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Öğe THE ACCESS RATE TO DIAGNOSIS AND TREATMENT MODALITIES IN BREAST CANCER PATIENTS IN TURKEY; MULTICENTER OBSERVATIONAL STUDY(Aves, 2011) Saip, Pinar; Keskin, Serkan; Ozkan, Metin; Kaplan, Mehmet Ali; Aydogan, Fatma; Demirag, Guzin Gonullu; Uzunoglu, SernazPurpose: We aimed to determine the elapsed time between the first notification of the disease and the accession to the diagnosis and treatment modalities and its associated factors in female patients with breast cancer in Turkey. Patients and Methods: The data was acquired by a questionnaire completed by 535 patients who applied to the 14 various oncology clinics between 1st and 28th of February 2010 in Turkey. The centers located in metrople - Istanbul, Izmir, and Ankara- were named Group 1 (n= 161), the centers located in Marmara and Central Anatolia region - Kocaeli, Bursa, Edirne and Kayseri- were named Group 2 (n= 189), and the centers located in Karadeniz and East-Southeast Anatolia region - Zonguldak, Samsun, Trabzon, Elazig and Diyarbakir- were named Group 3 (n= 185). The grouping for the centers were configured according to their socio- economic development of provinces. Results: Median age was 48 +/- 11.2 (24- 89) years, the number of patients of age less than 50 years were 282 (% 56.1). 85% of the patients detected a mass in their breast by themselves. % 27 of the patients over age 50 never had a breast ultrasound and/ or mammography done until the definite diagnosis was established. The median elapsed time between the disease noticed by the patient and the application to a health care center was 10 days, between the application and the biopsy was 19 days, between the biopsy and the surgery was 31 days. The elapsed time between recognition of the disease by the patient and the patient applying to a health care center in Group 1, Group 2, and Group 3 was 15, 10 and 14 days, respectively, and the elapsed time between the biopsy and surgery was 14, 1.5 and 12 days, respectively. The elasped time between the first recognition of the disease and applying of the patient to the health care center and the elapsed time between the biopsy and surgery in Group 2 centers was statistically significantly shorter compared to group 1 and 3 centers (p< 0.05). Conclusions: A high level of awareness of breast cancer in our country has examined through the time that is defined as 10 days between recognition of the disease and medical application. Compared with the developed countries the elapsed time between the application and biopsy, surgery and systemic therapy is longer than the expected and it has been marked differences between regions.Öğe Association of obesity with breast cancer clinical and pathological factors: Analysis of Turkish National Breast Cancer Registry.(Amer Soc Clinical Oncology, 2015) Coskun, Ugur; Altundag, Kadri; Aliustaoglu, Mehmet; Uncu, Dogan; Ozkan, Metin; Cicin, Irfan; Ciltas, Aydin[Abstract Not Available]Öğe Characteristics of Turkish colorectal cancer patients and bevacizumab preference.(Amer Soc Clinical Oncology, 2017) Cicin, Irfan; Gumus, Mahmut; Uncu, Dogan; Ozkan, Metin; Kilickap, Saadettin; Elkiran, Tamer E.; Isikdogan, Abdurrahman[Abstract Not Available]Öğe Comparison of survival with somatostatin analog and chemotherapy and prognostic factors for treatment in 165 advanced neuroendocrine tumor patients with Ki-67 20% or less(Lippincott Williams & Wilkins, 2017) Ozaslan, Ersin; Karaca, Halit; Koca, Sinan; Sevinc, Alper; Hacioglu, Bekir; Ozkan, Metin; Ozcelik, MelikeThe objectives of this study were to compare progression-free survival (PFS) with somatostatin analog (SSA) versus chemotherapy (CTx) in first-line therapy and to determine the patient group in which these treatments were more effective in neuroendocrine tumors (NETs) with a Ki-67 index of 20% or less. Patients who received SSA or CTx and had unresectable locally advanced and metastatic NETs with a Ki-67 index of 20% or less were retrospectively selected from 13 centers in the Turkish database between 2000 and 2015. One hundred and sixty-five patients were enrolled. The median age was 56 years and the male-to-female ratio was 1.09. Seventy-four (45%) patients were of grade 1 NET and 91 (55%) were of grade 2. SSA was given to 104 patients, whereas 61 were treated with CTx. The objective response rate after SSA was 15.4%; another 73.1% had stable disease. The objective response rate after CTx was 36.1%, and 40.9% had stable disease (P = 0.008). The median PFS in SSA patients was 21 months (95% confidence interval: 12.4-29.6), and 8 months for CTx (95% confidence interval: 5.5-10.6) (P < 0.001). There was no significant difference between PFS of receiving SSA and CTx in pancreatic neuroendocrine tumor (PNET) patients; however, the PFS of receiving SSA was longer in non-PNET patients (P < 0.001). SSA was better treatment in advanced NET patients with a Ki-67 index of less than 5%, having a primary resected and a performance status of 0 (P < 0.05). SSA may be preferred over CTx in advanced NET patients with low-to-intermediate grade. