Medicine, Diyarbakır, Turkey
| | - Erkan Bilen
- Department of Medical Oncology, Dicle University Faculty of Medicine, Diyarbakır, Turkey
| | - Halis Yerlikaya
- Department of Medical Oncology, Diyarbakir Gazi Yasargil Training & Research Hospital, Diyarbakır, Turkey
| | - Ziya Kalkan
- Department of Medical Oncology, Dicle University Faculty of Medicine, Diyarbakır, Turkey
| | - Zuhat Urakçı
- Department of Medical Oncology, Dicle University Faculty of Medicine, Diyarbakır, Turkey
| | - Mehmet Küçüköner
- Department of Medical Oncology, Dicle University Faculty of Medicine, Diyarbakır, Turkey
| | - Muhammet Ali Kaplan
- Department of Medical Oncology, Diyarbakir Gazi Yasargil Training & Research Hospital, Diyarbakır, Turkey
| | - Abdurrahman Işikdoğan
- Department of Medical Oncology, Dicle University Faculty of Medicine, Diyarbakır, Turkey
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Kepenek F, Karaoğlan H, Can C, Kömek H, Kaplan İ, Etem H, Ebinç S, Kavak Ş, Gündoğan C. The role of basal metabolic and volumetric 18F-FDG PET/CT parameters and their changes in predicting pathological complete response in breast cancer patients receiving neoadjuvant chemotherapy. Hell J Nucl Med 2022; 25:235-246. [PMID: 36507879 DOI: 10.1967/s002449912511] [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] [Received: 03/08/2022] [Accepted: 08/31/2022] [Indexed: 12/29/2022]
Abstract
OBJECTIVE The aim of this study is to investigate the roles of pre- and post- treatment quantitative fluorine-18-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) parameters including maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) and their rate of change in predicting pathological complete response (pCR) in patients with local and locally advanced invasive breast cancer receiving neoadjuvant chemotherapy (NAC). SUBJECTS AND METHODS Ninety-eight patients who received NAC after being diagnosed with local and locally advanced invasive breast cancer between January 2017 and September 2021 were retrospectively included in our study. Molecular subtypes of all patients were determined. Maximum SUV, MTV, TLG, percent change in SUVmax (ΔSUVmax), ΔMTV, and ΔTLG obtained from PET/CT scans performed before and after NAC were calculated. The cut-off, AUC, sensitivity, and specificity values of these parameters in predicting pCR were calculated using receiver operating characteristic (ROC) curves. RESULTS ΔTMTV (cut-off 94.01%, AUC: 0.846), ΔTTLG (cut-off 97.36%, AUC: 0.870), B2MTV (cut-off<1.75, AUC: 0.764), B2TLG (cut-off<2.11, AUC: 0.764), B2SUVmax (cut-off<1.58, AUC: 0.767), ΔBMTV (cut-off 93.67%, AUC: 0.851), ΔBTLG (cut-off 97.22%, AUC: 0.870), ΔBSUVmax (cut-off 84.99%, AUC: 0.846) calculated using ROC curves were found to significantly predict pCR with high sensitivity and specificity. CONCLUSION We concluded that metabolic and volumetric PET/CT parameters, the rates of their change, and metabolic response during NAC may be important variables in predicting pCR in patients with breast cancer.
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Affiliation(s)
- Ferat Kepenek
- Department of Nuclear Medicine, GaziYaşargil Training and Research Hospital, University of Health Sciences, Diyarbakır, Turkey.
