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Taşçı EŞ, Kutlu Y, Ölmez ÖF, Mutlu AU, Gündoğdu Y, Seyyar M, Şahin E, Çabuk D, Majidova N, Uğurlu İ, Demirci A, Aydın D, Çavdar E, Bayram S, Yıldırım N, Karataş F, Eryılmaz MK, Çağlayan D, Menekşe S, Kut E, Arak H, Keser M, Sunar V, Perkin P, Şakalar T, Oyan B, Sönmez Ö, Özer L, Yıldız İ. Efficacy of adjuvant capecitabine in residual triple negative breast cancer: a multicenter observational Turkish Oncology Group (TOG) study. Expert Opin Pharmacother 2024; 25:477-484. [PMID: 38568074 DOI: 10.1080/14656566.2024.2337261] [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: 11/08/2023] [Accepted: 03/26/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Triple negative breast cancer (TNBC) is characterized by high rates of recurrence, especially in patients with residual disease after neoadjuvant chemotherapy (NAC). Capecitabine is being used as standard adjuvant treatment in residual TNBC. We aimed to investigate the real-life data regarding the efficacy of capecitabine in residual TNBC. DESIGN AND METHODS In this retrospective multicenter study, TNBC patients with residual disease were evaluated. Patients, who received standard anthracycline and taxane-based NAC and adjuvant capecitabine were eligible. Overall survival (OS), disease free survival (DFS) and toxicity were analyzed. RESULTS 170 TNBC patients with residual disease were included. Of these, 62.9% were premenopausal. At the time of analysis, the recurrence rate was 30% and death rate was 18%. The 3-year DFS and OS were 66% and 74%, respectively. In patients treated with adjuvant capecitabine, residual node positive disease stood out as an independent predictor of DFS (p = 0.024) and OS (p = 0.032). Undergoing mastectomy and the presence of T2 residual tumor was independent predictors of DFS (p = 0.016) and OS (p = 0.006), respectively. CONCLUSION The efficacy of capecitabine was found lower compared to previous studies. Selected patients may have further benefit from addition of capecitabine. The toxicity associated with capecitabine was found lower than anticipated.
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Affiliation(s)
- Elif Şenocak Taşçı
- Department of Medical Oncology, Kanuni Sultan Süleyman Education and Research Hospital, Istanbul, Turkey
| | - Yasin Kutlu
- Department of Medical Oncology, Medipol University, Istanbul, Turkey
| | - Ömer Fatih Ölmez
- Department of Medical Oncology, Medipol University, Istanbul, Turkey
| | - Arda Ulaş Mutlu
- Department of Medicine, Acıbadem MAA University, Istanbul, Turkey
| | - Yasemin Gündoğdu
- Department of Internal Medicine, Acıbadem MAA University, Istanbul, Turkey
| | - Mustafa Seyyar
- Department of Medical Oncology, Kocaeli University, Kocaeli, Turkey
| | - Elif Şahin
- Department of Medical Oncology, Kocaeli University, Kocaeli, Turkey
| | - Devrim Çabuk
- Department of Medical Oncology, Kocaeli University, Kocaeli, Turkey
| | - Nargiz Majidova
- Department of Medical Oncology, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - İrem Uğurlu
- Department of Medical Oncology, Sakarya University Research and Education Hospital, Sakarya, Turkey
| | - Ayşe Demirci
- Department of Medical Oncology, Sakarya University Research and Education Hospital, Sakarya, Turkey
| | - Dinçer Aydın
- Department of Medical Oncology, Derince Education and Research Hospital, Kocaeli, Turkey
| | - Eyyüp Çavdar
- Department of Medical Oncology, Namık Kemal University, Tekirdağ, Turkey
| | - Selami Bayram
- Department of Medical Oncology, Antalya Education and Research Hospital, Antalya, Turkey
| | - Nilgün Yıldırım
- Department of Medical Oncology, Fırat University Faculty of Medicine, Elazığ, Turkey
| | - Fatih Karataş
- Department of Medical Oncology, Karabük University Faculty of Medicine, Karabük, Turkey
| | - Melek Karakurt Eryılmaz
- Meram Faculty of Medicine, Department of Medical Oncology, Necmettin Erbakan University, Konya, Turkey
| | - Dilek Çağlayan
- Meram Faculty of Medicine, Department of Medical Oncology, Necmettin Erbakan University, Konya, Turkey
| | - Serkan Menekşe
- Department of Medical Oncology, Manisa City Hospital, Manisa, Turkey
| | - Engin Kut
- Department of Medical Oncology, Manisa City Hospital, Manisa, Turkey
| | - Hacı Arak
- Department of Medical Oncology, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
| | - Murat Keser
- Department of Medical Oncology, Tepecik Training and Research Hospital, Istanbul, Turkey
| | - Veli Sunar
- Department of Medical Oncology, Aydın Atatürk Public Hospital, Aydın, Turkey
| | - Perihan Perkin
- Department of Medical Oncology, Ankara City Hospital, Ankara, Turkey
| | - Teoman Şakalar
- Department of Medical Oncology, Necip Fazıl City Hospital, Kahramanmaraş, Turkey
| | - Başak Oyan
- Department of Medical Oncology, Acıbadem MAA University, Istanbul, Turkey
| | - Özlem Sönmez
