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    Assessment of Prognostic Factors in Epithelial Ovarian Cancer
    (Kare Publ, 2017) Onal, Yilmaz; Kostek, Osman; Hacioglu, Muhammet Bekir; Erdogan, Bulent; Kodaz, Hilmi; Bekmez, Esma Turkmen; Hacibekiroglu, Ilhan
    Objectives: Ovarian cancer is the second most common gynecological cancer, and has a 5-year survival rate of about 40% to 45%. This ratio ranges from 15% to 95%, based on prognostic factors. There are numerous clinical, pathological and biological factors related to prognosis. The aim of this study was to assess prognostic factors in advanced epithelial ovarian cancer. Methods: A total of 119 stage III and stage IV ovarian cancer patients were evaluated. The patients age, menopausal status, age of menarche, number of children, height and weight values, surgery, tumor histopathological features, presence of metastasis, residual tumor volume, presence of ascites, abdominal lavage cytology, chemotherapy regimen, number of chemotherapy cycles, the first and last chemotherapy dates, relapse, and recent status were evaluated. Results: The median age of the study patients was 54 years (minimum: 34, maximum: 79 years). The pathological stages were 10 (8.6%) patients with IIIA, 6 (5%) patients with IIIB, 76 (63.9%) patients with IIIC, and 27 (22.7%) patients with stage IV. In multivariate analysis, age of diagnosis (hazard ratio [HR]: 0.44; 95% confidence interval [CI], 0.22-087; p=0.01), postoperative tumor residual status (HR: 0.32; 95% CI, 0.14-0.71; p<0.01), number of adjuvant chemotherapies (HR: 0.48; 95% CI, 0.23-0.98; p=0.04), and platinum sensitivity (HR: 0.37; 95% CI, 0.18-0.74; p<0.01) were found to be independent variables related to longer survival. Notably, a patient treated with more than 6 cycles of chemotherapy had a worse prognosis. Conclusion: Independent indicators of a poor prognosis in our study were determined to be advanced age at diagnosis, a residual tumor more than 2 cm in size, more than 6 cycles of chemotherapy, and the presence of platinum-resistant disease. A multidisciplinary approach is needed to improve prognosis.
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    Value of MRI apparent diffusion coefficient for assessment of response to sorafenib in hepatocellular carcinoma
    (Imprimatur Publications, 2018) Kostek, Osman; Yilmaz, Erdem; Hacioglu, Muhammet Bekir; Erdogan, Bulent; Kodaz, Hilmi; Bekmez, Esma Turkmen; Hacibekiroglu, Ilhan
    Purpose: Efficient and adequate evaluation of therapeutic response in hepatocellular carcinoma (HCC) is an evolving field. We aimed to evaluate apparent diffusion coefficient (ADC) values in the prediction of response to sorafenib and prognosis in patients with advanced HCC. Methods: Baseline magnetic resonance (MR) imaging was performed before treatment. After sorafenib started, clinical and radiological response were evaluated at approximately 3 months later. ADC measurements were performed by a 12year experienced radiologist who evaluated MR before and after sorafenib therapy. Results: A total of 17 patients (median age 60 years, range 51-66 and M/F ratio= 3.25/1) were analyzed. A significant increase in ADC levels in responders was observed 3 months after sorafenib therapy. Baseline and post-sorafenib ADC values were not significantly associated with mortality (hazard ratio/HR baseline ADC = 1.003, p = 0.98) and after sorafenib (HR 0.480, p = 0.48, respectively). Conclusion: Advanced HCC patients with a favorable response to sorafenib had a significant increase in ADC value at the first radiological evaluation. The predictive and prognostic role of ADC for overall survival is still unknown and further research is needed to investigate any possible association.