Browsing by Author "EVRENSEL, TÜRKKAN"

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An open-label trial to assess the safety of regorafenib in turkish patients with metastatic colorectal cancer (mCRC) that progressed on standard therapy (REGARD)
(Oxford University Press, 2015-06-01) Dane, F.; Özgürdal, K.; Yalçın, S.; Benekli, M.; Aykan, N. F.; Yücel, I.; Özkan, M.; Evrensel, T.; Sevinç, A.; Coşkun, H. S.; Şanlı, U. S.; Kara, I. O.; EVRENSEL, TÜRKKAN; 0000-0002-9732-5340; AAJ-1027-2021
Bu çalışma, 1-4 Temmuz 2015 tarihlerinde Barcelona'da düzenlenen ESMO 17. Dünya Gastrointestinal Kanser Kongresinde bildiri olarak sunulmuştur.
C-kit (CD117) expression in patients with small cell lung cancer
(Galenos Yayıncılık, 2015-03-01) Gözkaman, Ayşe; Okuturlar, Yıldız; Kanat, Özkan; Günald, Meral; Serin, Sibel Ocak; Saraydaroğlu, Özlem; Kumbasar, A. Baki; Evrensel, Türkkan; Gözkaman, Ayşe; Okuturlar, Yıldız; Kanat, Özkan; Serin, Sibel Ocak; SARAYDAROĞLU, ÖZLEM; EVRENSEL, TÜRKKAN; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı/Onkoloji Bilim Dalı.; ludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; Z-1463-2018; AAJ-1027-2021; X-3647-2018; AAH-9701-2021; JRQ-2583-2023; JRU-4028-2023; DQW-9819-2022
Aim: The tyrosine-kinase receptor c-kit and its ligand stem cell factor (SCF) are coexpressed in many small cell lung cancer (SCLC) cell lines. The aim of this study was to search the role of CD117 (c-kit) overexpression as a prognostic marker in SCLC.Methods: Demographic and clinical data of patients with SCLC was registered. C-kit overexpression was evaluated using immunohistochemistry performed in paraffin-embedded specimens. Immunostaining data of 87 patients were correlated with survival and other relevant clinical parameters.Results: The mean age of the patients was 57.1 +/- 9.9 years. Thirty-nine patients (44.8%) had limited disease and 48 patients (55.2%) had extensive disease. C-kit (+) expression was observed in 24.1% of 87 patients. The mean survival time for c-kit (+) patients was 10.2 (CI=5.7-14.7) months as compared with the c-kit (-) population in whom the survival was 14.7 (CI=10.7-18.6) months. The difference in survival time between c-kit (+) and (-) patients was not statistically significant (p=0.264).Conclusion: New prognostic markers and more effective treatment regimens are needed for SCLC. Our findings may provide an insight to future clinical trials searching c-kit inhibitors in SCLC.
Chemo-immunotherapy with atezolizumab in extensive-stage small-cell lung cancer; single-center experience
(Akad Doktorlar Yayınevi, 2020-01-01) Şahin, Ahmet Bilgehan; Çubukcu, Erdem; Ocak, Birol; Deligönül, Adem; Kaçan, Turgut; Orhan, Sibel Oyucu; Evrensel, Türkkan; ŞAHİN, AHMET BİLGEHAN; ÇUBUKÇU, ERDEM; OCAK, BİROL; DELİGÖNÜL, ADEM; OYUCU ORHAN, SİBEL; EVRENSEL, TÜRKKAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Onkoloji Anabilim Dalı; 0000-0002-7846-0870; 0000-0001-7537-1699; 0000-0001-8217-3471; 0000-0002-9732-5340; AAJ-8314-2021; AAJ-1027-2021; AAM-4927-2020; ETP-1691-2022; HHA-1866-2022; ESM-4544-2022
Chemo-immunotherapy (CIT) with platin, etoposide and monoclonal antibodies targeting the PD-1/PDL-1 pathway has recently improved survival in extensive-stage small-cell lung cancer (SCLC) after decades. We aimed to investigate the efficacy and safety of CIT with atezolizumab in extensive-stage SCLC in chemotherapy naive patients. Eleven patients who were treated and followed in our center were included in this retrospective observational study. All the patients received carboplatin, etoposide and atezolizumab in the induction phase and atezolizumab in the maintenance phase. The Kaplan-Meier test was used to determine progression-free survival (PFS) and overall survival (OS), and the effects of the sites of metastasis were analyzed using the log-rank test. The median age was 69.9 years, and 81.8% were male. The median number of CIT and total atezolizumab cycles was 4 and 7, respectively. 63.6% received maintenance therapy. Median PFS was 5.2 months (95% CI: 3.4-6.9), and median OS was 11.3 months (95% CI: 1.0-21.5). The overall response rate was 63.6%. There was no significant difference between patients with and without liver metastasis in terms of PFS and OS. We observed toxicity higher than grade 2 in more than half of the patients, and hematological toxicities were prominent. CIT with carboplatin, etoposide and atezolizumab is efficient and safe in extensive-stage SCLC considering the PFS, OS, response rates, 12-month survival rate, and side effects. The progression of liver lesions was remarkable. Cranial and thoracic radiation are issues that should be discussed in the future with data from clinical studies.
