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Öğe 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, IlhanObjectives: 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.Öğe Association between specific KRAS mutations and the clinicopathological characteristics of colorectal tumors(Spandidos Publ Ltd, 2015) Kodaz, Hilmi; Hacibekiroglu, Ilhan; Erdogan, Bulent; Turkmen, Esma; Tozkir, Hilmi; Albayrak, Dogan; Uzunoglu, SernazThe aim of this study was to investigate the clinicopathological characteristics and distribution by tumor localization of KRAS point mutations in metastatic colorectal cancer. A total of 189 patients diagnosed with colorectal cancer between 2007 and 2014, who were either metastatic at the time of diagnosis or developed metastasis subsequently, were included in this study. KRAS mutation analysis was performed in the primary tumor tissues and KRAS mutations were identified in 47.6% of the patients. There was a high frequency of the p.G13D point mutation in left-colon tumors (P=0.011), while the p.G12D point mutation was more frequent in right-colon tumors (P=0.004). KRAS wild-type frequency (P=0.02) was higher among patients aged <40 years. A comparison of codon 12 and 13 mutations revealed that codon 12 mutations were more common in the >50-year-old group (P=0.03) and codon 13 mutations were more common in the <70-year-old group (P=0.04). KRAS wild-type tumors were localized in the right colon (P=0.005) and tumors with the p.G13D point mutation (P=0.018) were diagnosed at non-metastatic stages. In conclusion, KRAS point mutations in colorectal cancer exhibited a heterogeneous distribution in terms of tumor localization. In addition, the p.G13D point mutation was found to differ from other mutations in several aspects.Öğe A case of Guillain-Barre syndrome in a patient with small cell lung cancer treated with chemotherapy(Kare Publ, 2014) Turkmen, Esma; Erdogan, Bulent; Hacibekiroglu, Ilhan; Kodaz, Hilmi; Uzunoglu, Sernaz; Celik, Yahya; Cicin, IrfanGuillain-Barre syndrome (GBS) is an acute inflammatory demyelinating polyradiculoneuropathy characterized by bilateral progressive symmetrical paralysis. GBS is rarely seen neuropathy in cancer patients. In the literature some cases of GBS associated with anticancer chemotherapy. In this case; the guillain-barre syndrome developed after the treatment of a 59-year-old male patient with metastatic small cell lung carcinoma who admitted to hospital with neutropenic fever after cisplatin/etoposide chemoteraphy regime is presented. The patients complained of bilteral progressive symmetrical paralysis in upper and lower limbs with depressed deep tendon reflexes and hypoesthesia. There was no pathological findings on electromyography. There was no a sign at radiological imaging that explained cranial and spinal mestastasis. The cerebrospinal fluid had albuminocytologic dissociation. Decline in tumoral lesions were detected on chest radiography. Accompanied by clinical and laboratory findings, a diagnosis of Guillain-Barre syndrome was considered. Semptoms completely disapperared after intravenous immunoglobulin for five days. Recurrence did not during follow-up. The patients was administered a total of 4 cycles of cisplatin/etoposide chemotherapy. The patient died due to disease progression six months later. We think that, in this case GBS was not a paraneoplatic syndrome because there was more than 50% tumor shrinkage. We propose GBS was induced by infection and chemotherapy rather than malignancy.Öğe Clinical features of the patient with multiple primary tumors: Single center experience(Kare Publ, 2017) Gokyer, Ali; Kostek, Osman; Hacioglu, Muhammet Bekir; Erdogan, Bulent; Kodaz, Hilmi; Turkmen, Esma; Hacibekiroglu, IlhanOBJECTIVE: Multiple primary tumors are the ones that develop in the same patient at the same or different times. They are usually examined under two groups. If the second tumor is diagnosed 6 months after the first tumor is diagnosed, it is named as metachronous tumor. If it is diagnosed in 6 months after the first diagnosis, it is called as synchronous tumor. The malignancy of tumors should be proved histologically. At least 2 cm of solid tissue should be present between two tumors. If they