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.Öğe Effect of body mass index in gastric cancer patients: Analysis of Turkish national gastric cancer registry(Amer Soc Clinical Oncology, 2015) Ciltas, Aydin; Karaca, Mustafa; Uncu, Dogan; Ozkan, Metin; Aliustaoglu, Mehmet; Tekin, Salim Basol; Cicin, Irfan[Abstract Not Available]Öğe Effectiveness and Safety of LMWH Treatment in Patients With Cancer Diagnosed With Non-High-Risk Venous Thromboembolism: Turkish Observational Study (TREBECA)(Sage Publications Inc, 2018) Ozaslan, Ersin; Ozkan, Metin; Cicin, Irfan; Benekli, Mustafa; Kocer, Murat; Uysal, Mukremin; Oksuzoglu, BernaWe compared the efficacy and safety of low-molecular-weight heparins (LMWHs) in patients with cancer who are at low risk of venous thromboembolism (VTE). Patients were treated by medical oncologists in Turkey at 15 sites, where they were enrolled and followed up for a period of 12 months. Due to the study design, there was no specific treatment protocol for LMWH. Primary end points were efficacy and the time to change in VTE status. Of the included 250 patients, 239 (95.6%), 176 (70.4%), 130 (52.0%), and 91 (36.4%) completed their day 15, month 3, month 6, and month 12 visits, respectively. Number of patients treated with enoxaparin, bemiparin, and tinzaparin were 133, 112, and 5, respectively. Anticoagulant therapy provoked thrombus resolution in 1.2% and 12.7% of patients using enoxaparin and bemiparin, respectively (P = .004). Thrombus resolution was observed in 81 more patients at month 3 visit. This ratio was 35 (40.2%) of 87 and 46 (54.1%) of 85 patients administered enoxaparin and bemiparin at the third visit, respectively (P = .038). Thrombus resolution was observed in 21 more patients during month 6 visit. This ratio was 5 (7.7%) of 65 and 15 (23.4%) of 64 patients administered enoxaparin and bemiparin at the fourth visit, respectively (P = .022). The LMWH was discontinued in only 2 patients due to gastrointestinal bleeding. This pioneering study shows bemiparin is more effective than enoxaparin in thrombosis resolution and has a similar tolerability profile.Öğe Effectiveness and safety of LMWH treatment in patients with cancer diagnosed with nonhigh-risk venous thromboembolism (VTE): Results of the Turkish observational study (TREBECA).(Amer Soc Clinical Oncology, 2017) Ozaslan, Ersin; Ozkan, Metin; Cicin, Irfan; Benekli, Mustafa; Kocer, Murat; Uysal, Mukremin; Oksuzoglu, Berna[Abstract Not Available]Öğe Efficacy and safety of raltitrexed combinations with uracil-tegafur or Mitomycin C as salvage treatment in advanced colorectal cancer patients.(Amer Soc Clinical Oncology, 2014) Ozkan, Metin; Bozkurt, Oktay; Karaca, Halit; Ozaslan, Ersin; Daloglu, Osman Onur; Ciltas, Aydin; Kaplan, Mehmet Ali[Abstract Not Available]Öğe Efficiency and Side Effects of Sorafenib Therapy for Advanced Hepatocellular Carcinoma: A Retrospective Study by the Anatolian Society of Medical Oncology(Asian Pacific Organization Cancer Prevention, 2013) Berk, Veli; Kaplan, Mehmet Ali; Tonyali, Onder; Buyukberber, Suleyman; Balakan, Ozan; Ozkan, Metin; Demirci, UmutBackground: Inoperable and metastatic hepatocellular carcinoma (HCC) is associated with a poor prognosis and low chemotherapeutic efficiency. Sorafenib is an oral multi-kinase inhibitor exerting its effects via the RAF/MEK/ERK pathway, vascular endothelial growth factor receptor (VEGFR) and platelet derived growth factor receptor beta (PDGFR-beta) tyrosine kinases. Randomized studies have shown a significant contribution of sorafenib to life expectancy and quality of life of cancer patients. The aim of the present study is to evaluate the efficacy and side effects of sorafenib therapy in Turkey. Materials and Methods: Data for 103 patients (82 males, 21 females) receiving sorafenib therapy in 13 centers from February 2008 to December 2012 were evaluated. Median age was 61 years and median ECOG performance status was 1 (range: 0-2). 