Cisplatin plus etoposide in the adjuvant treatment of patients with non small cell lung cancer
(Derman Medical Publ, 2014-09-01) Çubukcu, Erdem; Canhoroz, Mustafa; Ölmez, Ömer Fatih; Kanat, Özkan; Kurt, Ender; Erol, Muharrem; Çubukcu, Sinem; Yorulmaz, Nadide; Bayram, Sami; Evrensel, Türkkan; Manavoğlu, Osman; ÇUBUKÇU, ERDEM; Canhoroz, Mustafa; Ölmez, Ömer Fatih; Kanat, Özkan; Kurt, Ender; Erol, Muharrem; ÇUBUKÇU, SİNEM; Yorulmaz, Nadide; BAYRAM, AHMET SAMİ; EVRENSEL, TÜRKKAN; Manavoğlu, Osman; Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Cerrahisi Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Onkoloji Anabilim Dalı.; 0000-0002-9732-5340; JGT-4101-2023; CJW-6018-2022; DJG-4827-2022; CYM-0930-2022; DAS-3088-2022; JEN-3243-2023; JJB-0254-2023; GKI-1183-2022; EMY-5874-2022; AAJ-1027-2021; FLP-9613-2022
Aim: In this study, the efficacy and safety of cisplatin and etoposide (PE) combination in the adjuvant treatment of patients with resected non-small cell lung cancer (NSCLC) was investigated. Material and Method: We retrospectively evaluated the medical charts of patients receiving adjuvant treatment for NSCLC at our center. Results: Forty-five patients were evaluated. The disease-free survival was 10 (1-114) months and the median overall survival was 18 (3-114) months. Discussion: Based on our limited experience, we concluded that PE regimen is safe and effective as adjuvant therapy for patients with NSCLC.
Confidence intervals for proportions - the cinderella of statistical analyses - response
(Elsevier Science London, 2008-02-01) Kanat, O.; Yalçınkaya, U.; Akbunar, T.; Kurt, E.; Evrensel, T.; Manavoğlu, O.; Kanat, O.; YALÇINKAYA, ÜLVİYE; Akbunar, T.; Kurt, Ender; EVRENSEL, TÜRKKAN; Manavoğlu, Osman; Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Onkoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Nükleer Tıp Anabilim Dalı.; AAJ-1027-2021; AAH-8924-2021; CWN-8579-2022; EKU-8682-2022; DAS-3088-2022; FLP-9613-2022
DPYD c.1905+1G>A promotes fluoropyrimidine-induced anemia, a prognostic factor in disease-free survival, in colorectal cancer
(Mary Ann Liebert, Inc, 2021-04-01) Deligönül, Adem; Aksoy, Seçil; Tezcan, Gülçin; Tunca, Berrin; Kanat, Özkan; Çubukcu, Erdem; Yılmazlar, Tuncay; Öztürk, Ersin; Egeli, Ünal; Çeçener, Gülşah; Alemdar, Adem; Evrensel, Türkkan; DELİGÖNÜL, ADEM; AKSOY, SEÇİL; TEZCAN, GÜLÇİN; TUNCA, BERRİN; Kanat, Özka; ÇUBUKÇU, ERDEM; YILMAZLAR, AHMET TUNCAY; EGELİ, ÜNAL; ÇEÇENER, GÜLŞAH; ALEMDAR, ADEM; EVRENSEL, TÜRKKAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Onkoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Diş Hekimliği Fakültesi/Temel Bilimler Bölümü.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Biyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Onkoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Genel Cerrahi Anabilim Dalı.; Bursa Uludağ Üniversitesi/Sağlık Bilimleri Enstitüsü.; 0000-0002-6400-4911; 0000-0002-5956-8755; 0000-0002-1619-6680; 0000-0001-8593-5101; 0000-0001-7904-883X; 0000-0002-3820-424X; HIZ-7332-2022; AAH-1420-2021; AAH-3843-2020; ESM-4544-2022; JDG-0330-2023; ABI-6078-2020; CYM-0930-2022; ETP-1691-2022; CKK-3621-2022; AAP-9988-2020; EXZ-0745-2022
Background and Aim: In 10-30% of colorectal cancer (CRC) patients, toxic reactions occur after fluoropyrimidine-based chemotherapy. A dihydropyridine dehydrogenase (DPYD) gene variant, c.1905 + 1G>A, leads to intolerance to fluoropyrimidines. Due to the low frequency of this variant in many populations, the prevalence of fluoropyrimidine-induced hematologic side effects in CRC patients with the c.1905 + 1G>A variant is unclear. In this study, we investigated the prevalence of the DPYD c.1905 + 1 variants in a Turkish CRC cohort and the potential effects of these variants on fluoropyrimidine-induced hematologic side effects.Materials and Methods: The DPYD c.1905 + 1 variant was genotyped using polymerase chain reaction-restriction fragment length polymorphism analysis and confirmed by Sanger sequencing in peripheral blood samples of 100 CRC patients who received fluoropyrimidine-based chemotherapy and 60 healthy volunteers. The association of c.1905 + 1 variants with susceptibility to hematologic side effects was evaluated.Results: The DPYD c.1905 + 1G>A variant was more common in the CRC group than in the healthy control group (p = 0.001). The presence of the c.1905 + 1G>A variant was associated with thrombocytopenia (p = 0.039) and anemia (p = 0.035). CRC patients with fluoropyrimidine-induced anemia had shorter disease-free survival than CRC patients without fluoropyrimidine-induced anemia (p = 0.0009).Conclusions: Before administering fluoropyrimidine-based chemotherapy, genetic screening for the DPYD c.1905 + 1G>A variant should be performed with the aim of preventing anemia and anemia-induced complications in CRC patients.