are at localized at the same place, a gap of at least 5 years should be present between them. Metastatic disease should be eliminated. This study aimedto review the clinical, demographic, and pathological features of multiple primary tumors, detect the prevalence, compare the results with literature findings, and evaluate and improve the approach to multiple primary tumors. METHODS: A total of 170 patients diagnosed with multiple primary tumors were included in this study. Patient data were obtained from pathology and medical reports of the patients. RESULTS: Most of the multiple primary tumors were metachronous. The number of male patients was more than that of female patients. The median time between double tumors was 3 monthsforsynchronous tumorsand 26 months for metachronous tumors. Synchronous tumors with the highest prevalence of comorbidity were lung-larynx and lung-colon, whereas metachronous tumors with the highest prevalence of comorbidity were lung-bladder, lung-larynx, breast-endometrium, and breast-colon. The history of smoking and alcohol was found to be higher in male patients andsynchronous tumors. CONCLUSION: The detection of the first tumor in the metastatic stage and an accompanying synchronous secondary tumor was found to be a poor prognostic factor. The treatment of the first tumor, smoking, squamous cell histology, and male gender were among the other factors negatively affecting survival, although they were not statistically significant.Öğe Clinicopathologic analysis and prognostic factors for survival in early stage patients with ampullary carcinoma.(Amer Soc Clinical Oncology, 2016) Ozdemir, Nuriye; Demirci, Nebi Serkan; Yuksel, Sinemis; Erdem, Gokmen Umut; Odabas, Hatice; Boruban, Melih Cem; Hacibekiroglu, Ilhan[Abstract Not Available]Öğe Clinicopathological Characteristics and Prognosis of Patients According To Recurrence Time After Radical Nephrectomy for Localized Renal Cell Carcinoma: A Multicenter Study of Anatolian Society of Medical Oncology (ASMO)(Int Inst Anticancer Research, 2014) Bozkurt, Oktay; Inanc, Mevlude; Hacibekiroglu, Ilhan; Esbah, Onur; Seker, Metin; Ulas, Arife; Aydin, KubraAim: We investigated the clinicopathological features in patients with recurrent RCC within 5 years or more than 5 years after nephrectomy and determined predictors of survival and response treatment after recurrence. Materials and Methods: We retrospectively evaluated 144 patients with disease recurrence; 73 had recurrence more than 5 years after radical nephrectomy. We compared clinicopathological characteristics in patients with disease recurrence before vs. after 5 years. In addition, we investigated predictors of survival and response to treatment after recurrence. Results: Seventy-one patients (49%) were diagnosed with recurrence within 5 years after radical nephrectomy (early recurrence) and 73 patients (51%) were diagnosed with recurrence more than 5 years after radical nephrectomy (late recurrence). Fuhrman grade, tumor necrosis and lymphovascular invasion were statistically significantly different between the two groups (p<0.001, p=0.013, p=0.026, respectively). The late recurrence patients were significantly associated with the Memorial Sloan Kettering Cancer Center (MSKCC) favorable risk group compared to patients with early recurrence (p=0.001). From the time of disease recurrence, median Overall Survival (OS) was 36.0 (95% Confidence Interval (CI) 30.7-412) months in the late recurrence group, and 19 (95% CI 15.4-22.5) months in the early recurrence group (p=0.01). The median Progression Free Survival (PFS) was 6 (95% CI 3.87-8.12) months in the early recurrence group, and 18 (95% CI 15.4-20.5) months for the late recurrence group (p<0.001). Conclusion: Early recurrence was significantly associated with Fuhrman grade 3-4, tumor necrosis, lymphovascular invasion, MSKCC poor- risk group compared to patients with late recurrence. The study also demonstrated a potential prognostic value of late recurrence in terms of PFS and OS.