- Department of Medical Oncology, Acıbadem MAA University, Istanbul, Turkey
| | - Leyla Özer
- Department of Medical Oncology, Acıbadem MAA University, Istanbul, Turkey
| | - İbrahim Yıldız
- Department of Medical Oncology, Acıbadem MAA University, Istanbul, Turkey
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Unal OU, Akay S, Gul G, Keser M, Ozamrak BG, Solakoglu Kahraman D, Erdogan M. Impact of HER2-Low status in metastatic gastric cancer:A real-world retrospective cohort study. Oncology 2024:000537839. [PMID: 38354717 DOI: 10.1159/000537839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 02/08/2024] [Indexed: 02/16/2024]
Abstract
INTRODUCTION Information regarding HER2-low tumors in metastatic gastric cancer is sparse. Our aim here was to determine the frequency of low HER2 expression in metastatic gastric cancer and to compare the clinicopathological characteristics, survival, and treatment response of HER2-low patients with HER2-zero patients. METHODS All the data were collected retrospectively from computerized system of the hospital. We categorized the patients according to clinicopathological features, treatment responses, and survival in terms of HER2-low tumors and HER2-zero tumors. RESULTS Of 226 patients, 71 (31.4%) had low HER2 expression and 155 (68.6%) had zero HER2 expression. HER2-low tumors were detected more frequently in older patients and in low-grade tumors than HER2-zero tumors (69% vs 47.7%, P = 0.003, 16.9% vs 3.8%, P < 0.001). All patients received a first-line chemotherapy regimen. The disease control rate was not statistically different between both groups (40% vs 46.4%, P=0.11). The median survival was 12.05 (95% CI, 8.09-16.02) months in HER2-low patients, and 10.41 (95% CI, 8.52-12.3) months in HER20-zero patients with no statistical difference (P=0.73). CONCLUSION HER2-low metastatic gastric cancer has a higher rate of being low-grade than HER2-zero tumors. HER2-low metastatic gastric cancer is similar to HER2-zero in terms of chemotherapy response and survival.
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Karaali C, Emiroğlu M, Değirmenci M, Keser M, Salimoğlu S, Kelten Talu C. The Clinical and Pathological Characteristics That Differentiate Cases With "Low Estrogen Receptor Expression" From Triple-Negative Breast Cancer. Eur J Breast Health 2024; 20:19-24. [PMID: 38187108 PMCID: PMC10765462 DOI: 10.4274/ejbh.galenos.2023.2023-6-3] [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: 07/03/2023] [Accepted: 10/31/2023] [Indexed: 01/09/2024]
Abstract
Objective Estrogen receptor (ER) expression is an immunohistochemical marker that is examined in all invasive breast cancers and has prognostic and predictive value. ER-positive breast cancers refer to those that show positivity for ER at 1% cellular expression or higher. The American Society of Clinical Oncology/College of American Pathologists guidelines suggest using the term "low ER-positive breast cancer" for tumors with ER expression between 1% and 10%. Low ER-positive breast cancers exhibit similarities, in terms of disease-free survival and overall survival rates, to triple-negative breast cancers (TNBCs) rather than ER-positive breast cancers. In this study, our aim was to compare the clinicopathological characteristics of low ER-positive breast cancer cases diagnosed and followed in our clinic with TNBCs. Materials and Methods A total of 26 cases of low ER-positive breast cancer diagnosed at University of Health Sciences Turkey, İzmir Tepecik Training and Research Hospital between 2010 and 2016 were retrieved from hospital records. The relevant histopathology slides and blocks were retrieved and re-evaluated retrospectively through microscopic examination. Thirteen cases that met the criteria were included in the study. Additionally, a consecutive series of 13 TNBC cases that did not receive neoadjuvant treatment within the same time period were identified. Results In the low ER-positive group, the presence of tumor necrosis, as well as histological grade, nuclear grade and Ki-67 proliferation index were significantly lower compared to the TNBC group. Ductal carcinoma in situ (DCIS) was significantly more common in the low ER-positive group compared to the TNBC group. There were no significant differences between the two groups in terms of tumor size, histological tumor type, axillary lymph node involvement, tumor margins, peritumoral and intratumoral inflammation, local recurrence, distant metastasis, survival, and other characteristics. Conclusion Although our study consisted of a small number of cases, some features showed significant differences between low ER-positive breast cancers and TNBCs. Histological and nuclear grades, as well as the presence of a DCIS component, were associated with low ER-positive breast cancer. In contrast, the presence of tumor necrosis, as well as Grade 3 features and a high Ki-67 proliferation index indicated TNBC.
