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Öğe Abiraterone acetate (AA) in patients with metastatic castration-resistant prostate cancer (MCRPC) after docetaxel chemotherapy: Multicentric experience of Anatolian Society of Medical Oncology(Lippincott Williams & Wilkins, 2014) Demirci, Umut; Oflazoglu, Utku; Kodaz, Hilmi; Ciltas, Aydin; Kefeli, Umut; Akyol, Murat; Ozturk, Banu[Abstract Not Available]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 Combination of Docetaxel and Gemcitabine Ineffective in Metastatic Eccrine Porocarcinoma: A Case Report(Kare Publ, 2017) Kodaz, Hilmi; Hacioglu, Muhammet Bekir; Kostek, Osman; Erdogan, Bulent; Tastekin, Ebru; Kodaz, Cagnur Elpen; Cicin, IrfanMalignant eccrine porocarcinoma is a very rare tumor and the etiology is not known. Treatment is surgical removal of the tumor. The benefit of chemotherapy and radiotherapy is unclear. A 49-year-old male patient presented with the complaint of left inguinal swelling. Ultrasonography examination revealed 5x4 cm inguinal lymphadenopathy. The inguinal lymph nodes were excised. Pathology report indicated eccrine porocarcinoma. The patient was treated with cisplatin 40 mg/m(2) week as well as concurrent radiotherapy for 5 weeks. After 6 weeks of dual therapy, liver metastases were detected. KRAS, NRAS, and BRAF tests were negative. Gemcitabine was administered at a dose of 1000 mg/m(2) on days 1 and 8 every 21 days, and docetaxel was administered at a dose of 75 mg/m(2) on day 8, every 21 days. There was progression after 2 cycles of chemotherapy. The patient lived 7 months. In this case, use of synchronous cisplatin and radiotherapy as adjuvant treatment could not prevent tumor metastasis. The combination chemotherapy of docetaxel and gemcitabine applied after metastatic disease development was ineffective.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 Effect of delayed radical cystectomy for invasive bladder tumors on lymph node positivity, cancer-specific survival and total survival(Sage Publicatıons Ltd., 2018) Turk, Hakan; Un, Sitki; Cinkaya, Ahmet; Kodaz, Hilmi; Parvizi, Murtaza; Zorlu, FerruhIntroduction: Radical cystectomy (RC) is the main treatment option for patients with muscle-invasive bladder cancer (MIBC) and non-muscle-invasive bladder cancer (NMIBC), which carry the highest risk of progression. In this study, we investigated the effect of time from transurethral resection of the bladder (TUR-B) to cystectomy on lymph node positivity, cancer-specific survival and overall survival in patients with MIBC. Methods: The records were reviewed of 530 consecutive patients who had RC and pelvic lymphadenectomy procedures with curative intent performed by selected surgeons between May 2005 and April 2016. Our analysis included only patients with transitional cell carcinoma of the bladder; we excluded 23 patients with other types of tumor histology. Results: Patients who underwent delayed RC were compared with patients who were treated with early RC; both groups were similar in terms of age, gender, T stage, tumor grade, tumor differentiation, lymph node status and metastasis status. However, when both groups were compared for disease-free survival and overall survival, patients of the early-RC group had a greater advantage. Conclusions: The optimal time between the last TUR-B and RC is still controversial. A reasonable time for preoperative preparation can be allowed, but long delays, especially those exceeding 3 months, can lead to unfavorable outcomes in cancer control.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 Genç Yaş Akciğer Kanserlerinin Klinikopatolojik Özellikleri(2017) Kodaz, HilmiGİRİŞ ve AMAÇ: Akciğer kanseri dünyada en sık görülen veen ölümcül kanserlerden biridir. Sigara içmenin süresi vemiktarının akciğer kanseri gelişiminde etkin bir rol oynadığıbilinmektedir. Akciğer kanserleri genelde orta ileri yaşlardasık görülmekle birlikte 40 yaş altında nispeten nadirdir. Bizçalışmamızda 40 yaşın altında iken akciğer kanserineyakalanan hastaların klinikopatolojik özelliklerini ortayakoymayı amaçladık.GEREÇ ve YÖNTEM: 2000-2015 yılları arasında Trakyaüniversitesi tıp fakültesi tıbbi onkoloji polikliniğine başvuranhastalar retrospektif olarak tarandı ve 40 yaş altında ikenakciğer kanseri tanısı alan hastalar çalışmaya dahil edildi.BULGULAR: Çalışma kriterlerine uyan 11 erkek 4 kadıntoplam 15 hasta vardı. 