Öğe Comparative analysis of the efficacy and safety of modified FOLFOX-6 and DCF regimens as first-line treatment in advanced gastric cancer(Spandidos Publ Ltd, 2015) Hacibekiroglu, Ilhan; Kodaz, Hilmi; Erdogan, Bulent; Turkmen, Esma; Esenkaya, Asim; Onal, Yilmaz; Uzunoglu, SernazThe aim of this study was to retrospectively compare the efficacy and toxicity of the oxaliplatin + 5-fluorouracil (5-FU) + leucovorin (LV) regimen [modified (m) FOLFOX-6] with that of the docetaxel + cisplatin + 5-FU regimen (DCF) in patients with advanced gastric cancer (AGC). A total of 72 patients received DCF (75 mg/m(2) docetaxel and 75 mg/m(2) cisplatin on day 1 and 750 mg/m(2) 5-FU on days 1-5) every 21 days, whereas 54 patients received mFOLFOX-6 (85 mg/m(2) oxaliplatin and 400 mg/m(2) LV as a 2-h infusion, followed by a 5-FU bolus of 400 mg/m(2) and 2,400 mg/m(2) 5-FU as a 46-h continuous infusion) every 14 days. In the DCF arm, 55 (76.4%) of the patients received prophylactic granulocyte colony-stimulating factor (G-CSF), 48-72 h following completion of chemotherapy. The median follow-up of the study was 12.1 months. The overall response rate (ORR) was 37.0% for mFOLFOX-6 and 40.3% for DCF (P=0.72). The median time to progression was 6.5 and 6.2 months in the mFOLFOX-6 and DCF arms, respectively (P=0.70). The median overall survival was 11.4 and 13.5 months in the mFOLFOX-6 and DCF arms, respectively (P=0.72). The rates of hematological toxicity did not differ between the two arms. However, in the subgroup analysis, grade 3-4 neutropenia and febrile neutropenia were significantly more common among patients who had not received G-CSF prophylaxis in the DCF arm. The incidence of grade 3-4 nausea/vomiting and diarrhea were significantly higher in the DCF arm. In conclusion, the present study demon-strated that the efficacy of the mFOLFOX-6 regimen was comparable to that of the DCF regimen in AGC patients. In addition, the benefit of G-CSF prophylaxis in conjunction with the DCF regimen was demonstrated.Öğe Comparative assessment of three different second-line regimens in chemotherapy resistant / refractory small-cell lung cancer(Imprimatur Publications, 2021) Hacibekiroglu, Ilhan; Ozkul, Ozlem; Cakir, Emre; Kostek, Osman; Karatas, Fatih; Esenkaya, Asim; Demirci, AysePurpose: Small cell lung cancer (SCLC) patients unresponsive or relapsing within 90 days following frontline chemotherapy have poor prognosis and they should be treated with different chemotherapy regimens other than those used in the first-line regimen. Currently there is no globally accepted standard chemotherapeutic regimen for the treatment of these patients. This retrospective study was designed to compare CAV (Cyclophosphamide, Doxorubicin, Vincristine), weekly topotecan and weekly irinotecan regimens and to evaluate the efficacy of the three regimens in patients with chemotherapy resistant/refractory (CRR) SCLC. Methods: A total of 67 CRR-SCLC patients, who were treated with CAV, weekly topotecan and weekly irinotecan were reviewed for weekly irinotecan (27 for 60 mg/m(2) intravenously on days 1, 8 and 15 of a 28-day cycle, 24 for CAV (Cyclophosphamide 750 mg/m(2) on day 1, Doxorubicin 50 mg/m(2) on day 1 and Vincristine 1.4 mg/m(2) on day 1 every 3 weeks), 16 for weekly topotecan (4 mg/m(2) intravenously on days 1, 8 and 15 of a 28-day cycle). Results: The median follow-up time was 12.45 months, there was no difference about disease control rates (DCR) between three chemotherapy regimens (DCR; 25.9% with irinotecan, 29.2% with CAV and 31.3% with topotecan, p=0.92). Objective response rates (ORR) for irinotecan, CAV and topotecan groups were 3,7%, 8,8%, and 0%, respectively (p=0.63). Median progression free survival (PFS) and overall survival (OS) were similar according to irinotecan, CAV, and topotecan (PFS: 1.93 months, 2.30 months and 3.45 months; OS: 2.89 months, 4.79 months and 5.81 months, respectively). The adverse events were generally mild and manageable for both hematological and nonhematological toxicities in all three arms. Conclusions: Weekly irinotecan, CAV and weekly topotecan are similarly effective and safe chemotherapy protocols for the treatment of CRR-SCLC patients.