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Affiliation(s)
- Cem Karaali
- Department of General Surgery, İzmir Faculty of Medicine, University of Health Sciences Turkey, İzmir, Turkey
| | - Mümin Emiroğlu
- Department of Medical Pathology, İzmir Faculty of Medicine, University of Health Sciences Turkey, İzmir, Turkey
| | - Mustafa Değirmenci
- Department of Medical Oncology, İzmir Faculty of Medicine, University of Health Sciences Turkey, İzmir, Turkey
| | - Murat Keser
- Department of Medical Oncology, İzmir Faculty of Medicine, University of Health Sciences Turkey, İzmir, Turkey
| | - Semra Salimoğlu
- Department of General Surgery, İzmir Faculty of Medicine, University of Health Sciences Turkey, İzmir, Turkey
| | - Canan Kelten Talu
- Department of Medical Pathology, İzmir Faculty of Medicine, University of Health Sciences Turkey, İzmir, Turkey
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Caliskan Yildirim E, Atag E, Coban E, Umit Unal O, Celebi A, Keser M, Uzun M, Keskinkilic M, Tanrikulu Simsek E, Sari M, Yavuzsen T. The effect of low HER2 expression on treatment outcomes in metastatic hormone receptor positive breast cancer patients treated with a combination of a CDK4/6 inhibitor and endocrine therapy: A multicentric retrospective study. Breast 2023; 70:56-62. [PMID: 37343321 PMCID: PMC10382953 DOI: 10.1016/j.breast.2023.06.006] [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: 05/09/2023] [Revised: 06/12/2023] [Accepted: 06/13/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND CDK4/6 inhibitors combined with endocrine therapy have significantly improved treatment outcomes for metastatic hormone receptor-positive (HR+) breast cancer patients. However, the impact of low HER2 expression on treatment response and progression-free survival (PFS) remains unclear. METHODS This multicenter retrospective study included 204 HR+ breast cancer patients treated with a combination of CDK4/6 inhibitor and endocrine therapy. HER2-zero disease was detected in 138 (68%) and HER2-low disease in 66 (32%) patients. Treatment-related characteristics and clinical outcomes were analyzed, with a median follow-up of 22 months. RESULTS The objective response rate (ORR) was 72.7% in the HER2 low group and 66.6% in the HER2 zero group (p = 0.54). Median PFS was not significantly different between the HER2-low and HER2 zero groups (19 months vs.18 months, p = 0.89), although there was a trend toward longer PFS in the HER2-low group for first-line treatment (24 months progression-free survival rate 63% vs 49%). In recurrent disease, the median PFS was 25 months in the HER2-low group and 12 months in the HER2-zero group (p = 0.08), while in de novo metastatic disease, the median PFS was 18 months in the HER2-low group and 27 months in the HER2-zero group (p = 0.16). The order of CDK4/6 inhibitor use and the presence of visceral metastasis were identified as independent variables affecting PFS. CONCLUSION Low HER2 expression did not significantly impact treatment response or PFS in HR+ breast cancer patients treated with a CDK4/6 inhibitor and endocrine therapy. Because of the conflicting results in the literature, further prospective studies are needed to evaluate the clinical significance of HER2 expression in HR+ breast cancer.
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Affiliation(s)
- Eda Caliskan Yildirim
- Dokuz Eylul University, Department of Internal Medicine, Division of Medical Oncology, Izmir, Turkey.
| | - Elif Atag
- Dokuz Eylul University, Department of Internal Medicine, Division of Medical Oncology, Izmir, Turkey
| | - Ezgi Coban
- Haydarpasa Numune Training and Research Hospital, Department of Medical Oncology, Istanbul, Turkey
| | - Olcun Umit Unal
- Health Sciences University Izmir Faculty of Medicine, Department of Internal Medicine, Izmir, Turkey
| | - Abdussamet Celebi
- Marmara University Pendik Training and Research Hospital, Department of Medical Oncology, Istanbul, Turkey
| | - Murat Keser
- Health Sciences University Tepecik Training and Research Hospital, Department of Medical Oncology, Izmir, Turkey
| | - Mehmet Uzun
- Dokuz Eylul University, Department of Internal Medicine, Division of Medical Oncology, Izmir, Turkey
| | - Merve Keskinkilic
- Dokuz Eylul University, Department of Internal Medicine, Division of Medical Oncology, Izmir, Turkey
| | - Eda Tanrikulu Simsek
- Haydarpasa Numune Training and Research Hospital, Department of Medical Oncology, Istanbul, Turkey
| | - Murat Sari
- Marmara University Pendik Training and Research Hospital, Department of Medical Oncology, Istanbul, Turkey
| | - Tugba Yavuzsen
- Dokuz Eylul University, Department of Internal Medicine, Division of Medical Oncology, Izmir, Turkey
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5
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Kahraman S, Erul E, Seyyar M, Gumusay O, Bayram E, Demirel BC, Acar O, Aksoy S, Baytemur NK, Sahin E, Cabuk D, Basaran G, Paydas S, Yaren A, Guven DC, Erdogan AP, Demirci U, Yasar A, Bayoglu İV, Hizal M, Gulbagci B, Paksoy N, Davarci SE, Yilmaz F, Dogan O, Orhan SO, Kayikcioglu E, Aytac A, Keskinkilic M, Mocan EE, Unal OU, Aydin E, Yucel H, Isik D, Eren O, Uluc BO, Ozcelik M, Hacibekiroglu I, Aydiner A, Demir H, Oksuzoglu B, Cilbir E, Cubukcu E, Cetin B, Oktay E, Erol C, Okutur SK, Yildirim N, Alkan A, Selcukbiricik F, Aksoy A, Karakas Y, Ozkanli G, Duman BB, Aydin D, Dulgar O, Er MM, Teker F, Yavuzsen T, Aykan MB, Inal A, Iriagac Y, Kalkan NO, Keser M, Sakalar T, Menekse S, Kut E, Bilgin B, Karaoglanoglu M, Sunar V, Ozdemir O, Turhal NS, Karadurmus N, Yalcin B, Nahit Sendur MA. Treatment efficacy of ribociclib or palbociclib plus letrozole in hormone receptor-positive/HER2-negative metastatic breast cancer. Future Oncol 2023; 19:727-736. [PMID: 37133230 DOI: 10.2217/fon-2022-1287] [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: 05/04/2023] Open
Abstract
Background: Ribociclib, palbociclib and abemaciclib are currently approved CDK4/6 inhibitors along with aromatase inhibitors as the first-line standard-of-care for patients with hormone receptor-positive, HER2-negative metastatic breast cancer. Methods: The authors report retrospective real-life data for 600 patients with estrogen receptor- and/or progesterone receptor-positive and HER2-negative metastatic breast cancer who were treated with ribociclib and palbociclib in combination with letrozole. Results & conclusion: The results demonstrated that the combination of palbociclib or ribociclib with letrozole has similar progression-free survival and overall survival benefit in real life for the patient group with similar clinical features. Specifically, endocrine sensitivity may be a factor to be considered in the treatment preference.
