1
|
Güç ZG, Alacacıoğlu A, Kalender ME, Oflazoğlu U, Ünal S, Yıldız Y, Salman T, Küçükzeybek Y, Tarhan MO. HALP score and GNRI: Simple and easily accessible indexes for predicting prognosis in advanced stage NSCLC patients. The İzmir oncology group (IZOG) study. Front Nutr 2022; 9:905292. [PMID: 36061883 PMCID: PMC9437940 DOI: 10.3389/fnut.2022.905292] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 08/01/2022] [Indexed: 12/27/2022] Open
Abstract
ObjectiveThe Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) Score and the Geriatric Nutrition Risk Index (GNRI) are used as prognostic factors in different types of cancers. In this study we analyzed the prognostic value of the HALP Score and the GNRI calculated prior to first-line treatment in patients diagnosed with de novo metastatic non-small cell lung cancer (mNSCLC).Materials and methodsDe novo mNSCLC patients were retrospectively evaluated from January 2016 to December 2019. Patients with Driver’s mutation, severe comorbidities, active infection, or insufficient organ function, and those receiving anti-inflammatory treatment were excluded from the study. Optimal cut-off points for the HALP score and the GNRI were calculated with the receiver operating characteristic (ROC) curve analysis. Predictive factors for overall survival (OS) were assessed with univariate and multivariate Cox proportional hazard analyses, and OS was studied with the Kaplan–Meier analysis.ResultsThe study included 401 patients in total. In the ROC curve analysis, the cut-off points were found 23.24 (AUC = 0.928; 95% CI: 0.901–0.955, p < 0.001) for HALP, and 53.60 (AUC = 0.932; 95% CI: 0.908–0.955, p < 0.001) for GNRI. Groups with lower HALP scores and lower GNRI had significantly shorter OS compared to those with higher HALP scores and GNRIs. Univariate analysis showed that male gender, smoking, high ECOG score, low HALP score and low GNRI were associated with worse survival rates. Multivariate analysis showed that low HALP score (HR = 2.988, 95% CI: 2.065–4.324, p < 0.001); low GNRI score (HR = 2.901, 95% CI: 2.045–4.114, p < 0.001) and smoking history (HR = 1.447, 95% CI: 1.046–2.001, p = 0.025) were independent factors associated with worse OS rates.ConclusionOur study showed the HALP score and the GNRI to be of prognostic value as simple, cost-effective, and useful markers that predict OS in de novo mNSCLC patients.
Collapse
Affiliation(s)
- Zeynep Gülsüm Güç
- Department of Medical Oncology, İzmir Katip Çelebi University, Atatürk Training and Research Hospital, İzmir, Turkey
- *Correspondence: Zeynep Gülsüm Güç,
| | - Ahmet Alacacıoğlu
- Department of Medical Oncology, İzmir Katip Çelebi University, Atatürk Training and Research Hospital, İzmir, Turkey
| | - Mehmet Eren Kalender
- Department of Medical Oncology, İzmir Katip Çelebi University, Atatürk Training and Research Hospital, İzmir, Turkey
| | - Utku Oflazoğlu
- Department of Medical Oncology, İzmir Katip Çelebi University, Atatürk Training and Research Hospital, İzmir, Turkey
| | - Sinan Ünal
- Department of Medical Oncology, İzmir Katip Çelebi University, Atatürk Training and Research Hospital, İzmir, Turkey
| | - Yaşar Yıldız
- Department of Medical Oncology, İzmir Katip Çelebi University, Atatürk Training and Research Hospital, İzmir, Turkey
| | - Tarık Salman
- Department of Medical Oncology, İzmir Katip Çelebi University, Atatürk Training and Research Hospital, İzmir, Turkey
| | - Yüksel Küçükzeybek
- Department of Medical Oncology, İzmir Katip Çelebi University, Atatürk Training and Research Hospital, İzmir, Turkey
| | - Mustafa Oktay Tarhan
- Department of Medical Oncology, Institute of Oncology, Dokuz Eylül University, İzmir, Turkey
| |
Collapse
|
2
|
Güç ZG, Alacacıoğlu A, Yazır MG, Kalender ME, Ünal S, Oflazoğlu U, Yıldız Y, Salman T, Küçükzeybek Y, Ellidokuz H, Tarhan MO. Being a Cancer Patient during the Time of COVID-19: Impact of the Pandemic on the Anxiety and the Sleeping Quality of Oncology Patients. Chemotherapy 2021; 67:29-36. [PMID: 34875660 PMCID: PMC8805050 DOI: 10.1159/000520483] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 09/10/2021] [Accepted: 10/22/2021] [Indexed: 11/25/2022]