Öğe Frequency of EGFR Mutation in Nsclc and Its Relationship with Clinicopathological Features: A Multicenter Asmo Trial(Elsevier Science Inc, 2015) Yuksel, Sinemis; Kodaz, Hilmi; Yildiz, Ibrahim; Odabasi, Hatice; Ocak, Ayse; Bayoglu, Ibrahim V.; Hacibekiroglu, Ilhan[Abstract Not Available]Öğe Frequency of RAS Mutations (KRAS, NRAS, HRAS) in Human Solid Cancer(Kare Publ, 2017) Kodaz, Hilmi; Kostek, Osman; Hacioglu, Muhammet Bekir; Erdogan, Bulent; Kodaz, Cagnur Elpen; Hacibekiroglu, Ilhan; Turkmen, EsmaRAS oncogene affects numerous cellular functions including growth, proliferation, apoptosis, migration, division and differentiation of the cells. It has 3 known isoforms as Harvey- RAS (HRAS), Kirsten - RAS (KRAS) and Neuroblastoma-RAS (NRAS). RAS has an intrinsic GTPase activity. It encodes proteins binding the guanine nucleotides. KRAS and HRAS were discovered in studies carried out on viruses leading to cancer. Retroviral oncogenes related to murine sarcoma virus genes (Kristen Rat Sarcoma Virus and Murine Sarcoma Virus) were discovered in 1982. These two oncogenes are similar to human KRAS. Approximately 30% of all human cancers have ras genes. Mutations in KRAS account for about 85% for all RAS mutations in human tumors, NRAS is about 11-15%, and HRAS is about 1%.Öğe Hormonal therapy in advenced stage prostate cancer(Kare Publ, 2015) Hacibekiroglu, Ilhan; Kodaz, Hilmi; Turkmen, EsmaProstat cancer is the most common type of cancer in men. At the time of diagnosis, only 5% of prostat cancer patients have the disease in advanced stage. While the 5 year overall survival rate of the patients with locoregional disease is close to 100%, this ratio in patients with advanced disease decreases to 28%. Prostat cancer cells depend on androgens for development, proliferation and physiological function. The purpose of the standard hormone therapy is to keep testesteron levels in castrate levels. Androgen deprivation therapy (ADT) is the standard treatment approach in prostat cancer patients with advanced stage. Although this treatment possesses many clinical benefits, it has also side effects affecting many systems in the body. This article evaluated the types and mechanisms of action of ADT, the management of this treatment's side effects, and the controversial situations commonly encountered in daily oncology practice in the light of current literature.Öğe Impact of bevacizumab on survival outcomes in primary tumor resected metastatic colorectal cancer(Humana Press Inc, 2015) Kodaz, Hilmi; Erdogan, Bulent; Hacibekiroglu, Ilhan; Turkmen, Esma; Gurkan, Hakan; Albayrak, Dogan; Tastekin, EbruWe have studied the efficacy of bevacizumab in colorectal cancer with unresectable metastasis patients who had undergone resection of primary tumor. The patients with unresectable metastasis during diagnosis who had undergone resection of primary tumor without chemotherapy and the patients without resection of primary tumor were included. Among patients who had met the inclusion criteria, 46 patients with resection of primary tumor and 47 without resection of primary tumor were included in the study. A total of 93 unresectable metastatic colorectal cancer patients were included in the study. Median PFS was 9 months (95 % CI 7.37-10.62) in patients with resected primary tumor and bevacizumab containing first-line chemotherapy combination. Median PFS was 10 months (95 % CI 8.06-11.93) in patients without bevacizumab (P = 0.66) Median OS was 25 months (95 % CI 17.92-32.07) in patients with resected primary tumor and bevacizumab containing first-line chemotherapy combination. Median OS was 16 months (95 % CI 9.71-22.28) in patients without bevacizumab (P = 0.36) Median OS was 16 months (95 % CI 13.06-8.939) in patients without resected primary tumor and bevacizumab containing first-line chemotherapy combination. Median OS was 9 months (95 % CI 1.48-16.51) in patients without bevacizumab (P = 0.012). Bevacizumab seems ineffective in mCRC patients with resected primary tumor. An increase in number of retrospective literature data and randomized, prospective studies is required about this subject.