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12
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Kömek H, Can C, Kaplan İ, Gündoğan C, Kepenek F, Karaoglan H, Demirkıran A, Ebinç S, Güzel Y, Gündeş E. Comparison of [ 68 Ga]Ga-DOTA-FAPI-04 PET/CT and [ 18F]FDG PET/CT in colorectal cancer. Eur J Nucl Med Mol Imaging 2022; 49:3898-3909. [PMID: 35578038 DOI: 10.1007/s00259-022-05839-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 05/08/2022] [Indexed: 11/04/2022]
Abstract
AIM In this study, we aimed to evaluate the diagnostic sensitivity of [68 Ga]Ga-DOTA-FAPI-04 PET/CT in the evaluation of primary or recurrent tumor, and nodal, peritoneal, and distant organ metastases in patients with newly diagnosed or relapsed colorectal cancer (CRC) in comparison with [18F]FDG PET/CT. MATERIALS AND METHOD Thirty-nine patients with histopathologically confirmed primary or relapsed CRC were included in our study. All patients underwent both [18F]FDG and [68 Ga]Ga-DOTA-FAPI-04 PET/CT imaging in the same week. Primary lesions, lymph nodes, and metastatic lesions were recorded on both scans. SUVmax and background values were measured from the primary and metastatic lesions; tumor-to-background ratio (TBR) was calculated and compared. The results of the operation were compared with PET findings in patients who underwent surgical treatment without neoadjuvant chemotherapy (NAC). RESULTS The sensitivity and specificity of [68 Ga]Ga-DOTA-FAPI-04 PET/CT in the evaluation of primary tumors were 100%, while the sensitivity of [18F]FDG PET/CT was 100% and its specificity was 85.3%. When evaluated with surgical results in the detection of lymph nodes, [68 Ga]Ga-DOTA-FAPI-04 PET/CT had a sensitivity of 90% and a specificity of 100%, whereas [18F]FDG PET/CT had a sensitivity of 80% and a specificity of 81.8%. The sensitivity and specificity of [68 Ga]Ga-DOTA-FAPI PET/CT for peritoneal implants were 100%, and the sensitivity of [18F]FDG PET/CT was 55%. The SUVmax of primary lesions was higher with [18F]FDG (p < 0.001), while TBR was higher in [68 Ga]Ga-DOTA-FAPI PET/CT than [18F]FDG PET/CT (p: 0.008). SUVmax and TBR of the lymph nodes were significantly higher in [68 Ga]Ga-DOTA-FAPI PET/CT than [18F]FDG PET/CT (p < 0.001 for both). CONCLUSION [68 Ga]Ga-DOTA-FAPI-04 PET/CT achieved much higher sensitivity and specificity in the detection of primary lesions, and especially the lymph nodes and peritoneal metastases, suggesting that it can be employed in the assessment of primary tumor and metastases in patients with CRC in routine clinical practice.
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Affiliation(s)
- Halil Kömek
- Department of Nuclear Medicine, Gazi Yasargil Training and Research Hospital, 21070, Kayapınar, Diyarbakir, Turkey.
| | - Canan Can
- Department of Nuclear Medicine, Gazi Yasargil Training and Research Hospital, 21070, Kayapınar, Diyarbakir, Turkey
| | - İhsan Kaplan
- Department of Nuclear Medicine, Gazi Yasargil Training and Research Hospital, 21070, Kayapınar, Diyarbakir, Turkey
| | - Cihan Gündoğan
- Department of Nuclear Medicine, Gazi Yasargil Training and Research Hospital, 21070, Kayapınar, Diyarbakir, Turkey
| | - Ferat Kepenek
- Department of Nuclear Medicine, Gazi Yasargil Training and Research Hospital, 21070, Kayapınar, Diyarbakir, Turkey
| | - Hüseyin Karaoglan
- Department of Nuclear Medicine, Gazi Yasargil Training and Research Hospital, 21070, Kayapınar, Diyarbakir, Turkey
| | - Aykut Demirkıran
- Division of Medical Oncology, Department of Internal Medicine, Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey
| | - Senar Ebinç
- Division of Medical Oncology, Department of Internal Medicine, Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey
| | - Yunus Güzel
- Department of Nuclear Medicine, Gazi Yasargil Training and Research Hospital, 21070, Kayapınar, Diyarbakir, Turkey
| | - Ebubekir Gündeş
- Department of Gastroenterological Surgery, Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey
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Ebinç S, Kalkan Z, Oruç Z, Urakçı Z, Küçüköner M, Kaplan MA, Işıkdoğan A. Evaluation of the effectiveness and tolerability of sunitinib and pazopanib in the first line treatment of metastatic renal cell carcinoma. Oncol Clin Pract 2021. [DOI: 10.5603/ocp.2021.0033] [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: 11/25/2022] Open
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Oruç Z, Kaplan MA, Karaağaç M, Özyurt N, Tatlı AM, Kaya AO, Menekşe S, Kut E, Koca S, Sever ÖN, Yasin İ, Ebinç S, Zeynelgil E, Sakin A, Turhal NS, Isikdogan A. Efficacy and tolerability of current treatments for hormone-refractory prostate cancer patients with visceral metastases. Future Oncol 2021; 17:1611-1624. [PMID: 33631986 DOI: 10.2217/fon-2020-1032] [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] [Indexed: 11/21/2022] Open
Abstract
Aim: To assess the efficacy and tolerability of the first-line treatment options for hormone-refractory prostate cancer patients with visceral metastases. Materials & methods: The records of 191 patients diagnosed with hormone-refractory prostate cancer with visceral metastases were analyzed retrospectively. Results: Docetaxel was administered to 61.2% (n = 117), abiraterone to 14.2% (n = 27) and enzalutamide to 9.4% (n = 18) as the first-line treatment. The median survival of the patients receiving docetaxel, abiraterone and enzalutamide as the first-line treatment during the hormone-refractory period was 15 (95% Cl: 12.9-17) months, 6 (95% Cl: 1.8-10.1) months and 11 (95% Cl: 0.9-23.1) months (p = 0.038), respectively. Conclusion: The present study established a statistically significant difference in favor of docetaxel in terms of overall survival and progression-free survival.
