Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Patients with Distal Intestinal Gastric Cancer Have Superior Outcome with Addition of Taxanes to Combination Chemotherapy, While Proximal Intestinal and Diffuse Gastric Cancers do not: Does Biology and Location Predict Chemotherapy Benefit?(2015) Sedef, Ali Murat; Kose, Fatih; Sumbul, Ahmet Taner; Dogan, Ozlem; Besen, Ali Ayberk; Tatli, Ali Murat; Mertsoylu, Huseyin; Sezer, Ahmet; Muallaoglu, Sadik; Ozyilkan, Ozgur; Abali, Huseyin; 0000-0002-6445-1439; 0000-0002-6242-2802; 0000-0002-1932-9784; 0000-0002-7862-0192; 0000-0002-5573-906X; 0000-0001-8825-4918; 0000-0002-0156-5973; 25572818; AAD-2667-2020; IVU-7523-2023; -9530-2014; AAD-6910-2021; D-4793-2014; D-7660-2016; AAD-2817-2021; G-4827-2016; GZH-1913-2022Gastric cancer, with one million new cases observed annually, and its dismal prognosis, is one of the leading causes of cancer-related mortalities. Systemic chemotherapy is the main treatment modality in advanced gastric cancer patients. We aim to evaluate the predictive role of tumor localization and histopathology on choosing three or two-drug combination regimens. Consecutive 110 metastatic gastric adenocarcinoma patients who were admitted to the Baskent University Department of Medical Oncology and the Van Research and Training Hospital were included in the study. Data of patients were analyzed retrospectively. Median age of patients was 58 years (range 30-80). Proximal intestinal, distal intestinal, and diffuse gastric cancers were found in 35 (32 %), 64 (58 %), and 11 (10 %) patients, respectively. 5-fluoracil and platinum (PF) and PFtax were administered to 47 (43 %) and 63 (57 %) patients, respectively. Median progression-free survival (PFS) was 4.0 (95 % CI 2.5-5.6) and 7.4 months (95 % CI 6.0-8.7) for PF and PFtax groups, (p = 0.034). When we used tumor localization as strata in the PFS survival curve, PFtax produced significantly higher PFS rates only in distal intestinal-type gastric cancer, compared with PF (p = 0.03). Median overall survival (OS) was 9.0 (95 % CI 5.2-12.3) and 17.3 months (95 % CI 7.8-27) for PF and PFtax groups, (p = 0.010). When we used tumor localization as strata in the OS survival curve, PFtax produced significantly higher OS rates only in distal intestinal-type gastric cancer compared with PF (p = 0.015). Pathology and tumor location in gastric cancers may affect the outcome, the addition of taxanes as a third drug may significantly increase PFS and OS rate purely in distal intestinal-type gastric cancer but not in patients with proximal and diffuse-type gastric cancers.Item Procalcitonin as A Biomarker for Infection-Related Mortality in Cancer Patients(2015) Sedef, Ali M.; Kose, Fatih; Mertsoylu, Huseyin; Ozyilkan, Ozgur; 0000-0002-0156-5973; 0000-0002-1932-9784; 0000-0001-8825-4918; 25872114; G-4827-2016; M-9530-2014; AAD-2817-2021Purpose of review Infectious diseases are the second leading cause of death following direct cancer-related complications in the field of oncology. Clinical studies using the classic inflammatory biomarkers, C-reactive protein, erythrocyte sedimentation rate, leukocytosis, and thrombocytosis fail to show a significant correlation between these biomarkers and infection-related mortality. It is therefore crucial to define new biomarkers that are not affected by the primary cancer and precisely show the severity of the infection to help in the decision-making process. Recent findings A significant increase in the number of cancer patients in the past decades has created an exponential increase in the number of immunocompromised patients. Preemptive and typically unnecessary usage of broad-spectrum antibiotics is common during the treatment of these patients and may result in an increase in multidrug-resistant microbial strains. Recent clinical studies suggest that a significant reduction in antibiotic consumption