10 hastanın özgeçmişinde sigarakullanımı vardı. Özgeçmişlerinde sigara kullanımı olanlardaortalama genel genel sağkalım 7 ay olmayanlarda 43 aydı.TARTIŞMA ve SONUÇ: Çalışmamız 40 yaşın altında akciğerkanseri tanısı alan hastalarda, sigara içme öyküsününbulunmasının kötü bir prognostik faktör olabileceğinigöstermiştir.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 active smoking on survival of patients with metastatic lung adenocarcinoma harboring an epidermal growth factor receptor (EGFR) mutation(Assoc Basic Medical Sci Federation Bosnia & Herzegovina Sarajevo, 2016) Erdogan, Bulent; Kodaz, Hilmi; Karabulut, Senem; Cinkaya, Ahmet; Tozkir, Hilmi; Tanriverdi, Ozgur; Cabuk, DevrimLung cancer in smokers and non-smokers demonstrates distinct genetic profiles, and cigarette smoking affects epidermal growth factor receptor (EGFR) function and causes secondary EGFR tyrosine kinase resistance. We evaluated the effect of active smoking in patients with metastatic lung adenocarcinoma. A total of 132 metastatic lung adenocarcinoma patients, diagnosed between 2008 and 2013, with known EGFR mutation status, were evaluated retrospectively. Among these patients, 40 had an activating EGFR mutation. Patients who continued smoking during the treatment were defined as active smokers. Former smokers and never smokers were together defined as non-smokers. The outcomes of the treatment in relation to the EGFR mutation and smoking status were evaluated. The median follow-up time was 10.5 months. The overall response rate for the first-line therapy was significantly higher among the EGFR-mutant patients (p = 0.01), however, smoking status had no impact on the response rate (p = 0.1). The EGFR-mutant active smokers progressed earlier than the non-smokers (p < 0.01). The overall survival (OS) of the non-smokers and patients treated with erlotinib was significantly longer (p = 0.02 and p = 0.01, respectively). Smoking status did not affect the OS in EGFR wild type tumors (p = 0.49) but EGFR-mutant non-smokers had a longer OS than the active smokers (p = 0.01). The active smokers treated with erlotinib had poorer survival than the non-smokers (p = 0.03). Multivariate analysis of EGFR-mutant patients showed that erlotinib treatment at any line and non-smoking were independent prognostic factors for the OS (p = 0.04 and p = 0.01, respectively). Smoking during treatment is a negative prognostic factor in metastatic lung adenocarcinoma with an EGFR mutation.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 Incidence of contrast-induced nephropathy in hospitalised patients with cancer(Springer, 2014) Cicin, Irfan; Erdogan, Bulent; Gulsen, Emrah; Uzunoglu, Sernaz; Sut, Necdet; Turkmen, Esma; Kodaz, HilmiObjectives To determine the frequency of and possible factors related to contrast-induced nephropathy (CIN) in hospitalised patients with cancer. Methods Ninety adult patients were enrolled. Patients with risk factors for acute renal failure were excluded. Blood samples were examined the day before contrast-enhanced computed tomography (CT) and serially for 3 days thereafter. CIN was defined as an increase in serum creatinine (Cr) of 0.5 mg/dl or more, or elevation of Cr to 25 % over baseline. Relationships between CIN and possible risk factors were investigated. Results CIN was detected in 18/90 (20 %) patients. CIN developed in 25.5 % patients who underwent chemotherapy and in 11 % patients who did not (P=0.1). CIN more frequently developed in patients who had undergone CT within 45 days after the last chemotherapy (P=0.005); it was also an independent risk factor (P=0.017). CIN was significantly more after treatment with bevacizumab/irinotecan (P=0.021) and in patients with hypertension (P=0.044). Conclusions The incidence of CIN after CT in hospitalised oncological patients was 20 %. CIN developed 4.5-times more frequently in patients with cancer who had undergone recent chemotherapy. Hypertension and the combination of bevacizumab/irinotecan may be additional risk factors for CIN development. Key Points Contrast-induced nephropathy (CIN) is a concern for oncological patients undergoing CT. CIN occurs more often when CT is performed <45 days after chemotherapy. Hypertension and treatment with bevacizumab appear to be additional risk factors.