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Affiliation(s)
- Seda Kahraman
- Department of Medical Oncology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, 06800, Turkey
| | - Enes Erul
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, 06590, Turkey
| | - Mustafa Seyyar
- Department of Medical Oncology, Kocaeli University Medical Faculty Hospital, Kocaeli, 41000, Turkey
| | - Ozge Gumusay
- Department of Medical Oncology, Acibadem University, School of Medicine, Istanbul, 34750, Turkey
| | - Ertugrul Bayram
- Department of Medical Oncology, Cukurova University, Adana, 01330, Turkey
| | - Burcin Cakan Demirel
- Department of Medical Oncology, Pamukkale University Hospital, Denizli, 20160, Turkey
| | - Omer Acar
- Department of Medical Oncology, Manisa Celal Bayar University Hospital, Mersin, 45120, Turkey
| | - Sercan Aksoy
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, 06590, Turkey
| | | | - Elif Sahin
- Department of Medical Oncology, Kocaeli University Medical Faculty Hospital, Kocaeli, 41000, Turkey
| | - Devrim Cabuk
- Department of Medical Oncology, Kocaeli University Medical Faculty Hospital, Kocaeli, 41000, Turkey
| | - Gul Basaran
- Department of Medical Oncology, Acibadem University, School of Medicine, Istanbul, 34750, Turkey
| | - Semra Paydas
- Department of Medical Oncology, Cukurova University, Adana, 01330, Turkey
| | - Arzu Yaren
- Department of Medical Oncology, Pamukkale University Hospital, Denizli, 20160, Turkey
| | - Deniz Can Guven
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, 06590, Turkey
| | - Atike Pinar Erdogan
- Department of Medical Oncology, Manisa Celal Bayar University Hospital, Mersin, 45120, Turkey
| | - Umut Demirci
- Department of Medical Oncology, Ankara Memorial Hospital, Ankara, 06520, Turkey
| | - Alper Yasar
- Department of Medical Oncology, Marmara University Pendik Research & Application Hospital, Istanbul, 34899, Turkey
| | - İbrahim Vedat Bayoglu
- Department of Medical Oncology, Marmara University Pendik Research & Application Hospital, Istanbul, 34899, Turkey
| | - Mutlu Hizal
- Department of Medical Oncology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, 06800, Turkey
| | - Burcu Gulbagci
- Department of Medical Oncology, Sakarya University School of Medicine, Sakarya, 54187, Turkey
| | - Nail Paksoy
- Department of Medical Oncology, Istanbul University, Istanbul, 34093, Turkey
| | - Sena Ece Davarci
- Department of Medical Oncology, Afyonkarahisar Health Sciences University, Afyonkarahisar, 03200, Turkey
| | - Funda Yilmaz
- Department of Medical Oncology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training & Research Hospital, Ankara, 06200, Turkey
| | - Ozlem Dogan
- Department of Medical Oncology, Ankara Etlik City Hospital, Ankara, 06170, Turkey
| | - Sibel Oyucu Orhan
- Department of Medical Oncology, Uludag University, Bursa, 16059, Turkey
| | - Erkan Kayikcioglu
- Department of Medical Oncology, Suleyman Demirel University, Isparta, 32260, Turkey
| | - Ali Aytac
- Department of Medical Oncology, Aydin Adnan Menderes University Training & Research Hospital, Aydin, 09100, Turkey
| | - Merve Keskinkilic
- Department of Medical Oncology, Dokuz Eylül University Research & Application Hospital, Izmir, 35340, Turkey
| | - Eda Eylemer Mocan
- Department Of Medical Oncology, Ankara University, Ankara, 06080, Turkey
| | - Olcun Umit Unal
- Department of Medical Oncology, Tepecik Training & Research Hospital, Izmir, 35180, Turkey
| | - Esra Aydin
- Department of Medical Oncology, Recep Tayyip Erdoğan University Training & Research Hospital, Rize, 53020, Turkey
| | - Hakan Yucel
- Department of Medical Oncology, Gaziantep University, Gaziantep, 27580, Turkey
| | - Deniz Isik
- Department of Medical Oncology, Kocaeli Medical Park Hospital, Kocaeli, 41140, Turkey
| | - Onder Eren
- Department of Medical Oncology, Selcuk University Medical Faculty Hospital, Konya, 42250, Turkey
| | - Basak Oyan Uluc
- Department of Medical Oncology, Acibadem University, School of Medicine, Istanbul, 34750, Turkey
| | - Melike Ozcelik
- Department of Medical Oncology, Umraniye Training & Research Hospital, Istanbul, 34764, Turkey
| | - Ilhan Hacibekiroglu
- Department of Medical Oncology, Sakarya University School of Medicine, Sakarya, 54187, Turkey
| | - Adnan Aydiner
- Department of Medical Oncology, Istanbul University, Istanbul, 34093, Turkey
| | - Hacer Demir
- Department of Medical Oncology, Afyonkarahisar Health Sciences University, Afyonkarahisar, 03200, Turkey
| | - Berna Oksuzoglu
- Department of Medical Oncology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training & Research Hospital, Ankara, 06200, Turkey
| | - Ebru Cilbir
- Department of Medical Oncology, Ankara Etlik City Hospital, Ankara, 06170, Turkey
| | - Erdem Cubukcu
- Department of Medical Oncology, Uludag University, Bursa, 16059, Turkey
| | - Bulent Cetin
- Department of Medical Oncology, Suleyman Demirel University, Isparta, 32260, Turkey
| | - Esin Oktay
- Department of Medical Oncology, Aydin Adnan Menderes University Training & Research Hospital, Aydin, 09100, Turkey
| | - Cihan Erol
- Department of Medical Oncology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, 06800, Turkey
| | - Sadi Kerem Okutur
- Department of Medical Oncology, Istanbul Arel University, Bahcelievler Memorial Hospital, Istanbul, 34537, Turkey
| | - Nilgun Yildirim
- Department of Medical Oncology, Firat University Hospital, Elazig, 23200, Turkey
| | - Ali Alkan