may be achieved by procalcitonin-guided algorithms without sacrificing the outcome of patients with severe infection. Summary In this article, we focus on procalcitonin and its potential role in differentiating cancer and infection-induced inflammation. Using this strategy may significantly reduce the usage of empirical broad-spectrum antibiotics and result in earlier discharge of patients.Item The Clinicopathological and Survival Differences Between Never and Ever Smokers with Non-Small Cell Lung Cancer(2014) Muallaoglu, Sadik; Karadeniz, Cemile; Mertsoylu, Huseyin; Besen, Ali Ayberk; Sezer, Ahmet; Sedef, Ali Murat; Kose, Fatih; Ozyilkan, Ozgur; https://orcid.org/0000-0002-6242-2802; https://orcid.org/0000-0002-1932-9784; https://orcid.org/0000-0002-6445-1439; https://orcid.org/0000-0002-0156-5973; https://orcid.org/0000-0001-8825-4918; 24965406; IVU-7523-2023; M-9530-2014; AAD-2667-2020; G-4827-2016; AAD-2817-2021Purpose: Cigarette smoking was regarded as the most important carcinogenic factor of lung cancer, yet in recent years lung cancer in never-smokers is an increasingly prominent public health issue. The aim of this study was to assess the epidemiological and clinicopathological characteristics of never-smoker patients with non small cell lung cancer (NSCLC), focusing on clinical risk factors and survival. Methods: We retrospectively analyzed 290 NSCLC patients who presented between 2006 and 2011. Differences in clinical features and survival between never- and ever-smoker patients were analyzed. Student's t-test and Mann-Whitney U-test were used to assess the significance of the variables between the groups. Survival curves were calculated using Kaplan-Meier method. Hazard ratio (HR) for death and its 95% confidence interval (CI) were calculated by Cox regression analysis. Results: There were 243 (83.8%) ever-smokers and 47 (16.2%) never-smokers. In never-smokers females predominated (80.9%) as well as patients with adenocarcinomas (78.7%). At the time of analysis 143 (49.3%) patients had died. The 5-year overall survival (OS) rates were not significantly different between never- and ever-smokers (p=0.410). The median OS of all patients was 26 months (95% CI: 16.8-35.2). The median OS was 23 months (95% CI: 11.8-34.2)for never-smokers and 30 months (95% CI: 19.7-40.3) forever-smokers (p=0.410). Never-smokers tended to present with more advanced disease than ever-smokers (p<0.004) and also with more advanced age (p<0.001). The HR for death increased with poorer Eastern Cooperative Oncology Group (ECOG) performance status (PS) (ECOG 2-3), advanced stage (stage 3-4) and untreated patients. Slightly lower risk for death was registered in patients with adenocarcinoma vs those with squamous cell carcinoma (S CC). Conclusion: Although no difference in survival was seen, definite epidemiologic differences do exist between never-smokers and ever-smokers patients with NSCLC. Future efforts should focus on the underlying biological differences, and on identifying potential non-tobacco related risk factors in order to improve treatment strategies for these two groups of NSCLC patients.Item Can Primary Tumor Localization Predict the Which Patient Will Have Benefit From Addition of Taxanes to Platin-5-FU Based Regimens in Metastatic Gastric Cancer. Multi Center Retrospective Analysis from Turkey, Society of Turkish Oncology Group Study(2015) Kose, Fatih; Sedef, Ali Murat; Ozdemir, Nuriye; Gunaldi, Meral; Urun, Yuksel; Besen, Ali Ayberk; Sumbul, Ahmet Taner; Goksu, Sema Sezgin; Dogan, Ozlem; Mertsoylu, Huseyin; Tatli, Ali Murat; Erdem, Dilek; Demirci, Serkan; Gunduz, Seyda; Yildirim, Mustafa; Ozyilkan, Ozgur; Abali, HuseyinItem Neutrophil-to-lymphocyte Ratio Predicts PSA Response, but not Outcomes in Patients with Castration-Resistant Prostate Cancer Treated with Docetaxel(2014) Sumbul, Ahmet