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Affiliation(s)
- Zeynep Oruç
- Department of Medical Oncology, Dicle University Faculty of Medicine, Diyarbakır, Turkey
| | - M Ali Kaplan
- Department of Medical Oncology, Dicle University Faculty of Medicine, Diyarbakır, Turkey
| | - Mustafa Karaağaç
- Department of Medical Oncology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Neslihan Özyurt
- Department of Medical Oncology, Giresun University, Prof. Dr. A. İlhan Özdemir Training & Research Hospital, Giresun, Turkey
| | - Ali Murat Tatlı
- Department of Medical Oncology, School of Medicine, Akdeniz University, Antalya, Turkey
| | - Ali Osman Kaya
- Department of Medical Oncology, Faculty of Medicine, Biruni University, Medıcana Internatıonal Hospital, Istanbul, Turkey
| | - Serkan Menekşe
- Department of Medical Oncology, Manisa City Hospital, Manisa, Turkey
| | - Engin Kut
- Department of Medical Oncology, Manisa City Hospital, Manisa, Turkey
| | - Sinan Koca
- Department of Medical Oncology, Medeniyet University, Göztepe Training & Research Hospital, Istanbul, Turkey
| | - Özlem Nuray Sever
- Department of Medical Oncology, Gazi University School of Medicine, Ankara, Turkey
| | - İrem Yasin
- Department of Medical Oncology, Bezmialem University, Medical Faculty, Istanbul, Turkey
| | - Senar Ebinç
- Department of Medical Oncology, Dicle University Faculty of Medicine, Diyarbakır, Turkey
| | - Esra Zeynelgil
- Department of Medical Oncology, Dışkapı Training & Research Hospital, Ankara, Turkey
| | - Abdullah Sakin
- Department of Medical Oncology, Faculty of Medicine, Yuzuncu Yıl University, Van, Turkey
| | | | - Abdurrahman Isikdogan
- Department of Medical Oncology, Dicle University Faculty of Medicine, Diyarbakır, Turkey
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Oruc Z, Ebinç S, Kaplan MA. Rare Tumours of the Testis: Twelve Years of Experience. Prague Med Rep 2020; 121:181-193. [PMID: 33030147 DOI: 10.14712/23362936.2020.17] [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] [Indexed: 10/23/2022] Open
Abstract
Rare tumours of the testis includes a wide variety of tumours. We aim to present clinical and histological characteristics of our patients with rare tumours of the testis. The medical records of 33 patients who were treated and followed-up for testicular rare tumours in our center between 2007 and 2020 were retrospectively reviewed. Of all the 243 testicular tumours, 222 cases (91.4%) were germ cell tumours and 21 cases (8.6%) were non-germ cell tumours. Thirty-three rare tumours of the testis including rare germ cell tumours and non-germ cell tumours were detected. The mean age of the patients at diagnosis was 34 years (range 18-68 years). The histological types of rare testicular tumours were as follows: teratoma 4.5% (n=11), sex-cord stromal tumours 4.5% (n=11), paratesticular tumours 3.2% (n=8), and the others [lymphoma 0.4% (n=1), mesothelioma 0.4% (n=1) and choriocarcinoma 0.4% (n=1)]. The median duration of follow-up was 32 months (range 1 to 256 months). None of the patients with non-metastatic disease stage developed recurrence after having received appropriate therapy. Metastatic disease was documented in 9 cases at the time of diagnosis (five patients with teratomas, two patients with Leydig cell tumour, one patient with choriocarcinoma and rhabdomyosarcoma). The most common subtypes of testicular rare tumours in our center was teratoma and sex-cord stromal tumours. Because of testicular rare tumours have different biological features and different clinical outcomes, the management of each tumour requires a different approach.
