Wos Açık Erişimli Yayınlar

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Author: search.filters.author.Celik, HusnuSubject: search.filters.subject.Ovarian cancer

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    The clinical outcomes of ovarian cancer in patients with brain metastasis
    (2021) Simsek, Seda Yuksel; Guler, Ozan Cem; Durdag, Gulsen Dogan; Sari, Sezin Yuce; Gultekin, Melis; Yildiz, Ferah; Celik, Husnu; Erbay, Gurcan; Onal, Huseyin Cem; 0000-0003-3191-9776; AAK-7016-2021
    Objective: To present the clinical characteristics and treatment outcomes of patients with ovarian cancer with brain metastasis. Methods: This study was designed as a retrospective observational study. Patients' data were obtained from hospital records. Patients who were diagnosed with brain metastatic ovarian cancer in two tertiary referral centers between 2012 and 2020 were included in the study. Results: In total, there were 56 patients diagnosed as having brain metastatic ovarian cancer. The median age was 56 years, 91% of patients were at an advanced stage at initial diagnosis. The median time from the initial diagnosis to brain metastasis was 34.0 months. Sixty-seven percent of patients were determined as having multiple brain metastatic lesions. Whole brain radiotherapy (WBRT) , stereotactic radiosurgery (SRS) and combined approach were utilized as primary treatment. The 1 and 2-year survival rates were 38% and 17%, respectively. Patient age and tumor histology were found to be significant prognostic factors that impact the survival in univariate analyses. The 1-year survival of patients aged younger than 55 years was 49.2%, and 28.2% for patients aged over 55 years (p = 0.04). Patients with nonserous histology had significantly longer one year overall survival compared to serous histology (61.4% vs 29.8%) (p= 0.01). Conclusion: The brain is one of the rarest locations for ovarian cancer metastasis. Radiotherapeutic approaches are the mainstay of treatment but survival rates are low. Age and tumor histology were determined as significant parameters that affected survival rates.
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    Clinical characteristics of relapsed ovarian cancer patients with striking response to the bevacizumab at first relapse
    (2020) Kose, Fatih; Alemdaroglu, Songul; Mertsoylu, Huseyin; Besen, Ali Ayberk; Guler, Ozan Cem; Simsek, Seda Yuksel; Erbay, Gurcan; Onal, Cem; Celik, Husnu; 0000-0002-2742-9021; 0000-0003-4335-6659; 0000-0001-6908-3412; 0000-0002-0156-5973; 0000-0002-7862-0192; 0000-0002-1932-9784; D-5195-2014; AAI-8400-2021; AAC-5654-2020; G-4827-2016; AAD-6910-2021; M-9530-2014
    Background: Ovarian cancer is fifth leading cause of the cancer related death in women. Platin based doublet regimen plus bevacizumab is standard treatment in relapse. The primary aim of this study is to define clinicopathological characteristics of the relapsed ovarian cancer who derived unexpectedly long benefit from bevacizumab treatment. Methods: Total number of 106 patients with relapsed ovarian cancer and treated with bevacizumab (bevacizumab is not reimbursed as a part of adjuvant treatment in Turkey) on their first relapse were included. For the purpose of the study, the patients were placed into two groups, Group A and B, selected on the basis of the rate of PFS 1 (time between first day of adjuvant chemotherapy and first radiological progression) to PFS 2 (time between first day of second line treatment and second radiological progression). The patients included into Group A if PFS 1 greater than PFS 2 and Group B vice versa. Results: Group A and B were consisted of 67 (63%) and 39 (37%) patients. At a median follow-up of 32.1 months (5.3-110.8), 56 (52.8%) patients were died. Significant number of patients (78.4%) treated with primary surgery without neoadjuvant treatment and 59 (57.8%) out of the 102 patients had debulking surgery when their cancer relapsed. PFS 1 and 2 were estimated as 16.5 mo (14.1-18.9) vs. 13.7 mo (9.9-17.5) and 13.4 mo (8.0-18.6) vs. 29.7 mo (21.5-38.0) in group A and B, respectively (p < 0.001 and p < 0.001). Only parameter that show significant difference between groups was the rate of platin resistant patients; Group A: 13 (19.4%) out of 67 patients vs. Group B: 15 (38.6%) out of 39 patients with ap value of 0.041. Binary logistic regression indicates PFS1 is significant inverse predictor (shorter PFS-1 means greater chance of being in group B) of entering Group B [Chi-Square = 16.5, df = 6 and p = 0.011 (< 0.05)]. PFS1 is significant at the 5% level [ PFS1 wald = 4.33,p = 0.038 (p < 0.05)]. In multivariate analysis, cox-regression proportional hazard, cytoreductive surgery at second relapse (yes or no) (p: 0.028; HR: 0.3, 0.02-0.7, 95% CI) showed significant effect on PFS-2. On the other hand, platin resistance (< 6 mos; yes or no) (p: 0.04; HR: 4.0, 1.1-14.4, 95% CI) and secondary surgery outcome (no visible vs. visible) (p: 0.003; HR: 0.2, 0.07-0.58, 95% CI) showed significant effect on OS. Bevacizumab related adverse effects with greater than grad 3 detected in 13 (15%) and 10 (25%) in group A and B (p: 0.77). Conclusions: Our findings indicate that bevacizumab produced strikingly high PFS (over 24 months) in significant portion of relapsed ovarian cancer patients whom were mostly platin resistant cases with short PFS-1. This gain specifically achieved in patients who had aggressive secondary surgery with no-visible surgical outcome.