Taner; Sezer, Ahmet; Abali, Huseyin; Kose, Fatih; Gultepe, Ilhami; Mertsoylu, Huseyin; Muallaoglu, Sadik; Ozyilkan, Ozgur; https://orcid.org/0000-0002-6445-1439; https://orcid.org/0000-0001-5596-0920; https://orcid.org/0000-0002-0156-5973; https://orcid.org/0000-0002-1932-9784; https://orcid.org/0000-0002-6242-2802; https://orcid.org/0000-0001-8825-4918; 24526335; AAD-2667-2020; D-7660-2016; G-4827-2016; M-9530-2014; IVU-7523-2023; AAD-2817-2021The neutrophil-to-lymphocyte ratio (NLR) is a marker of systemic inflammatory response and evidences for the relationship between NLR and the response to treatment gradually increases in cancer patients. In this study, we aimed to investigate the effect of the pretreatment NLR and other factors related to the patient on predicting the outcome of docetaxel + prednisone chemotherapy in prostate cancer patients who become castration resistant. Thirty-three metastatic castration-resistant prostate cancer patients those who were treated between 2009 and 2013 were included in our study. All data of the patients, including pathological, clinical, radiological, biochemical and hematological data, were assessed retrospectively using our database system. The median progression-free survival (PFS) was determined as 23.9 months (range 0.36-118.7) with androgen suppression therapy and 9.5 months (range 1.7-39.4) with docetaxel + prednisone therapy. NLR was found to be correlated with only posttreatment psa levels. In the NLR a parts per thousand currency sign3 group, the PSA levels were statistically significantly lower than the other group (r = 0.002). Furthermore, the relationships between the clinical response and PFS and the other pretreatment parameters of the patients were evaluated in order to predict which group would respond better to docetaxel + prednisone therapy after becoming androgen resistant. No relationship was found between any of the parameters and the response to therapy. Although NLR was found effective in predicting the PSA response in docetaxel + prednisone therapy, neither NLR nor any other clinical parameter was found effective in predicting the outcome and the role of NLR in the future of CRPC is questionable.Item Effective Resolution of Lung Cancer Related Tracheal and/or Bronchial Obstruction with External Beam Radiotherapy(2015) Topkan, Erkan; Yildirim, Berna Akkus; Ozdemir, Yurday; Guler, Ozan C.; Kose, Fatih; 0000-0001-6908-3412; 0000-0001-8120-7123; 0000-0002-2218-2074; 0000-0001-6661-4185; AAC-5654-2020; AAG-2213-2021; AAG-5629-2021; V-5717-2017Item High Pretreatment Neutrophil-Lymphocyte Ratio: A Poor Prognostic Factor for Stage III Non-Small Cell Lung Cancer Patients(2015) Sumbul, Ahmet T.; Batmaci, Celal; Ucar, Edip; Kose, Fatih; Sedef, Ali M.; Yildirim, Berna; Mertsoylu, Huseyin; Sezer, Ahmet; Ozyilkan, Ozgur; 0000-0002-1932-9784; 0000-0001-8825-4918; 0000-0001-6661-4185; 0000-0002-5573-906X; M-9530-2014; AAD-2817-2021; V-5717-2017; D-4793-2014Item Prognostic Role of fox-p3 Positive T-Regulatory Cells in Curatively Resected NSCLC Other than Stage IA(2015) Kose, Fatih; Besen, Ayberk; Findikcioglu, Alper; Canbolat, Tuba; Ozdemir, Yurday; Sedef, Ali M.; Mertsoylu, Huseyin; Sumbul, Ahmet T.; Ozyilkan, Ozgur; Abali, Huseyin; 0000-0002-2218-2074; 0000-0002-1932-9784; 0000-0001-5596-0920; 0000-0002-7862-0192; 0000-0001-8825-4918; 0000-0002-5573-906X; AAG-5629-2021; M-9530-2014; D-7660-2016; AAD-6910-2021; AFT-2303-2022; AAD-2817-2021; D-4793-2014Item Addition of Taxanes to Combination Chemotherapy in Distal Intestinal Gastric Cancer Is More Beneficial Than Proximal Ones: A Multicenter Retrospective Study of Turkish Oncology Group(2019) Sedef, Ali Murat; Kose, Fatih; https://orcid.org/0000-0002-0156-5973; 31128019; G-4827-2016Purpose: Advanced gastric cancer has a dismal prognosis. Platin/5-fluorouracil (PF) combination chemotherapy is the main treatment modality for metastatic gastric cancer patients. Third drug addition