Abstract
Objective In this study, we aimed to assess anxiety and sleep quality in cancer patients treated or followed up at our clinic at the time of the outbreak of the COVID-19 pandemic. Methods Seven hundred and sixty-one patients who were either treated or followed up at our oncology clinic between April 2020 and May 2020 were included. Patients were assessed with the State-Trait Anxiety Inventory (STAI) and the Pittsburgh Sleep Quality Index (PSQI). Results Mean scores of the 761 participants were STAI, 43.45 ± 9.34 (range, 23–75), and PSQI, 5.67 ± 4.24 (range, 0–19). Quality of sleep was found bad in 447 (58.7%) (global score ≥5). Univariate analyses demonstrated statistical differences by stage of cancer, status of treatment, subgroup of treatment, monthly income, and levels of education in anxiety and sleep quality levels. Multivariate analyses showed active treatment (OR: 21.4; 95% CI: 9.08–50.4; p < 0.001) as the major independent variable that affected sleep quality; the major independent variable associated with anxiety was low income (OR: 4.43; 95% CI: 1.69–11.5; p = 0.002). Conclusion Anxiety and sleep quality levels were found comparable to pre-pandemic reports, and the pandemic was not observed to have additional negative impact on cancer patients. Also, universal basal anxiety and sleep disorder that accompany cancer or active treatment were observed in our study. The accurate effects of the pandemic can be analyzed in further studies using repeated data obtained from the same patient group.
Collapse
Affiliation(s)
- Zeynep Gülsüm Güç
- Department of Medical Oncology, Ataturk Training and Research Hospital, Izmir Katip Çelebi University, Izmir, Turkey
| | - Ahmet Alacacıoğlu
- Department of Medical Oncology, Ataturk Training and Research Hospital, Izmir Katip Çelebi University, Izmir, Turkey
| | - Merve Güleç Yazır
- Department of Internal Medicine, Ataturk Training and Research Hospital, Izmir Katip Çelebi University, Izmir, Turkey
| | - Mehmet Eren Kalender
- Department of Medical Oncology, Ataturk Training and Research Hospital, Izmir Katip Çelebi University, Izmir, Turkey
| | - Sinan Ünal
- Department of Medical Oncology, Ataturk Training and Research Hospital, Izmir Katip Çelebi University, Izmir, Turkey
| | - Utku Oflazoğlu
- Department of Medical Oncology, Ataturk Training and Research Hospital, Izmir Katip Çelebi University, Izmir, Turkey
| | - Yaşar Yıldız
- Department of Medical Oncology, Ataturk Training and Research Hospital, Izmir Katip Çelebi University, Izmir, Turkey
| | - Tarık Salman
- Department of Medical Oncology, Ataturk Training and Research Hospital, Izmir Katip Çelebi University, Izmir, Turkey
| | - Yüksel Küçükzeybek
- Department of Medical Oncology, Ataturk Training and Research Hospital, Izmir Katip Çelebi University, Izmir, Turkey
| | - Hülya Ellidokuz
- Department of Biostatistics and Medical Informatics, Dokuz Eylül University Medical Faculty, Izmir, Turkey
| | - Mustafa Oktay Tarhan
- Department of Medical Oncology, Institute of Oncology, Dokuz Eylül University, Izmir, Turkey
| |
Collapse
|
3
|
Seven MM, Ersen O, Akpancar S, Ozkan H, Turkkan S, Yıldız Y, Koca K. Effectiveness of prolotherapy in the treatment of chronic rotator cuff lesions. Orthop Traumatol Surg Res 2017; 103:427-433. [PMID: 28215611 DOI: 10.1016/j.otsr.2017.01.003] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 12/07/2016] [Accepted: 01/17/2017] [Indexed: 02/02/2023]
Abstract
