Browsing by Author "Cinkir, Havva Yesil"

Filter results by typing the first few letters
Now showing 1 - 2 of 2
  • No Thumbnail Available
    Item
    Investigational Tests and Treatments Performed in Terminal Stage Cancer Patients in Two Weeks Before Death: Turkish Oncology Group (TOG) Study
    (2014) Turker, Ibrahim; Komurcu, Seref; Arican, Ali; Doruk, Hatice; Ozyilkan, Ozgur; Coskun, Hasan Senol; Colak, Dilsen; Cavusoglu, Emel Ucgul; Ata, Alper; Sezer, Ahmet; Cinkir, Havva Yesil; Senler, Filiz Cay; Arpaci, Fikret; https://orcid.org/0000-0001-8825-4918; https://orcid.org/0000-0002-6445-1439; 25412940; AAD-2817-2021; AAD-2667-2020
    Although more palliative care is necessary for terminally ill cancer patients, excess investigational tests, invasive procedures, and treatments are given instead. Between November 2009 and December 2013, six hundred and twenty-four patients with end-stage cancer who were died at inpatient setting evaluated retrospectively. Patients' characteristics, sites of tumor and metastasis, tests and invasive procedures, treatments performed in the last 2 weeks before death were collected from the hospital files and analyzed. Median age of 624 patients was 58 (range 16-96) years. More than half of the patients (370, 59.3 %) were men. The most frequent cancer sites were gastrointestinal (GI) system (32.2 %), lung (24.0 %), and breast (11.1 %). Frequent metastatic sites were liver (34.8 %), bone (31.5 %), lung (23.3 %), and/or brain (16.9 %). Causes of death were respiratory failure, infections, and/or liver failure in 49.9, 23.9, and 19.4 % of patients, respectively. Radiological tests performed in the last 2 weeks before death were ultrasonography, computed tomography, magnetic resonance imaging, bone scan in 25.6, 16.3, 11.4, and 3.8 % of patients, respectively. Treatments received were intravenous (i.v) serum infusion, blood transfusion, total parenteral nutrition (TPN), human albumin infusion in 55.9, 44.1, 34.9, and 9.5 % of patients, respectively. Invasive procedures such as invasive pain relief, terminal sedation, and chemotherapy performed in 12.6, 4.4, and 10.0 % of patients, respectively. Central venous catheter application, paracentesis, thoracentesis, and GI endoscopy were applied in 41.7, 9.8, 5.6, and 3.4 % of the patients, respectively. Radiological tests, invasive procedures, TPN, and human albumin transfusion were used excessively in terminal stage cancer patients in our medical oncology inpatient clinics. Invasive pain relief and terminal sedation were still underused in our cancer clinics. There is an urgent need in developing national palliative care program to improve the understanding of end-of-life care in our medical oncology clinics.
  • No Thumbnail Available
    Item
    Prediction of Peritoneal Recurrence in Patients with Gastric Cancer: a Multicenter Study
    (2020) Kus, Tulay; Kose, Fatih; Aktas, Gokmen; Arslan, Ulku Yalcintas; Sedef, Ali Murat; Cinkir, Havva Yesil; Dirikoc, Merve; Akkus, Gulsum; Ozdemir, Nuriye Yildirim; 0000-0002-0156-5973; 32578034; G-4827-2016
    Purpose The peritoneum is the common recurrence site of gastric cancer (GC) presenting with worse survival. Although some predictive clinicopathological factors have been identified, there is no comprehensive assessment of peritoneal recurrence risk prediction for patients treated with adjuvant chemotherapy (CR) or chemoradiotherapy (CRT) after surgery. We aimed to predict peritoneal recurrence and develop a new scoring model in GC. Methods This retrospective study included 274 GC patients who presented with recurrence after curative gastrectomy followed by adjuvant chemotherapy (CT) or chemoradiotherapy (CRT). Risk factors for peritoneal recurrence were analyzed using the following parameters: age, gender, tumor location and characteristics, and differences between treatment modalities. All parameters were assessed by binary logistic regression analysis to compare the patients with and without peritoneal recurrence. Then, a new risk scoring model was developed. Results Peritoneal recurrence was observed in 115 (44.1%) patients. Peritoneal recurrence was higher in female gender (odds ratio (OR), 1.93; 1.07-3.49,P = 0.030, 1 point), T4a-b stage (OR, 2.47; 1.14-5.36,P = 0.022, 1 point), poor/undifferentiated (OR, 2.04; 1.31-4.06,P = 0.004, 1 point), and signet cell carcinoma (OR, 2.04; 1.04-4.02,P = 0.038, 1 point) after adjusted for resection and dissection types. The risk scoring model was developed using the related parameters: Peritoneal recurrence rates were 24.6%, 42.6%, and 71.4% for group 1 (0 point), group 2 (1-2 points), and group 3 (3-4 points), respectively. Conclusion Female gender, T4 tumor stage, undifferentiated histopathology, and signet cell type had a tendency to peritoneal recurrence after adjusted for treatment modalities. Patients with 3 or 4 risk factors had an 8.8-fold increased risk for the development of peritoneal recurrence.