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Öğe Alpha-fetoprotein Secreting Neuroendocrine Carcinoma of the Liver: a Case Report and Literature Review(Springer, 2019) Bozkaya, Yakup; Aydin, U.; Avci, A.; Tuncer, D.; Yilmaz, E.[Abstract Not Available]Öğe Is serum survivin expression a predictive biomarker in locally advanced gastric cancer patients treated with neoadjuvant chemotherapy?(Ios Press, 2018) Bozkaya, Yakup; Ozdemir, Nuriye Yildirim; Sezer, Sevilay; Kostek, Osman; Demirci, Nebi Serkan; Yazici, Ozan; Erdem, Gokmen UmutBACKGROUND: The potential prognostic value of survivin is variably reported depending on the gastric cancer. OBJECTIVE: Evaluation of the prognostic and predictive significance of serum survivin and its relation with survival and treatment response rates in patients with locally advanced gastric cancer (LAGC). METHODS: Serum samples were prospectively collected from 50 patients with newly diagnosed LAGC. Serum samples of 32 healthy subjects were also collected as control groups for survivin levels. Serum survivin levels were evaluated at baseline and after three cycles of neoadjuvant chemotherapy in LAGC patients. RESULTS: Median survivin level was 147 IU/L (range = 4.4-4936) at baseline and was 27 IU/L (range = 4.2-4737) after neoadjuvant chemotherapy. The difference between survivin levels of the control group (26 IU/L, range = 3.8-1430) and pretreatment patient group was statistically significant (p < 0.001). Clinical response to mDCF regimen was classified as progressive (progressive disease) and non-progressive groups (partial response + stable disease). Baseline survivin levels were similar between patients in progressive and non-progressive groups (p = 0.55). Survivin levels were significantly reduced after chemotherapy in non-progressive group (p < 0.001). In contrast, serum survivin levels increased in a stepwise fashion from baseline to post-chemotherapy in patients with progressive disease (p = 0.06). Patients were divided into low and high survivin groups according to baseline median survivin levels. Median DFS was 12.4 and 14.6 months for low and high groups, respectively (p = 0.18). Moreover, median OS was 14.4 and 24.9 months for low and high group, respectively (p = 0.14). CONCLUSION: It can be suggested that serum survivin can be used as a predictor of response to chemotherapy-but not survival-in LAGC patients receiving neoadjuvant mDCF chemotherapy. However, large multicenter prospective studies are required to confirm these results.Öğe Is the Charlson Comorbidity Index a Prognostic Indicator for Toxicity and Mortality in Elderly Patients with Locally Advanced Rectal Cancer?(Acad Medical Sciences I R Iran, 2019) Kostek, Osman; Bozkaya, Yakup; Hacioglu, Muhammet Bekir; Ozdemir, Nuriye Yildirim; Yilmaz, Erdem; Demircan, Nazim Can; Erdogan, BulentBackground: Aging is significantly related to multiple comorbidities. Even with a good performance score, some elderly patients may have poor survival outcomes. We aimed to evaluate the prognostic value of the Charlson comorbidity index (CCI) for mortality and toxicity in elderly patients with locally advanced rectal cancer (LARC). Methods: Seventy-two elderly patients with LARC who were treated with neoadjuvant chemoradiotherapy (CRT) were included. Based on their CCI score, severity of the comorbidity was categorized into 2 groups: CCI<7 and CCI >= 7. Results: The overall survival (OS) at 5 years was 54.4 percent in patients treated with neoadjuvant CRT. Median OS was not reached for all patients as well as patients with CCI score <7, but median OS was 25 (95% CI 1.0-62.1) months in patients with CCI >= 7 (P=0.002). The OS at 2 years was 79.1 percent in the patients with CCI <7 and 50.0 percent in the patients with CCI score >= 7 (P=0.002). Moreover, there was a trend toward, patients with higher CCI score who had more treatment related to grade 3 or 4 toxicity compared to those with CCI score <7 (33.3% vs 13.3%, respectively, P=0.09). Multivariable analysis indicated that the CCI score=7, presence of down-staging after therapy and clinical stage (III) independently predict mortality (HR 6.14, 95% CI 2.45-15.35, P<0.001) in patients with LARC. Conclusion: Although CCI score was not significantly associated with both toxicity and disease-free survival (DFS), we suggest that baseline CCI score might be a valuable prognostic indicator for physicians to evaluate elderly patiens with LARC for optimal treatment.Öğe Is the prognostic nutritional index a prognostic and predictive factor in metastatic non-small cell lung cancer patients treated with first-line chemotherapy?