BACKGROUND Rotator cuff lesions are one of the major causes of shoulder pain and dysfunction. Numerous non-surgical treatment modalities have been described for chronic rotator cuff lesions, but the debate continues over the optimal procedure. The aim of this report is to present the results of prolotherapy in the treatment of chronic refractory rotator cuff lesions. HYPOTHESIS Dextrose prolotherapy will reduce pain and improve shoulder function and patient satisfaction. MATERIAL AND METHODS We recruited 120 patients with chronic rotator cuff lesions and symptoms that persisted for longer than 6 months. Patients were divided into two groups: one treated with exercise (control group; n=60) and the other treated with prolotherapy injection (prolotherapy group; n=60). In the latter, ultrasound-guided prolotherapy injections were applied under aseptic conditions. In the former, patients received a physiotherapy protocol three sessions weekly for 12 weeks. Both groups were instructed to carry out a home exercise program. Clinical assessment of shoulder function was performed using a visual analog scale (VAS) for pain, Shoulder Pain and Disability Index (SPADI), Western Ontario Rotatory Cuff (WORC) Index, patient satisfaction, and shoulder range of motion. Patients were examined at baseline, weeks 3, 6, and 12, and last follow-up (minimum of one year). RESULTS A total of 101 patients (44 controls and 57 in the prolotherapy group) completed all study protocols and were included in the study. Using a within-group comparison, both groups achieved significant improvements over baseline, as measured by the VAS, SPADI, WORC index, and shoulder range of motion (P<0.001). Using a between-group comparison, a significant difference was found in the VAS scores at baseline, weeks 3, 6, and 12, and last follow-up. In addition, significant differences were found in the SPADIs and WORC indices at weeks 6 and 12 and the last follow-up. Significant differences were found in shoulder abduction and flexion at week 12 and last follow-up, and in internal rotation at last follow-up. However, no significant was found in external rotation at any follow-up period. In the prolotherapy group, 53 patients (92.9%) reported excellent or good outcomes; in the control group, 25 patients (56.8%) reported excellent or good outcomes. CONCLUSION Prolotherapy is an easily applicable and satisfying auxiliary method in the treatment of chronic rotatory cuff lesions. STUDY TYPE Randomized prospective comparative trial. LEVEL OF EVIDENCE Level of evidence 1.
Collapse
Affiliation(s)
- M M Seven
- Department of Sports Medicine, Gulhane Military Medicine Academy, Ankara, Turkey
| | - O Ersen
- Department of Orthopaedics, Gulhane Military Medicine Academy, Ankara, Turkey.
| | - S Akpancar
- Department of Orthopaedics, Gulhane Military Medicine Academy, Ankara, Turkey
| | - H Ozkan
- Department of Orthopaedics, Gulhane Military Medicine Academy, Ankara, Turkey
| | - S Turkkan
- Department of Orthopaedics, Gulhane Military Medicine Academy, Ankara, Turkey
| | - Y Yıldız
- Department of Sports Medicine, Gulhane Military Medicine Academy, Ankara, Turkey
| | - K Koca
- Department of Orthopaedics, Gulhane Military Medicine Academy, Ankara, Turkey
| |
Collapse
|
4
|
Bilir C, Yıldız İ, Bilici A, Ucar M, Berk V, Yıldız Y, Yazıcı O, İmamoğlu Gİ, Karadurmuş N, Pilancı KN, Arpacı E, Tanrıverdi Ö, Karcı E, Temiz S, Nayır E, Oktay E, Dal P, Petekkaya İ, Varım C, Cinemre H. Is Change in Hemoglobin Level a Predictive Biomarker of Tyrosine Kinase Efficacy in Metastatic Renal Cell Carcinoma? A Turkish Oncology Group Study. Cancer Invest 2017; 35:248-255. [PMID: 28333566 DOI: 10.1080/07357907.2017.1292518] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND There are insufficient predictive markers for renal cell carcinoma (RCC). METHODS A total of 308 metastatic RCC patients were analyzed retrospectively. RESULTS The increased hemoglobin (Hb) group had significantly higher progression-free survival and overall survival (OS) compared with the decreased Hb group at 11.5 versus 6.35 months (p < .001) and 21.0 versus 11.36 months (p < .001) respectively. The 1- and 3-year OS rates were higher in the Hb increased group, i.e., 84% versus 64% and 52% versus 35% respectively. CONCLUSIONS The present study showed that increased Hb levels after tyrosine kinase inhibitor therapy could be a predictive marker of RCC.