- Department of Medical Oncology, Muğla Sıtkı Koçman University Training & Research Hospital, Mugla, 48000, Turkey
| | - Fatih Selcukbiricik
- Department of Medical Oncology, Koç University Hospital, Istanbul, 34010, Turkey
| | - Asude Aksoy
- Department of Medical Oncology, Elazig Fethi Sekin City Hospital, Elazig, 23280, Turkey
| | - Yusuf Karakas
- Department of Medical Oncology, Acıbadem Bodrum Hospital, Mugla, 48420, Turkey
| | - Gulhan Ozkanli
- Department of Medical Oncology, Canakkale Onsekiz Mart University Research & Practice Hospital, Canakkale, 17100, Turkey
| | - Berna Bozkurt Duman
- Department of Medical Oncology, Adana City Training & Research Hospital, Adana, 01230, Turkey
| | - Dincer Aydin
- Department of Medical Oncology, Kocaeli Derince Training & Research Hospital, Kocaeli, 41310, Turkey
| | - Ozgecan Dulgar
- Department of Medical Oncology, Kahramanmaras Necip Fazil City Hospital, Kahramanmaras, 46050, Turkey
| | - Muhammed Muhiddin Er
- Department of Medical Oncology, Necmettin Erbakan University Meram Medical Faculty Hospital, Konya, 42080, Turkey
| | - Fatih Teker
- Department of Medical Oncology, Gaziantep University, Gaziantep, 27580, Turkey
| | - Tugba Yavuzsen
- Department of Medical Oncology, Dokuz Eylül University Research & Application Hospital, Izmir, 35340, Turkey
| | - Musa Baris Aykan
- Department of Medical Oncology, Gulhane Training & Research Hospital, Ankara, 06010, Turkey
| | - Ali Inal
- Department of Medical Oncology, Mersin City Hospital, Mersin, 96015, Turkey
| | - Yakup Iriagac
- Department of Medical Oncology, Namik Kemal University Health Application & Research Hospital, Tekirdag, 59030, Turkey
| | - Nurhan Onal Kalkan
- Department of Medical Oncology, Van Yüzüncü Yıl University Dursun Odabas Hospital, Van, 65090, Turkey
| | - Murat Keser
- Department of Medical Oncology, Tepecik Training & Research Hospital, Izmir, 35180, Turkey
| | - Teoman Sakalar
- Department of Medical Oncology, Kahramanmaras Necip Fazil City Hospital, Kahramanmaras, 46050, Turkey
| | - Serkan Menekse
- Department of Medical Oncology, Manisa City Hospital, Manisa, 45040, Turkey
| | - Engin Kut
- Department of Medical Oncology, Manisa City Hospital, Manisa, 45040, Turkey
| | - Burak Bilgin
- Department of Medical Oncology, Konya City Hospital, Konya, 42020, Turkey
| | - Muge Karaoglanoglu
- Department of Medical Oncology, Ordu State Hospital, Ordu, 52200, Turkey
| | - Veli Sunar
- Department of Medical Oncology, Aydin Ataturk State Hospital, Aydin, 09020, Turkey
| | - Ozlem Ozdemir
- Department of Medical Oncology, Izmir Bozyaka Training & Research Hospital, Izmir, 35170, Turkey
| | - Nazim Serdar Turhal
- Department of Medical Oncology, Anadolu Medical Center, Istanbul, 34758, Turkey
| | - Nuri Karadurmus
- Department of Medical Oncology, Gulhane Training & Research Hospital, Ankara, 06010, Turkey
| | - Bulent Yalcin
- Department of Medical Oncology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, 06800, Turkey
| | - Mehmet Ali Nahit Sendur
- Department of Medical Oncology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, 06800, Turkey
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Calderaro F, Keser M, Akeroyd M, Bevers LE, Eijsink VGH, Várnai A, van den Berg MA. Characterization of an AA9 LPMO from Thielavia australiensis, TausLPMO9B, under industrially relevant lignocellulose saccharification conditions. Biotechnol Biofuels 2020; 13:195. [PMID: 33292403 PMCID: PMC7706046 DOI: 10.1186/s13068-020-01836-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 11/19/2020] [Indexed: 05/02/2023]
Abstract
BACKGROUND The discovery of lytic polysaccharide monooxygenases (LPMO) has changed our perspective on enzymatic degradation of plant biomass. Through an oxidative mechanism, these enzymes are able to cleave and depolymerize various polysaccharides, acting not only on crystalline substrates such as chitin and cellulose, but also on other polysaccharides, such as xyloglucan, glucomannan and starch. Despite their widespread use, uncertainties related to substrate specificity and stereospecificity, the nature of the co-substrate, in-process stability, and the nature of the optimal reductant challenge their exploitation in biomass processing applications. RESULTS In this work, we studied the properties of a novel fungal LPMO from the thermophilic fungus Thielavia australiensis, TausLPMO9B. Heterologous expression of TausLPMO9B in Aspergillus niger yielded a glycosylated protein with a methylated N-terminal histidine showing LPMO activity. High sequence identity of the AA9 domain to that of MtLPMO9B (MYCTH_80312) from Myceliophthora thermophila (84%) indicated strictly C1-oxidizing activity on cellulose, which was confirmed experimentally by the analysis of products released from cellulose using HPAEC. The enzyme was stable and active at a pH ranging from 4 to 6, thus matching the conditions commonly used in industrial biomass processing, where a low pH (between 4 and 5) is used due to the pH-optima of commercial cellulases and a desire to limit microbial contamination. CONCLUSION While the oxidative cleavage of phosphoric acid swollen cellulose (PASC) by TausLPMO9B was boosted by the addition of H2O2 as a co-substrate, this effect was not observed during the saccharification of acid pretreated corn stover. This illustrates key differences between the lab-scale tests with artificial, lignin-free substrates and industrial settings with lignocellulosic biomass as substrate.