to PF is a controversial issue. The aim of this study was to evaluate the predictive role of tumor localization and histopathology on choosing three- or two-drug combination regimens. Methods: This study was designed as a hospital-based retrospective observational case-series study. A total of 516 patients with advanced gastric cancer has been treated at eight different oncology centers in Turkey between 2006 and 2016. Laboratory results and demographic data were collected and analyzed. Results: The median patient age was 59 years (range 25-85). Proximal intestinal and distal intestinal cancers were found in 357 (69.2 %) and 159 (30.8 %) patients, respectively. 5-fluorouracil (5FU) and cisplatin (PF) and cisplatin+5FU+docetaxel (PFtax, also known as DCF) were administered to 240 (46.5%) and 276 (53.5%) patients, respectively. Median progression free survival (PFS) was 5.0 (95% CI 4.21-5.29) and 8 months (95% CI 7.22-8.77)for PF and PFtax groups, respectively (p<0.01). When tumor localization was used as stratum in PFS survival, PFtax produced significantly higher PFS rates only in distal intestinal type gastric cancer compared to PF (p <0.01). Median overall survival (OS) was 12 (95% CI 9.8-14.2) and 16 months (95% CI 13.6-18.4)for the PF and PFtax groups, respectively (p=0.01). When tumor localization was used as stratum in OS, PFtax showed significantly higher OS rates only in the distal intestinal type gastric cancer compared to PF (p=0.01). Conclusion: Pathology and tumor location in gastric cancer may affect the outcome. Addition of taxanes as a third drug may significantly increase PFS and OS rates only in distal intestinal type gastric cancer but not in patients with proximal type gastric cancer.Item Prognostic Value of Procalcitonin in Infection-Related Mortality of Cancer Patients(2016) Sedef, Ali Murat; Kose, Fatih; Sumbul, Ahmet Taner; Dogan, Ozlem; Kursun, Ebru; Yurdakul, Zafer; Gultepe, Bilge Sumbul; Mertsoylu, Huseyin; Sezer, Ahmet; Ozyilkan, Ozgur; https://orcid.org/0000-0002-0156-5973; https://orcid.org/0000-0002-5573-906X; https://orcid.org/0000-0002-1932-9784; https://orcid.org/0000-0002-6445-1439; https://orcid.org/0000-0001-8825-4918; 27569098; G-4827-2016; D-4793-2014; GZH-1913-2022; AAG-5020-2020; M-9530-2014; AAD-2667-2020; AAD-2817-2021Purpose: Infectious diseases are a major cause of morbidity and mortality in cancer patients. Tumor-induced inflammatory responses may increase the value of classical inflammatory markers in blood, so these markers may not be as useful in cancer patients as in non-cancer patients. Serum procalcitonin (PCT) is a sensitive and specific biomarker for severe infection, and has been shown to be unaffected by tumor-induced inflammatory response. In this study we aimed to evaluate the possible role of PCT in mortality in cancer patients with infection. Methods: In total, 104 consecutive adult cancer patients who presented with fever (body temperature >= 38.3 degrees C or >= 38 degrees C on two consecutive measurements) during follow-up and needing hospitalization for infection were enrolled in this study. Results: The majority (72%) of the patients were male. The most common diagnosis and type of infection were lung cancer (40.4%) and pneumonia (56.7%), respectively. The overall mortality rate was 17%. Statistical analysis showed a significant relationship between PCT levels and mortality (p=0.001), but not between classical inflammatory markers and mortality (p>0.05). The mortality rate of patients with a PCT value > 2 ng/mL was 34.3%, compared with 9.6% in patients with a PCT below this value (p=0.005). Furthermore, PCT predicted in-ward cancer patient mortality with a sensitivity of 66% and a specificity of 76%. Conclusion: PCT is a unique serum biomarker significantly related to infection-related mortality and predicts mortality with a relatively high sensitivity and specificity.