60 patients (58%) had hepatitis B, 15 patients (15%) had hepatitis C infection and 12 patients (12%) had a history of alcohol consumption. All of the patients had Child scores meeting the utilization permit of the drug in our country (Child A). Results: A total of 571 cycles of sorafenib therapy were administered with a median of four per patient. Among the evaluable cases, there was partial response in 15 (15%), stable disease in 52 (50%), and progressive disease in 36 (35%). Median progression-free survival was 18 weeks and median overall survival was 48 weeks. The dose was reduced only in 6 patients and discontinued in 2 patients due to grade 3-4 toxicity, 18 patients (17%) suffering hand-foot syndrome, 7 (7%) diarrhea, and 2 (2%) vomiting. Conclusions: This retrospective study demonstrated better efficacy of sorafenib therapy in patients with advanced HCC compared to the literature while progression-free survival and overall survival findings were comparable. The side effect rates indicate that the drug was tolerated well. In conclusion, among the available treatment options, sorafenib is an efficient and tolerable agent in patients with inoperable or metastatic HCC.Öğe Investigation of Turkey and Singapore Schools in Terms of Teacher Professional Development and Teacher Behaviors Hindering Learning Variables(Turkish Education Assoc, 2019) Ozkan, Metin; Ozkan, Yesim Ozer; Guvendir, Meltem AcarThis study compares Turkey and Singapore in terms of teacher's professional development and teacher behaviors that inhibit student learning by using PISA 2015 data. Relational survey method was used during the research design. In the PISA study, school sampling is determined by stratified random sampling method. The study was implemented on data collected from a total of 364 schools, 187 from Turkey and 177 from Singapore that participated in PISA 2015. In order to compare the two countries, t-test for independent groups was used when independent variable was continuous and chi-square test was used when the independent variable was categorical. The chi-square test was used to determine the differences between categorical data and survey results. Logistic regression analysis was used to find the significance level of the variables in the study according to the classification of the schools. The study results display noteworthy differences between the two countries in terms of variables that have been addressed. The proportion of the teachers participating in professional development program shows a significant difference according to the countries. The proportion of teachers participating in the program of professional development in Singapore is higher than in Turkey. The effect size obtained from the test result shows that this difference is very large. There was a significant difference between countries in all the responses given to the four items related to teacher's professional development. The examination of Phi coefficients shows that the effect size is the highest in the organization of in-service workshops which deal with specific issues that school faces. The variable contributing most to the model is Our school organizes in-service workshops which deal with specific issues that our school faces. This variable is followed by Our school organizes in-service workshops for specific groups of teachers (e.g. newly appointed teachers), Teacher absenteeism, The percentage of teaching staff who has attended a program of professional development during the last three months and Teachers being too strict with students, respectively. The correct classification ratios of the observations are 91.4% in total. As a result, an important determinant of success between the two countries is related to meeting the needs for school-based professional development. Another important variable, according to the function that classifies between the two countries in a similar way, is organizing workshops for teachers who have special needs. Both variants emphasize the importance of school-based professional development. Teacher absenteeism and the strictness of teachers to students were found to be the determining variables in discriminating between the two countries' schools. However, the contribution of these variables to the function comes after the variables of professional development. Nevertheless, as teacher behaviors that prevent student learning can be reduced by providing teacher professional development, the most important result of the research is the necessity of ensuring school-based professional development.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 Safety and efficacy of trifluridine/tipiracil in previously treated metastatic colorectal cancer: PRECONNECT Turkey(Future Medicine Ltd, 2022) Ozet, Ahmet; Dane, Faysal; Aykan, Nuri Faruk; Yalcin, Suayib; Evrensel, Turkkan; Ozkan, Metin; Karabulut, BulentBackground: The efficacy and safety of trifluridine/tipiracil (FTD/TPI) for third-line treatment of metastatic colorectal cancer have been demonstrated. The authors present the Turkish post hoc analysis of the PRECONNECT study. Methods: An international, multicenter, single-arm, open-label, phase IIIb trial evaluating FTD/TPI in patients with >= 2 previous lines of chemotherapy for metastatic colorectal cancer was conducted. The primary end point was safety. Results: In this Turkish cohort (n = 100; eight centers), the most frequent treatment-emergent adverse event was neutropenia (48%). Median progression-free survival was 3.0 months; disease control rate was 36%; quality of life remained stable. Conclusion: Outcomes with FTD/TPI in Turkey are consistent with previous studies and confirm the efficacy and safety of FTD/TPI treatment in the third-line setting.