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Affiliation(s)
- Zeynep Oruc
- Department of Medical Oncology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey.
| | - Senar Ebinç
- Department of Medical Oncology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| | - M Ali Kaplan
- Department of Medical Oncology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
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Demir C, Ebinç S, Ekinci Ö. Presence of paroxysmal nocturnal hemoglobinuria in patients with idiopathic portal vein thrombosis: a single-center study. Turk J Med Sci 2020; 50:1344-1349. [PMID: 32490645 PMCID: PMC7491302 DOI: 10.3906/sag-1912-204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Accepted: 05/23/2020] [Indexed: 01/04/2023] Open
Abstract
Background/aim Paroxysmal nocturnal hemoglobinuria (PNH) is a very rare clonal hematopoietic stem cell disease characterized by chronic hemolytic anemia and thrombosis. We report data from a study of the occurrence of PNH among patients with idiopathic portal vein thrombosis (PVT). Materials and methods Patients who were followed up with the diagnosis of idiopathic PVT were enrolled into this study. Those with laboratory and/or imaging evidence of any local or systemic factor that could lead to PVT were excluded. PNH clone was examined in all patients using established FLAER methodology. Results A total of 112 patients (42 males and 70 females), none of them had a markedly PNH clone, but 4 patients (3.6%) with confirmed tests two times had small PNH clones (size between 3.02% and 4.62%). The median ages of PNH clone (-) and PNH clone (+) patients were 42 (range; 24–59) vs 39 (range; 36–42) years, respectively. The median hemoglobin concentration, platelet count and leukocyte count were lower in the PNH clone (+) group than the PNH clone (-) group. Anemia, thrombocytopenia, and leukopenia were detected in all PNH clone (+) patients. In addition, the PNH clone positivity size in monocytes was higher than erythrocytes in all of 4 patients. Conclusions PNH should be considered during differential diagnosis among patients with idiopathic PVT. Small PNH clones can be detected in PVT patients that we cannot clearly determine its relationship with PVT. We need furthermore studies to explore the potential role of this finding.
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Affiliation(s)
- Cengiz Demir
- Department of Hematology, Faculty of Medicine, Yüzüncü Yıl University, Van, Turkey
| | - Senar Ebinç
- Department of Hematology, Faculty of Medicine, Yüzüncü Yıl University, Van, Turkey
| | - Ömer Ekinci
- Department of Hematology, Faculty of Medicine, Fırat University, Elazığ, Turkey
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Akdeniz N, Küçüköner M, Kaplan MA, Urakçı Z, Karhan O, Sezgin Y, Bilen E, Ebinç S, Teke F, Laçin Ş, Alan Ö, Ercelep Ö, Işıkdoğan A, Yumuk PF. Comparison of three different chemotherapy regimens for concomitant chemoradiotherapy in locally advanced non-small cell lung cancer. Int J Clin Oncol 2020; 25:2015-2024. [PMID: 32797321 DOI: 10.1007/s10147-020-01767-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 12/06/2019] [Accepted: 08/07/2020] [Indexed: 12/28/2022]
Abstract
PURPOSE The optimal chemotherapy regimen for concurrent chemoradiation in locally advanced non-small cell lung cancer (NSCLC) remains unclear. Cisplatin-etoposide regimen related toxicity is high, weekly regimens have been investigating. We aimed to compare the efficacy and safety of different concurrent chemotherapy regimens in the context. METHODS A total of 225 patients with locally advanced, unresectable stage III NSCLC were included. Patients who were treated with weekly docetaxel-platin (DP), paclitaxel-platin (PP) and standard dose etoposide-platin (EP) chemotherapy regimens were selected and divided into groups for the comparison of toxicity, response rate, progression free survival (PFS), and overall survival (OS) times. RESULTS There was a statistically significant difference between overall response rate of each treatment groups (DP: 96.1%, PP: 94% and EP: 76.7%, p < 0.001). The median PFS time of patients who were treated with DP, PP and EP was 16, 15 and 13.3 months, respectively (p = 0.435). The median OS time of patients treated with DP, PP and EP was 19.2, 29.7 and 28.3 months, respectively (p < 0.001). The rates of adverse events such as nausea, vomiting, neuropathy and anaphylaxis was similar. Grade 1-2 mucositis or esophagitis, anemia, pneumonitis were significantly higher in PP group than other groups. However, hematologic toxicities were higher in the EP group than other groups. CONCLUSIONS Compared to the weekly chemotherapy regimens with the standard dose, our study demonstrated similar PFS, but a prolonged OS with the EP regimen. The clinical response rate of weekly regimens was better than the full-dose regimen. Adverse events and toxicity rates were different and depended on the type of chemotherapy regimen used.