Collapse
Affiliation(s)
- Cemil Bilir
- a Department of Internal Medicine and Medical Oncology , Sakarya University School of Medicine , Sakarya , Turkey
| | | | - Ahmet Bilici
- c Department of Medical Oncology , Medipol University School of Medicine , Istanbul , Turkey
| | - Mahmut Ucar
- d Department of Medical Oncology , Erciyes University School of Medicine , Kayseri , Turkey
| | - Veli Berk
- d Department of Medical Oncology , Erciyes University School of Medicine , Kayseri , Turkey
| | - Yaşar Yıldız
- e Department of Medical Oncology , Izmir Katip Çelebi University School of Medicine , Izmir , Turkey
| | - Ozan Yazıcı
- f Department of Medical Oncology , Ankara Numune Teaching and Education Hospital , Ankara , Turkey
| | - Gökşen İnanç İmamoğlu
- g Department of Medical Oncology , Dışkapı Teaching and Education Hospital , Ankara , Turkey
| | - Nuri Karadurmuş
- h Department of Medical Oncology , Gulhane School of Medicine , Ankara , Turkey
| | - Kezban Nur Pilancı
- i Department of Medical Oncology , Haseki Teaching and Education Hospital , Istanbul , Turkey
| | - Erkan Arpacı
- j Department of Medical Oncology , Bülent Ecevit University School of Medicine , Zonguldak , Turkey
| | - Özgür Tanrıverdi
- k Department of Medical Oncology , Mugla Sıtkı Koçman University School of Medicine , Mugla , Turkey
| | - Ebru Karcı
- l Department of Medical Oncology , Ankara University School of Medicine , Ankara , Turkey
| | | | - Erdinc Nayır
- n Department of Medical Oncology , Kahramanmaras Necip Fazil City Hospital , Kahramanmaras , Turkey
| | - Esin Oktay
- o Department of Medical Oncology , Adnan Menderes University Faculty of Medicine , Aydin , Turkey
| | - Pınar Dal
- p Department of Medical Oncology , Eskisehir Osman Gazi University School of Medicine , Eskişehir , Turkey
| | | | - Ceyhun Varım
- a Department of Internal Medicine and Medical Oncology , Sakarya University School of Medicine , Sakarya , Turkey
| | - Hakan Cinemre
- a Department of Internal Medicine and Medical Oncology , Sakarya University School of Medicine , Sakarya , Turkey
| |
Collapse
|
5
|
Cicin İ, Özatlı T, Türkmen E, Özturk T, Özçelik M, Çabuk D, Gökdurnalı A, Balvan Ö, Yıldız Y, Şeker M, Özdemir N, Yapar B, Tanrıverdi Ö, Günaydin Y, Menekşe S, Öksüzoğlu B, Aksoy A, Erdogan B, Bekir Hacıoglu M, Arpaci E, Sevinç A. Predictive and Prognostic Factors in Ovarian and Uterine Carcinosarcomas. Balkan Med J 2016; 33:517-524. [PMID: 27761279 DOI: 10.5152/balkanmedj.2016.151268] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 04/18/2016] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Prognostic factors and the standard treatment approach for gynaecological carcinosarcomas have not yet been clearly defined. Although carcinosarcomas are more aggressive than pure epithelial tumours, they are treated similarly. Serous/clear cell and endometrioid components may be predictive factors for the efficacy of adjuvant chemotherapy (CT) or radiotherapy (RT) or RT in patients with uterine and ovarian carcinosarcomas. Heterologous carcinosarcomas may benefit more from adjuvant CT. AIMS We aimed to define the prognostic and predictive factors associated with treatment options in ovarian (OCS) and uterine carcinosarcoma (UCS). STUDY DESIGN Retrospective cross-sectional study. METHODS We retrospectively reviewed the medical records of patients with ovarian and uterine carcinosarcoma from 2000 to 2013, and 127 women were included in this study (24 ovarian and 103 uterine). Patients admitted to seventeen oncology centres in Turkey between 2000 and December 2013 with a histologically proven diagnosis of uterine carcinosarcoma with FIGO 2009 stage I-III and patients with sufficient data obtained from well-kept medical records were included in this study. Stage IV tumours were excluded. The patient records were