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    Adrenocortical Cancer in the Real World: A Comprehensive Analysis of Clinical Features and Management from the Turkish Oncology Group (TOG)
    (Cig Media Group, Lp, 2024) Yasar, Hatime Arzu; Aktas, Burak Yasin; Ucar, Gokhan; Goksu, Sema Sezgin; Bilgetekin, Irem; Cakar, Burcu; Sakin, Abdullah
    Adrenocortical cancer is a rare and poor prognostic malignant tumor. The definitions of prognostic factors in localized and metastatic diseases are important. In this paper, we defined the clinical features, management, and prognostic factors related to survival in patients with metastatic and nonmetastatic ACC. Cox regression analysis showed that age, Ki67 value, ECOG PS, and hormonal activity were significantly associated with survival in patients with nonmetastatic disease. Only patients who underwent surgery had significantly better OS compared with patients without surgery in univariate analyses of metastatic disease. Introduction: Adrenocortical carcinoma (ACC) is a rare yet highly malignant tumor associated with significant morbidity and mortality. This study aims to delineate the clinical features, survival patterns, and treatment modalities of ACC, providing insights into the disease's prognosis. Materials and Methods: A retrospective analysis of 157 ACC patients was performed to assess treatment methodologies, demographic patterns, pathological and clinical attributes, and laboratory results. The data were extracted from the hospital's database. Survival analyses were conducted using the Kaplan-Meier method, with univariate and multivariate analyses being performed through the log -rank test and Cox regression analyses. Results: The median age was 45, and 89.4% had symptoms at the time of diagnosis. The median tumor size was 12 cm. A total of 117 (79.6%) patients underwent surgery. A positive surgical border was detected in 26 (24.1%) patients. Adjuvant therapy was administered to 44.4% of patients. The median overall survival for the entire cohort was 44.3 months. Median OS was found to be 87.3 months (95% confidence interval [CI] 74.4-100.2) in stage 2, 25.8 (95% CI 6.5-45.1) months in stage 3, and 13.3 (95% CI 7.0-19.6) months in stage 4 disease. Cox regression analysis identified age, Ki67 value, Eastern Cooperative Oncology Group performance status, and hormonal activity as significant factors associated with survival in patients with nonmetastatic disease. In metastatic disease, only patients who underwent surgery exhibited significantly improved overall survival in univariate analyses. Conclusion: ACC is an uncommon tumor with a generally poor prognosis. Understanding the defining prognostic factors in both localized and metastatic diseases is vital. This study underscores age, Ki67 value, Eastern Cooperative Oncology Group performance status, and hormonal activity as key prognostic determinants for localized disease, offer ing cr itical insights into the complexities of ACC management and potential avenues for targeted therapeutic interventions.
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    Is there any prognostic significance in pleural involvement and/or effusion in patients with ALK-positive NSCLC?
    (Springer, 2023) Guner, Gurkan; Aktas, Burak Yasin; Basal, Fatma Bugdayci; Demirkazik, Ahmet; Gursoy, Pinar; Demirci, Umut; Erman, Mustafa
    PurposeAnaplastic lymphoma kinase (ALK) mutations occurs in approximately 3-5% of patients with non-small cell lung cancer (NSCLC). Pleural involvement/effusion is common in ALK-positive patients with NSCLC at baseline. The aim of the study was to evaluate the characteristics of ALK-positive patients who have Ple-I/E.MethodsIn this multicenter study, patients with ALK-positive NSCLC who have Ple-I/E were retrospectively analyzed. Clinical and demographic characteristics of the disease, response rates, median progression-free survival (PFS), and overall survival (OS) were evaluated in 362 ALK-positive patients with NSCLC.ResultsOf the patients, 198 (54.7%) were male. The median age at the time of diagnosis was 54 (range 21-85) years. All patients' histology was adenocarcinoma (100%). At baseline, 57 (15.7%) patients had Ple-I/E. There was no association between Ple-I/E and gender, lung metastasis, or distant lymphadenopathy (LAP) metastasis. The frequencies of liver, brain, and bone metastases were significantly higher in ALK-positive patients without Ple-I/E compared to those with Ple-I/E (respectively 18.2% vs 4.8%, p = 0.008; 19.1% vs 4.8%, p = 0.001; 20.6% vs 8.9%, p = 0.002). The median PFS was longer in ALK-positive patients who had Ple-I/E (18.7 vs 10.6 months, p = 0.017). Similarly, the median OS was longer in ALK-positive patients who had Ple-I/E (44.6 vs 22.6 months, p = 0.051).ConclusionBrain, liver, and bone metastases were lower in ALK-positive patients with Ple-I/E. Patients presented with Ple-I/E were prone to have better PFS and OS.
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    Retrospective analysis of ribociclib and letrozole as first-line therapy in patients with hormone receptor (HR) positive metastatic breast cancer (MBC) within a managed access program (MAP) in Turkey.
    (Lippincott Williams & Wilkins, 2020) Basaran, Gul; Demirci, Umut; Yildiz, Fatih; Cicin, Irfan; Aktas, Burak Yasin; Ozturk, Banu; Goksu, Sema Sezgin
    [Abstract Not Available]