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Affiliation(s)
- Nadiye Akdeniz
- Department of Medical Oncology, Dicle University Medical Faculty, Diyarbakır, Turkey.
| | - Mehmet Küçüköner
- Department of Medical Oncology, Dicle University Medical Faculty, Diyarbakır, Turkey
| | - Muhammet Ali Kaplan
- Department of Medical Oncology, Dicle University Medical Faculty, Diyarbakır, Turkey
| | - Zuhat Urakçı
- Department of Medical Oncology, Dicle University Medical Faculty, Diyarbakır, Turkey
| | - Oğur Karhan
- Department of Medical Oncology, Dicle University Medical Faculty, Diyarbakır, Turkey
| | - Yasin Sezgin
- Department of Medical Oncology, Dicle University Medical Faculty, Diyarbakır, Turkey
| | - Erkan Bilen
- Department of Medical Oncology, Dicle University Medical Faculty, Diyarbakır, Turkey
| | - Senar Ebinç
- Department of Medical Oncology, Dicle University Medical Faculty, Diyarbakır, Turkey
| | - Fatma Teke
- Department of Radiation Oncology, Dicle University Medical Faculty, Diyarbakır, Turkey
| | - Şahin Laçin
- Department of Medical Oncology, Gazi Yasargil Education and Training Hospital, Diyarbakir, Turkey
| | - Özkan Alan
- Department of Medical Oncology, Marmara University Medical Faculty, Istanbul, Turkey
| | - Özlem Ercelep
- Department of Medical Oncology, Marmara University Medical Faculty, Istanbul, Turkey
| | - Abdurrahman Işıkdoğan
- Department of Medical Oncology, Dicle University Medical Faculty, Diyarbakır, Turkey
| | - Perran Fulden Yumuk
- Department of Medical Oncology, Marmara University Medical Faculty, Istanbul, Turkey
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Işıkdoğan A, Akdeniz N, Küçüköner M, Kaplan M, Urakçı Z, Karhan O, Sezgin Y, Bilen E, Ebinç S, Teke F, Laçin Ş, Alan O, Ercelep O, Yumuk F. Comparison of three different chemotherapy regimens for concomitant chemoradiotherapy in locally advanced non-small cell lung cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz259.007] [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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19
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Akdeniz N, Kaplan MA, Küçüköner M, Urakçı Z, Sezgin Y, Ebinç S, Bilen E, Karhan O, Laçin Ş, Büyükbayram H, Işıkdoğan A. Prognostic importance of primary tumor location in RAS mutant metastatic colorectal cancer. Dicle Tıp Dergisi 2019. [DOI: 10.5798/dicletip.539998] [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: 11/14/2022] Open
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Abstract
Background Chronic lymphocytic leukemia (CLL) usually expresses CD5 antigen. However, 7–20% of patients are CD5 negative. We report here a series of 19 CD5-negative B-CLL cases. Material/Methods We reviewed 19 consecutive CD5-negative B-CLL cases seen in our medical center from 2009 to 2015 and compared them with 105 CD5-positive B-CLL cases. The two groups were compared in terms of clinical parameters, laboratory parameters, and survival characteristics. Results Lymphadenopathy was present in 31.5% of the CD5-negative group and 51.4% of the CD5-positive group (p=0.029). Splenomegaly was present in 42.1% of the CD5-negative group and 16.1% of the CD5-positive group (p=0.029). There was no difference between the groups in terms of Binet A, B, and C stages (p=0.118, p=0.051, and p=0.882, respectively). The median thrombocyte count was 144×109/L and 160×109/L in the CD5-negative and CD5-positive groups, respectively (p=0.044). There was no difference between the two groups in terms of median neutrophil count (p=0.169). The mean lymphocyte count was 43.2±4.0×109/L and 36.7±3.2×109/L in the CD5-negative and CD5-positive groups, respectively (p=0.001). There was no difference between the groups in terms of autoimmune hemolytic anemia and autoimmune thrombocytopenia. In five-year follow-up, 84.2% of CD5-negative patients and 90.5% of CD5-positive patients were alive (p=0.393). Conclusions We found more isolated splenomegaly, less lymphadenopathy, a higher lymphocyte count, and a lower thrombocyte count in the CD5-negative group. There was no difference between the groups in terms of clinical stage, autoimmune phenomena, hemoglobin and neutrophil count, and survival.