retrospectively reviewed. Data from 104 patients were evaluated for this study. RESULTS Age (≥70 years) was a poor prognostic factor for UCS (p=0.036). Pelvic±para aortic lymph node dissection did not affect overall survival (OS) (p=0.35). Macroscopic residual disease was related with OS (p<0.01). The median OS was significantly longer in stage I-II patients than stage III patients (p=0.03). Adjuvant treatment improved OS (p=0.013). Adjuvant radiotherapy tended to increase the median OS (p=0.075). However, this tendency was observed in UCS (p=0.08) rather than OCS (p=0.6).Adjuvant chemotherapy had no effect on OS (p=0.15).Adjuvant radiotherapy significantly prolonged the median OS in patients with endometrioid component (p=0.034). A serous/clear cell component was a negative prognostic factor (p=0.035). Patients with serous/clear cell histology for whom adjuvant chemotherapy was applied had significantly longer OS (p=0.019), and there was no beneficial effect of adjuvant radiotherapy (p=0.4). Adjuvant chemotherapy was effective in heterologous tumours (p=0.026). In multivariate analysis, the stage and chemotherapy were prognostic factors for all patients. Age was an independent prognostic factor for UCS. However, serous/clear cell histology and radiotherapy tended to be significant prognostic factors. CONCLUSION The primary location, the histological type of sarcomatous and the epithelial component may be predictive factors for the efficacy of chemotherapy or radiotherapy in UCS and OCS.
Collapse
Affiliation(s)
- İrfan Cicin
- Department of Medical Oncology, Trakya University School of Medicine, Edirne, Turkey
| | - Tahsin Özatlı
- Department of Medical Oncology, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey
| | - Esma Türkmen
- Department of Medical Oncology, Trakya University School of Medicine, Edirne, Turkey
| | - Türkan Özturk
- Department of Medical Oncology, Karadeniz Technical University School of Medicine, Trabzon, Turkey
| | - Melike Özçelik
- Department of Medical Oncology, Dr. Lütfi Kırdar Research and Training Hospital, İstanbul, Turkey
| | - Devrim Çabuk
- Department of Medical Oncology, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Ayşe Gökdurnalı
- Department of Medical Oncology, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey
| | - Özlem Balvan
- Department of Medical Oncology, Dr. Lütfi Kırdar Research and Training Hospital, İstanbul, Turkey
| | - Yaşar Yıldız
- Department of Medical Oncology, Atatürk Research and Training Hospital, İzmir, Turkey
| | - Metin Şeker
- Department of Medical Oncology, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Nuriye Özdemir
- Department of Medical Oncology, Ankara Numune Research and Training Hospital, Ankara, Turkey
| | - Burcu Yapar
- Department of Medical Oncology, Pamukkale University School of Medicine, Denizli, Turkey
| | - Özgür Tanrıverdi
- Department of Medical Oncology, Muğla University School of Medicine, Muğla, Turkey
| | - Yusuf Günaydin
- Department of Medical Oncology, Gazi University School of Medicine, Ankara, Turkey
| | - Serkan Menekşe
- Department of Medical Oncology, Celal Bayar University School of Medicine, Manisa, Turkey
| | - Berna Öksüzoğlu
- Department of Medical Oncology, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey
| | - Asude Aksoy
- Department of Medical Oncology, İnönü University School of Medicine, Malatya, Turkey
| | - Bülent Erdogan
- Department of Medical Oncology, Trakya University School of Medicine, Edirne, Turkey
| | - M Bekir Hacıoglu
- Department of Medical Oncology, Trakya University School of Medicine, Edirne, Turkey
| | - Erkan Arpaci
- Department of Medical Oncology, Sakarya Research and Training Hospital, Sakarya, Turkey
| | - Alper Sevinç
- Department of Medical Oncology, Gaziantep University School of Medicine, Gaziantep, Turkey
| |
Collapse
|