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Affiliation(s)
- F Calderaro
- DSM Biotechnology Center, PP 699-0310, Alexander Fleminglaan 1, 2613 AX, Delft, The Netherlands.
- Molecular Enzymology, Groningen Biomolecular Sciences and Biotechnology Institute, University of Groningen, Groningen, The Netherlands.
| | - M Keser
- DSM Biotechnology Center, PP 699-0310, Alexander Fleminglaan 1, 2613 AX, Delft, The Netherlands
| | - M Akeroyd
- DSM Biotechnology Center, PP 699-0310, Alexander Fleminglaan 1, 2613 AX, Delft, The Netherlands
| | - L E Bevers
- DSM Biotechnology Center, PP 699-0310, Alexander Fleminglaan 1, 2613 AX, Delft, The Netherlands
| | - V G H Eijsink
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences (NMBU), Ås, Norway
| | - A Várnai
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences (NMBU), Ås, Norway
| | - M A van den Berg
- DSM Biotechnology Center, PP 699-0310, Alexander Fleminglaan 1, 2613 AX, Delft, The Netherlands
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Oktay E, Levent M, Gelincik H, Aktaş G, Yumuk F, Koral L, Arpacı E, Keser M, Alkan A, Karci E, Karadurmuş N, Degirmencioglu S, Turan M, Uyeturk U, Cabuk D, Avci N, Toprak O, Ergen A, Urvay S, Bayman E, Petekkaya E, Nayir E, Paydaş S, Yavuzsen T, Senler FC, Yaren A, Barutca S, Şahinler İ, Ozyilkan O, Tanriverdi O. Perspective of Turkish Medicine Students on Cancer, Cancer Treatments, Palliative Care, and Oncologists (ARES Study): a Study of the Palliative Care Working Committee of the Turkish Oncology Group (TOG). J Cancer Educ 2020; 35:69-75. [PMID: 30446981 DOI: 10.1007/s13187-018-1441-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Cancer is one of the most common causes of death all over the World (Rahib et al. in Cancer Res 74(11):2913-2921, 2014; Silbermann et al. in Ann Oncol 23(Suppl 3):iii15-iii28, 2012). It is crucial to diagnose this disease early by effective screening methods and also it is very important to acknowledge the community on various aspects of this disease such as the treatment methods and palliative care. Not only the oncologists but every medical doctor should be educated well in dealing with cancer patients. Previous studies suggested various opinions on the level of oncology education in medical schools (Pavlidis et al. in Ann Oncol 16(5):840-841, 2005). In this study, the perspectives of medical students on cancer, its treatment, palliative care, and the oncologists were analyzed in relation to their educational status. A multicenter survey analysis was performed on a total of 4224 medical school students that accepted to enter this study in Turkey. After the questions about the demographical characteristics of the students, their perspectives on the definition, diagnosis, screening, and treatment methods of cancer and their way of understanding metastatic disease as well as palliative care were analyzed. The questionnaire includes questions with answers and a scoring system of Likert type 5 (absolutely disagree = 1, completely agree = 5). In the last part of the questionnaire, there were some words to detect what the words "cancer" and "oncologist" meant for the students. The participant students were analyzed in two study groups; "group 1" (n = 1.255) were phases I and II students that had never attended an oncology lesson, and "group 2" (n = 2.969) were phases III to VI students that had attended oncology lessons in the medical school. SPSS v17 was used for the database and statistical analyses. A value of p < 0.05 was noted as statistically significant. Group 1 defined cancer as a contagious disease (p = 0.00025), they believed that early diagnosis was never possible (p = 0.042), all people with a diagnosis of cancer would certainly die (p = 0.044), and chemotherapy was not successful in a metastatic disease (p = 0.003) as compared to group 2. The rate of the students that believed gastric cancer screening was a part of the national screening policy was significantly more in group 1 than in group 2 (p = 0.00014). Group 2 had a higher anxiety level for themselves or their family members to become a cancer patient. Most of the students in both groups defined medical oncologists as warriors (57% in group 1 and 40% in group 2; p = 0.097), and cancer was reminding them of "death" (54% in group 1 and 48% in group 2; p = 0.102). This study suggested that oncology education was useful for the students' understanding of cancer and related issues; however, the level of oncology education should be improved in medical schools in Turkey. This would be helpful for medical doctors to cope with many aspects of cancer as a major health care problem in this country.
