PubMed İndeksli Yayınlar Koleksiyonu
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Item Clinicopathologic and Prognostic Significance of CD47 Expression and Tumor-associated Macrophages in Endometrial Carcinoma(2022) Sercan, Cigdem; Haberal Reyhan, Asuman N.; Ozen, Ozlem; Ayhan, Ali; 34282107Tumor-associated macrophages (TAMs) influence cancer progression. CD47 is an antiphagocytic molecule aiding tumor resistance against host immune surveillance. The relationship between CD47 expression and TAM-related microenvironment in endometrial carcinoma (EC) is poorly understood. The expression and prognostic significance of CD47 and CD163-labeled TAMs in 165 EC cases was assessed with CD47 and CD163 immunohistochemical studies. CD47 expression was found in 156/165 (94.6%) cases. CD47 expression was significantly higher in nonendometrioid carcinomas. CD47 overexpression was associated with histologic grade. High epithelial and stromal TAMs counts were also associated with high tumoral CD47 expression. High epithelial, stromal, and margin TAMs counts were associated with higher histologic grade and lymphovascular invasion. Epithelial TAMs counts were higher in patients with nonendometrioid carcinomas (P=0.0001) and cases with recurrence (P=0.018). High stromal TAMs counts were associated with deeper myometrial invasion (P=0.017) and the presence of distant metastasis (P=0.024). The counts of margin TAMs was significantly correlated with the depth of myometrial invasion, lymphovascular invasion, FIGO stage, lymph node metastases, distant metastasis, and recurrence (P=0.0001, 0.0001, 0.004, 0.005, 0.014, and 0.04, respectively). CD47 expression was not associated with overall survival (OS) and progression-free survival. However, high epithelial and stromal TAM counts were associated with shorter OS. Besides, high epithelial and margin TAM counts were associated with shorter progression-free survival. Furthermore, increased stromal and margin TAM counts were determined to be an independent prognostic marker of reduced OS. TAM count is, therefore, a significant prognostic factor in EC and the CD47 assessment has potential benefit for future clinical use.Item Post-Recurrence Survival In Patients With Cervical Cancer(2022) Cibula, David; Dostalek, Lukas; Jarkovsky, Jiri; Mom, Constantijne H.; Lopez, Aldo; Falconer, Henrik; Scambia, Giovanni; Ayhan, Ali; Kim, Sarah H.; Isla Ortiz, David; Klat, Jaroslav; Obermair, Andreas; Di Martino, Giampaolo; Klat, Jaroslav; Obermair, Andreas; Di Martino, Giampaolo; Pareja, Rene; Manchanda, Ranjit; Kos'un, Jan; dos Reis, Ricardo; Meydanli, Mehmet Mutlu; Odetto, Diego; Laky, Rene; Zapardiel, Ignacio; Weinberger, Vit; Benesova, Klara; Borcinova, Martina; Cardenas, Fernando; Wallin, Emelie; Borcinova, Martina; Cardenas, Fernando; Wallin, Emelie; Anchora, Luigi Pedone; Akilli, Huseyin; Abu-Rustum, Nadeem R.; Barquet-Munoz, Salim Abraham; Javurkova, Veronika; Fischerova, Daniela; van Lonkhuijzen, Luc R. C. W.; https://orcid.org/0000-0002-5240-8441; 34955236; AAX-3230-2020Background. Up to 26% of patients with early-stage cervical cancer experience relapse after primary surgery. However, little is known about which factors influence prognosis following disease recurrence. Therefore, our aims were to determine post-recurrence disease-specific survival (PR-DSS) and to identify respective prognostic factors for PR-DSS. Methods. Data from 528 patients with early-stage cervical cancer who relapsed after primary surgery performed between 2007 and 2016 were obtained from the SCANN study (Surveillance in Cervical CANcer). Factors related to the primary disease and recurrence were combined in a multivariable Cox proportional hazards model to predict PR-DSS. Results. The 5-year PR-DSS was 39.1% (95% confidence interval [CI] 22.7%-44.5%), median disease-free interval between primary surgery and recurrence (DFI1) was 1.5 years, and median survival after recurrence was 2.5 years. Six significant variables were identified in the multivariable analysis and were used to construct the prognostic model. Two were related to primary treatment (largest tumour size and lymphovascular space invasion) and four to recurrence (DFI1, age at recurrence, presence of symptoms, and recurrence type). The C-statistic after 10-fold cross-validation of prognostic model reached 0.701 (95% CI 0.675-0.727). Three risk-groups with significantly differing prognoses were identified, with 5-year PR-DSS rates of 81.8%, 44.6%, and 12.7%. Conclusions. We developed the robust model of PR-DSS to stratify patients with relapsed cervical cancer according to risk profiles using six routinely recorded prognostic markers. The model can be utilised in clinical practice to aid decision-making on the strategy of recurrence management, and to better inform the patients.Item Does lymph node ratio have any prognostic significance in maximally cytoreduced node-positive low-grade serous ovarian carcinoma?