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 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 KRAS Mutation in Small Cell Lung Carcinoma and Extrapulmonary Small Cell Cancer(2016) Kodaz, Hilmi; Taştekin, Ebru; Erdoğan, Bülent; Hacıbekiroğlu, İlhan; Tozkır, Hilmi; Gürkan, Hakan; Çiçin, İrfanBackground: Lung cancer is one of the most lethal cancers. It is mainly classified into 2 groups: non-small cell lung can-cer (NSCLC) and small cell lung cancer (SCLC). Extrapul-monary small cell carcinomas (EPSCC) are very rare. The Ras oncogene controls most of the cellular functions in the cell. Overall, 21.6% of human cancers contain a Kirsten Ras (KRAS) mutation. SCLC and EPSCC have several similar features but their clinical course is different.Aims: We investigated the KRAS mutation status in SCLC and EPSCC.Study design: Mutation research.Methods: Thirty-seven SCLC and 15 EPSCC patients were included in the study. The pathological diagnoses were confirmed by a second pathologist. KRAS analysis was performed in our medical genetic department. DNA isola-tion was performed with primary tumor tissue using the QIAamp DNA FFPE Tissue kit (Qiagen; Hilden, Germany) in all patients. The therascreen KRAS Pyro Kit 24 V1 (Qia-gen; Hilden, Germany) was used for KRAS analyses. Results: Thirty-four (91.9%) of the SCLC patients were male, while 11 (73.3%) of the EPSCC l patients were fe-male. SCLC was more common in males, and EPSCC in females (p=0.001). A KRAS mutation was found in 6 (16.2%) if SCLC patients. The most common mutation was Q61R (CAA>CGA). Among the 15 EPSCC patients, 2 had a KRAS mutation (13.3%). When KRAS mutant and wild type patients were compared in the SCLC group, no differ-ence was found for overall survival (p=0.6).Conclusion: In previous studies, the incidence of KRAS mutation in SCLC was 1-3%; however, it was 16.2% in our study. Therefore, there may be ethnic and geographical differences in the KRAS mutations of SCLC. As a result, KRAS mutation should not be excluded in SCLCÖğe Multicenter experience of adult medulloblastoma: A study of Anatolian Society of Medical Oncology (ASMO)(Zerbinis Medical Publ, 2016) Esbah, Onur; Demirci, Umut; Dane, Faysal; Gunaydsin, Yusuf; Ozdemir, Nuriye; Ekinci, Ahmet Siyar; Kodaz, HilmiPurpose: Medulloblastoma (MB) is rarely seen in adults. For adjuvant therapy in adults the same therapy protocols used in pediatric cases are used. The present study retrospectively evaluated the data of MB patients who were treated in different Oncology Centers in Turkey. Methods: The data of 60 adult patients with MB from 8 Oncology Centers diagnosed between 2005 and 2012 were retrospectively analyzed. Results: The median patient age was 28.8 years (range 16-54). The administered chemotherapy included procarbazine-Flomustin vincristine (group A, N=31) and cyclophosphamide/ifosfamide+vincristine+cisplatin (group B, N=13). Median chemotherapy courses were 4 (range 1-8). Median progression free survival (PFS) was 76 months and median overall survival (OS) has not been reached in both groups. In young female patients and in those who received adjuvant chemotherapy, median PFS and OS were longer but without statistical significance. Mean PFS and OS were 65.9 months and 101.2 months in group A and 113.6 months and 141.6 months in group B, respectively. Conclusion: Improved survival results were obtained in women, in patients aged below 25 years, in those who underwent gross total excision (GTE) and in those who received adjuvant therapy with cyclophosphamide/ifosphamide.