(Springer, 2020) Bozkaya, Yakup; Kostek, Osman; Sakin, Abdullah; Ozyukseler, Deniz Tataroglu; Sakalar, Teoman; Cil, IbrahimPurpose We aimed to assess the prognostic and predictive significance of pretreatment Onodera's prognostic nutritional index (OPNI) in metastatic non-small cell lung cancer patients (NSCLC) treated with first-line chemotherapy. Materials and methods Patients with metastatic NSCLC who attended five different medical oncology clinics between December 2008 and January 2018 were retrospectively analyzed. The optimal cut-off point for OPNI was performed by a receiver operating characteristic (ROC) curve analysis. Patients were assigned to either the low OPNI group or high OPNI group. Results A total of 333 patients were included in the study. Significant differences between the low and high OPNI groups were found regarding the rates of response to chemotherapy, sex, and hemoglobin level (p < 0.05). The patients in high OPNI group had a longer overall survival (OS) (15.3 vs. 10.6 months, p < 0.001) and progression-free survival (PFS) (6.7 vs. 5.3 months, p < 0.001) compared to the patients in low OPNI group. A multivariate analysis using Cox regression model revealed that a high OPNI score was an independent prognostic factor of OS (HR = 1.535, p = 0.002) and PFS (HR = 1.336, p = 0.014), but failed to demonstrate a statistical significance of pretreatment OPNI scores in predicting treatment response (p = 0.56). Conclusions Pretreatment OPNI is an independent prognostic factor for OS and PFS in metastatic NSCLC patients treated with first-line chemotherapy. Thus, it may be used as easily calculated and low-cost prognostic tool in the routine clinical practice in this patient group.Öğe Primary bilateral breast lymphoma in an elder male patient(Wiley, 2019) Bozkaya, Yakup; Oz Puyan, Fulya; Bimboga, Busem[Abstract Not Available]Öğe Prognostic importance of the albumin to globulin ratio in metastatic gastric cancer patients(Taylor & Francis Ltd, 2019) Bozkaya, Yakup; Erdem, Gokmen Umut; Demirci, Nebi Serkan; Yazic, Ozan; Ozdemir, Nuriye Yildirim; Kostek, Osman; Zengin, NurullahAim: The aim of this study was to evaluate the prognostic importance of the albumin to globulin ratio (AGR) in terms of overall survival (OS) and progression free survival (PFS) in metastatic gastric cancer patients. Methods: The patients diagnosed with metastatic gastric cancer between 2009 and April 2016 at the hospital have been studied retrospectively. The clinicopathological characteristics, laboratory, and treatment parameters have been assessed. AGR value has been calculated using the following formula (AGR = serum albumin/total protein - serum albumin). Results: In total, 251 patients were included in the study population. The median value of AGR was 1.206 (range = 0.460-3.130), and the cut-off value was set as 1.20. Based on the cut-off value, 126 patients were categorized in the low AGR group, while the remaining 125 patients were categorized in the high AGR group. ECOG (Eastern Cooperative Oncology Group) performance scores, CEA levels, CA19-9 levels, hemoglobin levels, lactate dehydrogenase levels, and liver metastasis ratios varied significantly between the low and high AGR groups (p < .05). The Kaplan-Meier curve has shown that, compared to the low AGR group, the high AGR group has better OS (12.2 vs 9.3 months, p = .002) and better PFS (8.0 vs 5.7 months, p < .001) rates. The univariate and multivariate analyses also proved that low AGR is an independent bad risk factor in metastatic gastric cancer patients, both in terms of OS (p = .019, Hazard Ratio (HR) = 1.380, 95% Confidence Interval (CI) = 1.055-1.805) and PFS (p = .002, HR = 1.514, 95% CI = 1.164-1.968). Conclusion: In metastatic gastric cancer patients, AGR is an independent prognostic factor for OS and PFS. Thus, in this patient group, the low cost albumin and globulin which can be measured with routine clinical practice may be used as an appropriate prognostic tool.Öğe Terapötik aferez işlemlerinin değerlendirilmesi;retrospektif ve prospektif veri toplama çalışması(Trakya Üniversitesi Tıp Fakültesi, 2013) Bozkaya, Yakup; Demir, Ahmet MuzafferTerapötik aferez çeşitli hastalıklarda primer veya yardımcı tedavi olarak kullanılmaktadır. Trakya Üniversitesi Sağlık-Araştırma ve Uygulama Hastanesi Terapötik Aferez Merkezi'nde Ocak 2007 ve Ekim 2012 tarihleri arasında yapılan terapötik aferez işlemleri geriye dönük ve ileriye yönelik olarak incelenmiştir. Her bir hastanın; yaş, cinsiyet, boy, kilo, klinik endikasyon uygulama öncesi ve sonrası lökosit, biyokimyasal parametreleri kaydedildi. Her işlem için şu parametreler incelendi: cihaz ve venöz yol tipi (santral/periferal), kan miktarı ve plazma türü, işlem süresi, verilen yedek sıvının tipi, tedavi yanıtı ve yan etkiler. Ocak 2007 ve Ekim 2012 tarihleri arasında 126 hastaya 753 işlem yapıldı (64 erkek ve 62 kadın, ortalama yaş aralığı 50,5 ± 18,3 yıl). Bu işlemlerin 628'i terapötik plazma değişimi, 79'u kaskad filtrasyonu ve 46`sı sitaferez (lökositaferez ve trombositaferez) oluşturdu. Terapötik aferez uygulanan hastalıkların başında hematolojik (%42,9) ve nörolojik hastalıklar (%25,4) yer aldı. En sık üç hastalık grubu: Trombotik trombositopenik purpura, Gullian-Barre Sendromu ve Multipl Miyelom idi. American Society for Apheresis kılavuzuna göre terapötik plazma değişiminin %76,7'si, kaskad filtrasyonunun %63,2'si ve sitaferez işlemlerinin %82,6'sı kategori I-II idi. Trombotik trombositopenik purpura hastalık grubunda terapötik plazma değişimi sonrası trombosit sayısı anlamlı bir şekilde yükseldi. Lökosit sayısı lökositaferez sonrası, trombosit sayısı ise trombositaferez sonrası istatiksel olarak anlamlı bir şekilde düştü. Çalışmamızda total terapötik aferez komplikasyon oranı %9,6 olarak bulundu. Komplikasyonların %3,9'u damar yolu ve cihaz, %5,7'si ise tedavi ile ilgili idi. En sık görülen yan etki; hipokalsemik semptomlardı. Akut myeloblastik lösemi tanılı bir hasta lökositaferez işlemi sırasında öldü. Sonuç olarak verilerimizin diğer yapılan çalışmalara benzer olduğu ve çeşitli hematolojik, nörolojik, metabolik ve diğer hastalıklarda uygulanabilen güvenli bir işlem olduğu düşünüldü.