Öğe Importance of Ki-67 in human epidermal growth factor receptor 2 positive breast cancer(Imprimatur Publications, 2015) Erdogan, Bulent; Turkmen, Esma; Yalta, Tulin Deniz; Usta, Ufuk; Kodaz, Hilmi; Hacibekiroglu, Ilhan; Tanriverdi, OzgurPurpose: The aim of this study was to evaluate the importance of Ki-67 in Human Epidermal Growth Factor Receptor 2 (Her-2) positive breast cancer patients. Methods: We reviewed the records of patients diagnosed with Her-2-positive non-metastatic breast cancer between 2005 and 2011. Paraffin-embedded tissue samples were stained with MIB-1 mouse monoclonal antibody to find Ki-67 levels. Patients were grouped as low Ki-67 <20% and high Ki-67 >= 20%. Demographic and clinical features were compared. Results: One hundred and six patients were included in the study. Median follow up time was 41 months (range 15-100). Median age was 49.5 years (range 29-79). Twenty-nine patients (27.4%) were in the Ki-67 low group. Demographic features were similar in both groups. Lymphovascular invasion was more frequent in the Ki-67 high group, and hormone receptor (HR) positivity was more frequent in the Ki-67 low group (p=0.03, p=0.03, respectively). Recurrence rate was not significantly different in both groups (p=0.36). T stage (p=0.02), stage (p<0.01), lymphovascular invasion (p=0.02), ER status (p=0.02), and HR status (p<0.01) were related with recurrence. In multivariate analysis, stage and HR negativity were independent factors for recurrence (p<0.01, p=0.01, respectively). Recurrence sites were also similar in both groups. Survival rates at the third year for Ki-67 low group and Ki-67 high group were 94% and 92%, respectively. Conclusion: Her-2 positive patients with low Ki-67 and high Ki-67 had similar demographic and pathologic features except lymphovascular invasion and HR status. HR status was an important factor for disease course. Clinical course was determined by HR status rather than Ki-67.Öğe Increased dose single-agent gemcitabine in platinum-taxane resistant metastatic ovarian cancer(Sage Publications Ltd, 2015) Kodaz, Hilmi; Hacibekiroglu, Ilhan; Turkmen, Esma; Erdogan, Bulent; Elpen, Cagnur; Uzunoglu, Sernaz; Cicin, IrfanBackground: In platinum-taxane resistant epithelial ovarian cancer (EOC), we aimed to determine the effectiveness. Patients and Methods: Between 2004 and 2013, patients afflicted with platinum-taxane resistant EOC and who were administered a 30-minute i.v. infusion of single-agent gemcitabine at a dose of 1,250 mg/m(2) on the 1st, 8th and 15th days, every 28 days, were examined retrospectively. Results: Twenty-six patients with platinum-taxane resistant EOC were included in the study. The overall survival (OS) was 48 months. The median survival after becoming platinum-taxane resistant was 16 months for the study population. Median time to progression (TTP) and median survival after becoming platinum-taxane resistant for patients who received second-line treatment were 3.3 months and 16 months, respectively; for patients who received third-line treatment with gemcitabine, these were 3.7 months and 19 months, respectively. Administration of gemcitabine as second- and third-line chemotherapy in platinum-taxane resistant EOC, provides similar TTP and OS outcomes (p = 0.4, p = 0.9) with a similar response and toxicity rate. Conclusions: Second- and third-line gemcitabine at a dose of 1,250 mg/m(2) on days 1 , 8 and 15 every 28 days as a 30-minute i.v. infusion in platinum-taxane resistant EOC is an effective treatment option with a tolerable and manageable toxicity.Öğe Investigation of the Effect of Tumor Location in Patients with Stage III Colon Cancer Receiving Adjuvant Oxaliplatine-Based Adjuvant Chemotherapy(Akad Doktorlar Yayinevi, 2021) Urvay, Semiha; Demir, Hacer; Gokyer, Ali; Hacibekiroglu, Ilhan; Kucukarda, Ahmet; Cakir, Emre; Beypinar, IsmailLeft-sided (LCC) and right-sided (RCC) colon cancers have different prognostic and predictive features in metastatic colon cancers, however there is insufficent data about tumor location in stage III disease. The aim of this study is to investigate the effect of tumor location on prognosis in patients with stage III colon cancer. From 2006 to 2012, medical records of 215 patients who underwent primary surgery and received adjuvant oxaliplatin based chemotherapy at 5 referral centers were collected, retrospectively. Disease-free survival (DFS) and overall survival were analysed using Kaplan-Meier and log-rank tests, and prognostic facrtors were identified by Cox regression methods. Clinicopathological characteristics of patients were similar