(2020) Aslan, Koray; Meydanli, Mehmet Mutlu; Akilli, Huseyin; Durmus, Yasin; Gokcu, Mehmet; Kayikcioglu, Fulya; Demirkiran, Fuat; Ayhan, Ali; 0000-0002-5404-0118; 32409929; AAP-6729-2021; AAJ-5802-2021Purpose To determine the prognostic impact of the lymph node ratio (LNR) in node-positive low-grade serous ovarian cancer (LGSOC). Methods We retrospectively reviewed women with LGSOC who had undergone maximal cytoreduction followed by standard chemotherapy in 11 centers from Turkey during a study period of 20 years. Sixty two women with node-positive LGSOC were identified. LNR was defined as the number of metastatic lymph nodes (LNs) divided by the number of total LNs removed. We grouped patients pursuant to the LNR as LNR <= 0.09 and LNR > 0.09. The prognostic value of LNR was investigated by employing the univariate log-rank test and multivariate Cox-regression model. Results With a median follow-up of 45 months, the 5-year progression-free survival (PFS) rates were 61.7% for women with LNR <= 0.09 and 32.0% for those with LNR > 0.09 (p = 0.046) whereas, the 5-year overall survival (OS) rates were 72.8% for LNR <= 0.09 and 54.7% for LNR > 0.09 (p = 0.043). On multivariate analyses, lymphovascular space invasion (LVSI) (Hazard Ratio [HR] 4.18, 95% confidence interval [CI] 1.88-9.27; p < 0.001), omental involvement (HR 3.48, 95% CI 1.36-8.84; p = 0.009) and LNR > 0.09 (HR 3.51, 95% CI 1.54-8.03; p = 0.003) were adverse prognostic factors for PFS. Additionally, LVSI (HR 6.56, 95% CI 2.33-18.41; p < 0.001), omental involvement (HR 6.34, 95% CI 1.86-21.57; p = 0.003) and LNR > 0.09 (HR 7.20, 95% CI 2.33-22.26; p = 0.001) were independent prognostic factors for decreased OS. Conclusion LNR > 0.09 seems to be an independent prognosticator for decreased survival outcomes in LGSOC patients who received maximal cytoreduction followed by standard adjuvant chemotherapy.Item Pretreatment Photopenia on F-18-Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography Scans Predicts Poor Prognosis in Nasopharyngeal Cancer Patients Undergoing Concurrent Chemoradiotherapy(2020) Topkan, Erkan; Selek, Ugur; Mertsoylu, Huseyin; Ozdemir, Yurday; Kucuk, Ahmet; Torun, Nese; Besen, Ali Ayberk; 0000-0002-2218-2074; 0000-0002-1932-9784; 0000-0001-8120-7123; 0000-0002-7862-0192; 0000-0002-5597-676X; 32075362; AAG-5629-2021; M-9530-2014; AAG-2213-2021; AAD-6910-2021; AAE-2718-2021Objectives. To investigate the influence of pretreatment primary tumor or nodal photopenia (PP) on F-18-fluorodeoxyglu- case positron emission tomography-computed tomography (FDG PET-CT), an indicator of tumor ischemia, on survival results of nasopharyngeal cancers (NPCs) treated with concurrent chemoradiotherapy (C-CRT). Methods. The pre-C-CRT FDG PET-CT scans of 104 patients with NPC (cT1-4 N0-3 M0) were retrospectively examined to determine the presence of PP (PP+). Our primary endpoint was the influence of PP+ on overall survival (OS), while the progression-free survival (PFS) and locoregional PFS (LRPFS) constituted the secondary endpoints. Results. The PP+ was detected in 29 (27.9%): nine (8.7%), seven (6.7%), and 13 (12.5%) in the primary tumor alone, primary tumor plus neck nodes, and neck nodes alone, respectively. Because the PP+ cases were small by count per location, all comparative analyses were performed according to overall PP+/PP- status instead of per detected site. At a median follow-up of 67.8 months (range, 9 to 130 months), the median survival times were not reached (NR) for the entire population. while 5-year OS, LRPFS, and PFS rates were 73.3%, 68.2%, and 63.4%, respectively. Comparatively the PP patients exhibited significantly poorer median OS (49.8 months vs. NR, P<0.001), LRPFS (40.7 months vs. NR, P=0.001), and PFS (31.8 months vs. NR, P=0.002) durations than their PP- counterparts. Furthermore, the PP+ retained its independent prognostic significance in multivariate analysis (P <0.001). Conclusion. Present results uncovered the pre-C-CRT PP as an independent predictor of poor prognosis for NPC patients, which underscore the requirement for the fortification of the local and systemic treatments in hypoxic NPCs.Item The prognostic significance of stage I ovarian clear cell and endometrioid carcinomas arising from endometriotic cysts: is it a myth?