Öğe Tobacco Control(Aves, 2006) Karlikaya, Celal; Oztuna, Funda; Solak, Zeynep Aytemur; Ozkan, Metin; Orsel, OsmanTobacco is now a major preventable cause of death in both developed and developing countries. Assuming current patterns of tobacco use and intervention efforts, from 2000 to 2030 the number of smokers will rise from 1.2 billion to 1.6 billion and the annual number of deaths will increase from 4.9 million to 10 million especially in low-and middleincome countries. Smoking causes death mostly from cancers, heart diseases and respiratory diseases and is associated with over fifty health conditions. Exposure in utero to maternal, or paternal tobacco smoke, is causally related to stillbirth, low-birth weight, congenital defects, childhood asthma and other respiratory illness. Exposure to others' tobacco smoke increases the risks for lung cancer and heart disease. Tobacco control is a complex problem that depends on concerted multisectorial effort. Preventing children from using tobacco, promoting smoking cessation and increased access to cessation therapies, restrictions on smoking in public places and in workplaces, comprehensive bans on advertising and promotion are the major tobacco control policies. Tobacco cessation treatment is a significant component of an overall tobacco control program to reduce morbidity and mortality due to tobacco-related diseases. This article reviews human and societal harms of tobacco and tobacco control measures.Öğe Turkish Breast Cancer Registry: A multicenter epidemiologic study(Lippincott Williams & Wilkins, 2014) Coskun, Ugur; Gumus, Mahmut; Uncu, Dogan; Ozkan, Metin; Cicin, Irfan; Altundag, Kadri; Elklran, Tamer[Abstract Not Available]Öğe Turkish National Breast Cancer Registry.(Amer Soc Clinical Oncology, 2015) Altundag, Kadri; Dumanli, Esra; Aliustaoglu, Mehmet; Uncu, Dogan; Ozkan, Metin; Cicin, Irfan; Coskun, Ugur[Abstract Not Available]Öğe Turkish National Gastric Cancer Registry.(Amer Soc Clinical Oncology, 2015) Buyukberber, Suleyman; Dumanli, Esra; Uncu, Dogan; Ozkan, Metin; Uslu, Ruchan; Dogu, Gamze Gokoz; Kara, Oguz[Abstract Not Available]Öğe Tyrosine kinase inhibitors in the treatment of metastatic renal cell cancer patients with early cytokine intolerance: TURCOS, a Turkish national, prospective observational study(Sage Publications Ltd, 2021) Benekli, Mustafa; Gumus, Mahmut; Ozkan, Metin; Dane, Faysal; Elkiran, Emin T.; Cicin, Irfan; Sevinc, AlperObjective Cytokines have been the mainstay of treatment in metastatic renal cell cancer (mRCC) for decades before the introduction of tyrosine kinase inhibitors (TKIs), which dramatically changed the therapeutic landscape in these patients. This observational study was designed to evaluate use of TKIs in the treatment of cytokine-intolerant mRCC patients. Methods A total of 151 cytokine-intolerant mRCC patients who were treated with TKIs (sunitinib, pazopanib and sorafenib) were enrolled in this prospective, non-interventional, multi-center observational study at 16 oncology centers across Turkey. Mean (SD) age was 61.3 (11.1) years and 74.8% were males. Data on duration of TKI treatment was the primary outcome measure. Additionally, overall response rate (ORR), progression free survival (PFS), overall survival (OS) and safety data were recorded. Results Median duration of treatment was 8.2 months at a median follow up of 17.9 months. ORR and disease control rate were 12.5% and 70.8%, respectively. Median PFS and OS were 7.5 months (95%CI: 6.4-10.4) and 27.3 months (95%CI: 17.6-27.3) with no significant difference among three TKI agents in terms of treatment duration, ORR, PFS and OS. The most common adverse events excluding progression-which was the protocol requirement were diarrhea (13.6%), asthenia (13.6%) and hand-foot syndrome (12.6%). Dose modifications were required in 30.5% of the patients and 15% discontinued TKIs because of toxicity. Conclusions Our findings confirm the efficacy and safety profile of TKIs in the first-line treatment of mRCC patients intolerant to cytokine treatment. There was no significant difference among three TKI agents in terms of treatment duration, ORR, PFS and OS.