between patients with right-and left-sided colon cancers. The 3-year DFS rate was similar (88% vs 78%, p= 0.07) but the RCC was significantly associated with a shorter 3-year OS than LCC (76% vs 87%, p= 0.03). The 3-year median OS was 125.8 months for all patients groups, 92.2 (+/- 5.81) months for the RCCs and 132.2 (+/- 5.52) months for the LCCs (p= 0.037). Multivariate analysis showed that stage (HR:0.32, p= 0.042 for OS) and venous invasion (HR: 0.28, p= 0.002 for OS) were the independent prognostic factors. Although there was no DFS difference between RCCs and LCCs, poorer survival of RCC indicated that the prognosis of RCC worsened after transitioning to the metastatic stage. Tumor location may be a prognostic factor in metastatic colon cancer but not in stage III disase.Öğe Is Late Recurrence a Predictive Clinical Marker for Better Sunitinib Response in Metastatic Renal Cell Carcinoma Patients?(Cig Media Group, Lp, 2015) Bozkurt, Oktay; Hacibekiroglu, Ilhan; Kaplan, Muhammet Ali; Duzkopru, Yakup; Uysal, Mukremin; Karaca, Halit; Berk, VeliAlthough there has been an increase in overall and progression-free survival with the use of novel targeted therapies in metastatic renal cell carcinoma (mRCC) in recent times, predictive markers to determine which patients would benefit from tyrosine kinase inhibitor therapies are needed. The late recurrence might be a predictive marker for response to sunitinib treatment in patients with mRCC. Background: We investigated the clinicopathological features in patients with recurrent renal cell carcinoma (RCC) within 5 years or more than 5 years after nephrectomy and determined predictors of overall survival (OS) and progression-free survival (PFS) after disease recurrence in the administration of first-line sunitinib in the treatment of metastatic RCC (mRCC). Patients and Methods: In this study we enrolled 86 Turkish patients with mRCC who received sunitinib. Univariate analyses were performed using the log rank test. Results: Fifty-six patients (65%) were diagnosed with disease recurrence within 5 years after radical nephrectomy (early recurrence) and 30 patients (35%) were diagnosed with recurrence more than 5 years after radical nephrectomy (late recurrence). Fuhrman grade was statistically significantly different between the 2 groups (P = .013). The late recurrence patients were significantly associated with the Memorial Sloan Kettering Cancer Center favorable risk group compared with patients with early recurrence (p = .001). There was a statistically significant correlation between recurrence time and the rate of objective remission (ORR) (the late recurrence group vs. the early recurrence group: 43.3% vs. 14.3%, respectively; P = .004). From the time of disease recurrence, the median OS was 42.0 (95% confidence interval [CI], 24.4-59.5) months in the late recurrence group, and 16 (95% CI, 11.5-20.4) months in the early recurrence group (P = .001). Median PFS was 8(95% CI, 4.05-11.9) months in the early recurrence group, and 20 (95% CI, 14.8-25.1) months in the late recurrence group (P <= .001). Conclusion: The study demonstrated a potential prognostic value of late recurrence in terms of PFS, OS, and ORR. (C) 2015 Elsevier Inc. All rights reserved.Öğe Is sunitinib-induced hypothyroidism a predictive clinical marker for better response in metastatic renal cell carcinoma patients?(Taylor & Francis Ltd, 2016) Bozkurt, Oktay; Karaca, Halit; Hacibekiroglu, Ilhan; Kaplan, Muhammed Ali; Duzkopru, Yakup; Uysal, Mukremin; Berk, VeliBackground: The main goal of this study was to examine whether the occurrence of hypothyroidism during sunitinib therapy in patients with metastatic renal cell carcinoma (mRCC) is associated with a better outcome. Methods: The study enrolled 81 patients with pathologically proven mRCC who were treated with sunitinib between March 2008 and June 2013. Thyroid function evaluation comprised (free-thyroxine) FT4 and thyroid-stimulating hormone (TSH) before treatment and at day 1 of each 6-week cycle. Survival analysis was performed using the Kaplan-Meier method, and the differences among the groups were determined using the log-rank test. Results: Hypothyroidism occurred in 30 (37%) of 81 patients within a median 