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Affiliation(s)
- Esin Oktay
- Faculty of Medicine, Department of Medical Oncology, Adnan Menderes University, Aydın, Turkey.
| | - Mustafa Levent
- Faculty of Medicine, Department of Internal Medicine, Sıtkı Kocman University, Mugla, Turkey
| | - Hakan Gelincik
- Faculty of Medicine, Department of Medical Oncology, Cukurova University, Adana, Turkey
| | - Gizem Aktaş
- Faculty of Medicine, Department of Medical Oncology, Cukurova University, Adana, Turkey
| | - Fulden Yumuk
- Faculty of Medicine, Department of Medical Oncology, Marmara University, Istanbul, Turkey
| | - Lokman Koral
- Faculty of Medicine, Department of Medical Oncology, Onsekiz Mart University, Canakkale, Turkey
| | - Erkan Arpacı
- Faculty of Medicine, Department of Medical Oncology, Sakarya University, Sakarya, Turkey
| | - Murat Keser
- Faculty of Medicine, Department of Medical Oncolog, Dokuz Eylul University, Izmir, Turkey
| | - Ali Alkan
- Faculty of Medicine, Department of MedicalOncology, Ankara University, Ankara, Turkey
| | - Ebru Karci
- Department of Medical Oncology, Gulhane Military Medical Academy, Ankara, Turkey
| | - Nuri Karadurmuş
- Department of Medical Oncology, Gulhane Military Medical Academy, Ankara, Turkey
| | - Serkan Degirmencioglu
- Faculty of Medicine, Department of Medical Oncology, Pamukkale University, Denizli, Turkey
| | - Merve Turan
- Faculty of Medicine, Department of Medical Oncology, Adnan Menderes University, Aydın, Turkey
| | - Ummugul Uyeturk
- Faculty of Medicine, Department of Medical Oncology, Izzet Baysal University, Bolu, Turkey
| | - Devrim Cabuk
- Faculty of Medicine, Department of Medical Oncology, Kocaeli University, Izmit, Turkey
| | - Nilufer Avci
- Faculty of Medicine, Department of Medical Oncology, Balıkesir University, Balıkesir, Turkey
| | - Omer Toprak
- Faculty of Medicine, Department of Internal Medicine, Balıkesir University, Balıkesir, Turkey
| | - Arzu Ergen
- Cerrahpasa Faculty of Medicine, Department of Radiation Oncology, Istanbul University, Istanbul, Turkey
| | - Semiha Urvay
- Faculty of Medicine, Department of Medical Oncology, Cumhuriyet University, Sivas, Turkey
| | - Evrim Bayman
- Faculty of Medicine, Department of Radiation Oncology, Osmangazi University, Eskisehir, Turkey
| | - Emine Petekkaya
- Faculty of Medicine, Department of Anatomy, Beykent University, Istanbul, Turkey
| | - Erdinç Nayir
- Department of Medical Oncology, Mersin Medicalpark Hospital, Mersin, Turkey
| | - Semra Paydaş
- Faculty of Medicine, Department of Medical Oncology, Cukurova University, Adana, Turkey
| | - Tugba Yavuzsen
- Faculty of Medicine, Department of Medical Oncolog, Dokuz Eylul University, Izmir, Turkey
| | - Filiz Cay Senler
- Faculty of Medicine, Department of MedicalOncology, Ankara University, Ankara, Turkey
| | - Arzu Yaren
- Faculty of Medicine, Department of Medical Oncology, Pamukkale University, Denizli, Turkey
| | - Sabri Barutca
- Faculty of Medicine, Department of Medical Oncology, Adnan Menderes University, Aydın, Turkey
| | - İsmet Şahinler
- Cerrahpasa Faculty of Medicine, Department of Radiation Oncology, Istanbul University, Istanbul, Turkey
| | - Ozgur Ozyilkan
- Faculty of Medicine, Department of Medical Oncology, Başkent University, Ankara, Turkey
| | - Ozgur Tanriverdi
- Faculty of Medicine, Department of Medical Oncology, Mugla Sıtkı Kocman University, Mugla, Turkey
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Atag E, Mutlay F, Soysal P, Semiz HS, Kazaz SN, Keser M, Ellidokuz H, Karaoglu A. Prevalence of depressive symptoms in elderly cancer patients receiving chemotherapy and influencing factors. Psychogeriatrics 2018; 18:365-370. [PMID: 29998465 DOI: 10.1111/psyg.12329] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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: 07/25/2017] [Revised: 12/12/2017] [Accepted: 02/03/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Depression is one of the most prevalent causes of distress in the geriatric population. The purpose of this study was to examine the prevalence of depressive symptoms in elderly cancer patients and to determine the possible associated factors. METHODS Cancer patients 65 years or older and on active chemotherapy completed the Yesavage Geriatric Depression Scale. We examined the relationship of depressive symptoms with age, gender, marital status, educational background, type of cancer, stage of disease, comorbidities, types of treatment for cancer, the duration after diagnosis of cancer, social support, and pain status. RESULTS The study included 170 patients with a mean age of 71 years, and 47.1% were women. The prevalence of a high depressive symptom score was 19.4%. Of the patients who had a high depressive symptom score based on the Yesavage Geriatric Depression Scale, 18.2% had already been diagnosed with depression and used antidepressants. The mean pain score was significantly higher in patients who had a high depressive symptom score compared to others (P = 0.012). CONCLUSION The prevalence of depressive symptoms in elderly cancer patients receiving chemotherapy was similar to that in the geriatric population without cancer. It was also consistent with previous studies on elderly cancer population. Pain was found to be a factor related to depressive symptoms. The prevalence of depression may be reduced by pain control. The treatment of depression may both improve the patient's quality of life and enhance their compliance with treatment.