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Affiliation(s)
- Cengiz Demir
- Department of Hematology, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey
| | - Erdal Kara
- Department of Hematology, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey
| | - Ömer Ekinci
- Department of Hematology, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey
| | - Senar Ebinç
- Department of Hematology, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey
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Atmaca M, Acar İ, Gönültaş E, Seven İ, Üçler R, Ebinç S, Alay M, Candan Z. Type 2 Diabetes Mellitus and Functional Hypoparathyroidism. tjem 2014. [DOI: 10.4274/tjem.2591] [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: 12/01/2022] Open
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22
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Gültepe B, Dülger AC, Gültepe İ, Karadas S, Ebinç S, Esen R. Higher seroprevalence of hepatitis B virus antigen in patients with cystic hydatid disease than in patients referred to internal medicine clinics in Turkey. Korean J Parasitol 2014; 52:47-9. [PMID: 24623881 PMCID: PMC3948993 DOI: 10.3347/kjp.2014.52.1.47] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Revised: 10/13/2013] [Accepted: 11/07/2013] [Indexed: 11/23/2022]
Abstract
Turkey remains an intermediate area for prevalence of hepatitis B virus (HBV) surface antigenemia. The sheep-raising areas of Turkey also pose a high risk for cystic hydatid disease (CHD). Both HBV infection and CHD are major public health issues particularly in eastern parts of Turkey; however, there is no data regarding HBV infection in patients who have had CHD. The aims of this study were to evaluate the association between HBV infection and CHD and suggest ways to reduce HBV infection which is still widespread in Turkey. A retrospective study was conducted with 94 adult patients with active CHD referred to the hepatology department, Yuzuncuyil University School of Medicine from December 2010 to December 2012. All subjects came from rural areas of the region and underwent ultrasonography of abdomen which detected CHD of the liver. All the patients were serologically positive for Echinococcus granulosus. The control group consisted of 500 patients (300 men and 200 women) referred to the internal medicine clinics for other reasons. The patients with CHD and in the control group were tested for the existence of HBs antigen according to the standard procedures. The seroprevalence of HBs antigen was significantly higher in patients with active CHD than those in the control group (12.7% vs 5.2%; P=0.0017). Our data indicate that there is significant association between HBV infection and CHD. All patients with CHD should be screened for HBV infection.
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Affiliation(s)
- Bilge Gültepe
- Division of Microbiology, Yuzuncu Yil University, School of Medicine, 65100 Zeve Kampus, Turkey
| | - Ahmet Cumhur Dülger
- Division of Gastroenterology, Yuzuncu Yil University, School of Medicine, 65100 Zeve Kampus, Turkey
| | - İlhami Gültepe
- Van Lokman Hekim Hospital, Division of internal Medicine, Turkey
| | - Sevdegul Karadas
- Division of Emergency Medicine, Yuzuncu Yil University, School of Medicine, 65100 Zeve Kampus, Turkey
| | - Senar Ebinç
- Division of Gastroenterology, Yuzuncu Yil University, School of Medicine, 65100 Zeve Kampus, Turkey
| | - Ramazan Esen
- Division of Hematology, Yuzuncu Yil University, School of Medicine, 65100 Zeve Kampus, Turkey
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