3 months (range 1-18) of treatment initiation. There was a statistically significant correlation between the occurrence of hypothyroidism during treatment and the rate of objective remission (ORR) (hypothyroid patients vs euthyroid patients: 46.7 vs 13.7%, respectively; P = 0.001). Median progression-free survival (PFS) was 10 (95% CI 6.13-13.8) months in the euthyroid patients, and 17 (95% CI 9.33-24.6) months in the hypothyroid patients (P = 0.001). The median overall survival (OS) was 39 (95% CI 25.4-52.5) months in the hypothyroid patients and 20 (95% CI 14.7-25.2) months in the euthyroid patients (P = 0.019). Conclusions: The occurrence of hypothyroidism during treatment in patients was significantly associated with longer PFS, OS and better ORR in the current study.Öğe Is sunitinib-induced hypothyroidism a predictive clinical marker for better response in metastatic renal cell carcinoma patients? [Meeting Abstract](Amer Soc Clinical Oncology, 2015) Ozkan, Metin; Bozkurt, Oktay; Hacibekiroglu, Ilhan; Kaplan, Muhammet Ali; Duzkopru, Yakup; Uysal, Mukremin; Karaca, Halit[Abstract Not Available]Öğe K-RAS and N-RAS mutations in testicular germ cell tumors(Assoc Basic Medical Sci Federation Bosnia & Herzegovina Sarajevo, 2017) Hacioglu, Bekir Muhammet; Kodaz, Hilmi; Erdogan, Bulent; Cinkaya, Ahmet; Tastekin, Ebru; Hacibekiroglu, Ilhan; Turkmen, EsmaTesticular cancer is a relatively rare tumor type, accounting for approximately 1% of all cancers in men. However, among men aged between 15 and 40 years, testicular cancer is the most commonly diagnosed malignancy. Testicular germ cell tumors (TGCTs) are classified as seminoma and non-seminoma. The RAS oncogene controls several cellular functions, including cell proliferation, apoptosis, migration, and differentiation. Thus, RAS signaling is important for normal germ cell development. Mutations of the Kirsten RAS (K-RAS) gene are present in over 20% of all cancers. RAS gene mutations have also been reported in TGCTs. We investigated K-RAS and N-RAS mutations in seminoma and non-seminoma TGCT patients. A total of 24 (55%) pure seminoma cases and 19 (45%) non-seminoma cases were included in the study. K-RAS and N-RAS analyses were performed in our molecular pathology laboratory, using K-RAS and N-RAS Pyro Kit 24 V1 (Qiagen). In total, a RAS mutation was present in 12 patients (27%): 7 seminoma (29%) and 5 non-seminoma cases (26%) [p = 0.55]. AK-RAS mutation was present in 4 pure seminoma tumors (16%) and 3 non-seminoma tumors (15%) [p = 0.63], and an N-RAS mutation was observed in 4 seminoma tumors (16%) and 3 non-seminoma tumors (15%) [p = 0.63]. Both, K-RAS and N-RAS mutations were present in two patients: One with seminoma tumor and the other with non-seminoma tumor. To date, no approved targeted therapy is available for the treatment of TGCTs. The analysis of K-RAS and N-RAS mutations in these tumors may provide more treatment options, especially in platinum-resistant tumors.Öğe Major and minor salivary gland cancers: A multicenter retrospective study(Wiley, 2023) Hacioglu, Muhammet Bekir; Erdogan, Bulent; Bardakci, Murat; Algin, Efnan; Gulbagci, Burcu; Hacibekiroglu, Ilhan; Hamdard, JamshidBackgroundMost of the studies on salivary gland cancers are limited for various reasons such as being single-center, small number of patients, including only major or minor SGCs, or only including epidemiological data. MethodsA total of 37 medical oncology clinics from different regions of Turkey participated in this retrospective-multicenter study. The analyzed data included clinical and demographical features, primary treatment, metastasis localizations, and treatments and includes certain pathologic features. ResultsThe study included data from a total of 443 SGCs. 56.7% was in major salivary glands and 43.3% was in minor salivary glands. Distant metastasis in the major SGCs was statistically significantly more common than in the minor SGCs, locoregional recurrence was statistically significantly more common in the minor SGCs than in the major SGCs (p = 0.003). ConclusionsEpidemiological information, metastasis and recurrence patterns, treatment modalities, and survival analysis of the patients over 20 years of follow-up are presented.