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Affiliation(s)
- Elif Atag
- Department of Medical Oncology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Feyza Mutlay
- Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Pinar Soysal
- Geriatric Center, Kayseri Education and Research Hospital, Kayseri, Turkey
| | - Huseyin S Semiz
- Department of Medical Oncology, Izmir Tepecik Education and Research Hospital, Izmir, Turkey
| | - Seher N Kazaz
- Department of Medical Oncology, Trabzon Kanuni Education and Research Hospital, Trabzon, Turkey
| | - Murat Keser
- Department of Medical Oncology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Hulya Ellidokuz
- Department of Biostatistics, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Aziz Karaoglu
- Department of Medical Oncology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
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Cetin P, Keser M, Solmaz D, Sen G, Zengin B, Sari I, Akkoc N, Onen F. AB0803 Obesity is Associated with Psoriatic Arthritis and Contributes to the Increased Use of Biologics. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4598] [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: 11/04/2022]
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Keser M, Cetin P, Solmaz D, Kozacı D, Gunay N, Oztürk S, Sarı I, Akar S, Birlik M, Akkoc N, Onen F. AB0744 There is NO Relationship between Glucagon like Peptide-1 and Inflammation in Psoriasis and Psoriatic Arthritis: Table 1. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4514] [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: 11/04/2022]
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Ozturk S, Keser M, Kozaci D, Cetin P, Gunay N, Onen F, Akkoc N, Sari I. THU0088 Fetuin-A and Its Association with Disease Activity in Psoriatic Arthritis: Table 1. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4473] [Citation(s) in RCA: 2] [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: 11/03/2022]
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Yüksekkaya H, Ozbek O, Goncu F, Keser M, Hasibe A, Harun P, Keles S. Hyperimmunoglobulin E syndrome presenting with renal abscess. J Investig Allergol Clin Immunol 2012; 22:143-145. [PMID: 22533242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Affiliation(s)
- H Yüksekkaya
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Meram Medicine of Faculty, Selcuk University, Konya, Turkey.
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Tuygun AK, Keser M, Tuygun A, Ketenci B, Sensöz Y, Balci AY, Karaci AR, Kizilay M, Yurtseven N, Yekeler I. Effects of endothelial nitric oxide synthase, interleukin-6 gene polymorphisms and asymmetric dimethylarginine levels on risk factors and lesion sites in peripheral artery disease. J Int Med Res 2009; 37:1003-10. [PMID: 19761682 DOI: 10.1177/147323000903700404] [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: 11/16/2022] Open
Abstract
This study investigated risk factors for atherosclerosis and their relationship with lesion sites. Patients (n = 160) with peripheral artery disease (PAD) completed a questionnaire regarding risk factors for PAD. Endothelial nitric oxide synthase (eNOS) and interleukin (IL)-6 gene polymorphisms and asymmetric dimethylarginine (ADMA) levels were measured. Patients with coronary artery disease had significantly higher ratios of eNOS T/C and C/C genotypes, which include the C allele, than the T/T genotype. The IL-6 gene polymorphism distribution ratios for patients with over four risk factors were significantly different compared with other patients, with a higher rate of the C/C genotype. ADMA levels did not show any significant relationship to risk factors or polymorphism. Levels were, however, slightly higher in femoral lesion sites. The results support a model in which the C/C genotype of eNOS and IL-6 gene polymorphisms promote PAD development. The eNOS C/C genotype may have an independent effect, whereas the effects of the IL-6 C/C genotype are seen in conjunction with other risk factors.
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Affiliation(s)
- A K Tuygun
- Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
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Abstract
Miniaturized triblock copolymers have been found to self-assemble into nanostructures that are highly regular in size and shape. Mushroom-shaped supramolecular structures of about 200 kilodaltons form by crystallization of the chemically identical blocks and self-organize into films containing 100 or more layers stacked in a polar arrangement. The polar supramolecular material exhibits spontaneous second-harmonic generation from infrared to green photons and has an adhesive tape-like character with nonadhesive-hydrophobic and hydrophilic-sticky opposite surfaces. The films also have reasonable shear strength and adhere tenaciously to glass surfaces on one side only. The regular and finite size of the supramolecular units is believed to be mediated by repulsive forces among some of the segments in the triblock molecules. A large diversity of multifunctional materials could be formed from regular supramolecular units weighing hundreds of kilodaltons.
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Affiliation(s)
- SI Stupp
- The authors are in the Department of Materials Science and Engineering, Department of Chemistry, Beckman Institute for Advanced Science and Technology, Materials Research Laboratory, University of Illinois at Urbana-Champaign, Urbana 61801, IL, USA
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Trompke R, Gregl A, Keser M. [On the natural course of gastric cancer]. Bruns Beitr Klin Chir (1971) 1965; 211:19-36. [PMID: 4158521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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