(2019) Ayhan, Ali; Akilli, Huseyin; Haberal, Nihan; 30315413PurposeThe aim of this study was to determine the clinicopathologic features and the prognostic significance of Stage I ovarian clear cell and endometrioid carcinomas arising from endometriotic cysts.Materials and methodsPatients with either Stage I ovarian clear cell or endometrioid carcinoma were divided into three groups. *Group 1: Patients with cancers arising from endometriotic cysts *Group 2: Patients with ovarian and pelvic endometriosis *Group 3: Patients without endometriosis Patient characteristics (overall survival and disease-free survival) were compared between groups.ResultsOf the 78 patients who participated in this study, 39 were in group 1, 13 were in group 2, and 26 were in group 3. The mean age in groups 1, 2, and 3 were 46years, 54years, and 48years, respectively (p=0.39). Tumoral characteristics, including capsule rupture, positive cytology, grade, and the presence of synchronous endometrial cancer were similar in both groups. The 5-year overall survival rate in groups 1, 2, and 3 were 100, 90, and 93%, respectively (p=0.4). Moreover, the recurrence rates did not differ significantly between groups. Furthermore, subgroup analysis of clear cell carcinoma and endometrioid adenocarcinoma separately showed no effect of endometriosis on disease-free survival (DFS) or overall survival (OS).ConclusionClear cell or endometrioid ovarian carcinoma arising from ovarian and/or pelvic endometriosis shares the same clinicopathologic characteristics with their counterparts that do not arise from endometriosis and patients have similar overall and disease-free survival.Item Detection of occult neoplastic infiltration in the corpus callosum and prediction of overall survival in patients with glioblastoma using diffusion tensor imaging(2019) Mohan, Suyash; Wang, Sumei; Cohan, Gokcen; Kural, Feride; Chawla, Sanjeev; O'Rourke, Donald M.; Poptani, Harish; 30777198Objective: Corpus callosum (CC) involvement is a poor prognostic factor in patients with glioblastoma (GBM). The purpose of this study was to determine whether diffusion tensor imaging (DTI) can quantify occult tumor infiltration in the CC and predict the overall survival in GBM patients. Methods: Forty-eight patients with pathologically proven GBM and 17 normal subjects were included in this retrospective study. Patients were divided into four groups based on CC invasion and overall survival: long survivors without CC invasion; short survivors without CC invasion; long survivors with CC invasion; short survivors with CC invasion. All patients underwent DTI at 3T MRI scanner. Fractional anisotropy (FA) and mean diffusivity (MD) values were measured from genu, mid-body, and splenium of the CC. The mean values of these parameters were compared between different groups and Kaplan Meier curves were used for prediction of overall survival. Results: Patients with short survival and CC invasion had the lowest FA values (0.64 +/- 0.05) from the CC compared with other groups (p < 0.05). Receiver operator characteristic curve (ROC) analysis indicated that a FA cutoff value of 0.70 was the best predictor for overall survival with an area under the curve (AUC) of 0.77, sensitivity 1, specificity 0.59. Kaplan-Meier survival curves demonstrated that the mean survival time was significantly longer for patients with high FA ( > 0.70) compared with those with low FA ( < 0.70) (p < 0.001). Conclusions: FA values from the CC can quantify occult tumor infiltration and serve as a sensitive prognostic marker for prediction of overall survival in GBM patients.Item Prognostic value of pretreatment Glasgow prognostic score in stage IIIB geriatric non-small cell lung cancer patients undergoing radical chemoradiotherapy(2019) Topkan, Erkan; Bolukbasi, Yasemin; Ozdemir, Yurday; Besen, Ali Ayberk; Mertsoylu, Huseyin; Selek, Ugur; 31178158Objectives: To investigate the prognostic significance of pre-treatment Glasgow prognostic score (GPS) in stage 11113 non-small-cell lung cancer (NSCLC) older patients treated with radical concurrent chemoradiotherapy (C-CRT). Materials and Methods: We included 83 stage IIIB NSCLC older patients (age > 70 years) treated with C-CRT consisting of 60-66 Gy (2 Gy/fx) thoracic radiotherapy and at least 1 cycle of platinum-based chemotherapy. Patients were grouped into three: GPS-0: c-reactive protein (CRP) <= 10 mg/L and albumin >35 g/L, GPS-1: CRP <= 10 mg/L and albumin <= 35 g/L or CRP > 10 mg/L and albumin >35 g/L, GPS-2: CRP > 10 mg/L and albumin <= 35 g/L according to the definition. The relationship between GPS groups and overall survival (OS) was the primary objective, while locoregional-(LRPFS) and progression-free survival (PFS) were secondary objectives. Results: For the whole cohort, the median OS, LRPFS, and OS were 19.7 (95% confidence interval [CI]: 16.8-22.6), 13.2 (95% CI: 8.7-17.7), and 83 months (95% CI: 6.6-10.0), respectively. Comparisons between the GPS-0, GPS-1, and GPS-2 groups revealed that the lower GPS was associated with significantly superior median OS (25.8 versus 16.3 versus 9.4 months; p < .001) which retained its independent significance in multivariate analysis (p < .001), as well. Similarly, the respective median LRPFS (20.0 versus 10.4 versus 63 months; p < .001), and PFS (11.3 versus 73 versus 4.1 months; p < .001) durations were also significantly longer in the earlier GPS groups. Discussion: The present results suggested that the GPS was useful in three layered stratification of older stage IIIB NSCLC patients undergoing C-CRT in terms of OS, LRPS, and PFS times. (C) 2018 Elsevier Ltd. All rights reserved.Item Weight gain as a surrogate marker of longer survival in advanced non-small cell lung cancer patients(2016) Topkan, Erkan; 0000-0001-8120-7123; 27826583; AAG-2213-2021Weight loss (WL), as a key step of the irreversible and fatal cancer-related anorexia cachexia syndrome is present to some degree in 80% of non-small cell lung cancer (NSCLC) patients upon diagnosis which has been clearly proved to negatively alter patients' performance status, quality of life (QOL), response to treatment, and prognosis. However, WL is not a problem encountered only upon diagnosis but is also commonly reported during the course of aggressive chemotherapy, radiotherapy (RT) and particularly the concurrent chemoradiotherapy (C-CRT) which may further diminish QOL measures and clinical outcomes. In general, the NSCLC literature has concentrated on WL during the treatment course, but recent studies have demonstrated that it is possible to preserve or even experience weight gain (WG) during or just short after the discontinuation of various cancer treatments in approximately 40% to 45% NSCLC patients. Considering the fact that recent evidence suggest a prognostic and predictive role for WG in anticipation of longer survival times and better response rates in weight gainers, this current manuscript will specifically aim to realize the actual value of WG in locally advanced and metastatic NSCLC patients which may potentially be added to the conventional prognostic and predictive factors as a novel surrogate marker of outcomes in such patients.Item Prognostic factors for maximally or optimally cytoreduced stage III nonserous epithelial ovarian carcinoma treated with carboplatin/paclitaxel chemotherapy(2018) Ayhan, Ali; Cuylan, Zeliha Fırat; Meydanli, Mehmet M.; Sari, Mustafa E.; Akbayir, Ozgur; Celik, Husnu; Dede, Murat; Sahin, Hanifi; Gungorduk, Kemal; Kuscu, Esra; Ozgul, Nejat; Gungor, Tayfun; 29727055ObjectiveTo identify factors predictive of poor prognosis in women with stage III nonserous epithelial ovarian cancer (EOC) who had undergone maximal or optimal primary cytoreductive surgery (CRS) followed by six cycles of intravenous carboplatin/paclitaxel chemotherapy. MethodsA multicenter, retrospective department database review was performed to identify patients with stage III nonserous EOC who had undergone maximal or optimal primary CRS followed by six cycles of carboplatin/paclitaxel chemotherapy at seven gynecological oncology centers in Turkey. Demographic, clinicopathological and survival data were collected. ResultsA total of 218 women met the inclusion criteria. Of these, 64 (29.4%) patients had endometrioid, 61 (28%) had mucinous, 54 (24.8%) had clear-cell and 39 (17.9%) had mixed epithelial tumors. Fifty-five (25.2%) patients underwent maximal CRS, whereas 163 (74.8%) had optimal debulking. With a median follow-up of 31.5 months, the 5-year progression-free survival (PFS) and overall survival (OS) rates were 34.8% and 44.2%, respectively. Bilaterality (hazard ratio [HR] 1.44, 95% CI 1.01-2.056; P = 0.04), age (HR 2.25, 95% CI 1.176-4.323; P = 0.014) and maximal cytoreduction (HR 0.34, 95% CI 0.202-0.58; P < 0.001) were found to be independent prognostic factors for PFS. However, age (HR 2.6, 95% CI 1.215-5.591; P = 0.014) and maximal cytoreduction (HR 0.31, 95% CI 0.166-0.615; P < 0.001) were defined as independent prognostic factors for OS. ConclusionThe extent of CRS seems to be the only modifiable prognostic factor associated with stage III nonserous EOC. Complete cytoreduction to no gross residual disease should be the main goal of management in these women.