Efficacy and safety of trastuzumab emtansine in her2 positive metastatic breast cancer: Real-world experience
(Taylor & Francis, 2021-06-05) Bahçeci, Aykut; Paydaş, Semra; Ak, Naziye; Ferhatoğlu, Ferhat; Saip, Pınar Mualla; Şeydaoğlu, Gülşah; Bilici, Mehmet; Şimşek, Melih; Tekin, Salim Başol; Çalıkuşu, Züleyha; Yavuz, Sinan; Şahin, Ahmet Bilgehan; Çubukcu, Erdem; Evrensel, Türkkan; Değirmencioğlu, Serkan; Demiray, Atike Gökçen; Yumuk, Perran Fulden; Alan, Özkan; Çıkman, Duygu İlke; Demirelli, Fuat Hulusi; Köstek, Osman; Gökyer, Ali; Doğan, Mutlu; Bal, Öznur; Çakar, Burcu; Gökmen, Erhan; Yamaç, Deniz; Korkmaz, Taner; Aliyev, Altay; Keskin, Özge; Urvay, Semiha; Buyukşimşek, Mahmut; Karadeniz, Cemile; Yıldız, Birol; Çınkır, Havva Yeşil; Demir, Hacer; Beypınar, İsmail; Karacin, Cengiz; Eser, Kadir; Baykara, Meltem; Kılıçkap, Saadettin; Okutur, Kerem; Bulut, Gülcan; Alkan, Ali; Arpacı, Erkan; Pilancı, Kezban Nur; Demir, Atakan; Işık, Deniz; Yıldırım, Nilgün; ŞAHİN, AHMET BİLGEHAN; ÇUBUKÇU, ERDEM; EVRENSEL, TÜRKKAN; 0000-0002-7846-0870 ; AAM-4927-2020; JGT-4101-2023 ; EXZ-0745-2022
Aim The aim of this study is to evaluate the efficacy and toxicity of trastuzumab emtansine (T-DM1) in cases with metastatic breast cancer (mBC) in different lines of treatment. Method Retrospective analysis of T-DM1 results of human epidermal growth factor receptor 2 (Her2) positive 414 cases with mBC from 31 centers in Turkey. Findings Except 2, all of the cases were female with a median age of 47. T-DM1 had been used as second-line therapy in 37.7% of the cases and the median number of T-DM1 cycles was 9. Progression-free survival (PFS) and overall survival (OS) times were different according to the line of treatment. The median OS was found as 43, 41, 46, 23 and 17 months for 1st, 2nd, 3rd, 4th and 5th line, respectively (p = 0.032) while the median PFS was found as 37, 12, 8, 8 and 8 months, respectively (p = 0.0001). Treatment was well tolerated by the patients. The most common grade 3-4 adverse effects were thrombocytopenia (2.7%) and increased serum gamma-glutamyl transferase (2%). Discussion The best of our knowledge this is the largest real-life experience about the safety and efficacy of T-DM1 use in cases with mBC after progression of Her2 targeted treatment. This study suggests and supports that T-DM1 is more effective in earlier lines of treatment and is a reliable option for mBC.
Efficacy of chemotherapeutics on classic and non-classic kaposi sarcoma: A single-center retrospective real-world study
(Assoc Basic Medical Sci Federation Bosnia & Herzegovina Sarajevo, 2021-01-01) Orhan, Sibel Oyucu; OYUCU ORHAN, SİBEL; Sahin, Ahmet Bilgehan; ŞAHİN, AHMET BİLGEHAN; Çubukcu, Erdem; ÇUBUKÇU, ERDEM; Deligonul, Adem; DELİGÖNÜL, ADEM; Ocak, Birol; OCAK, BİROL; Orhan, Bedrettin; ORHAN, BEDRETTİN; Evrensel, Turkkan; EVRENSEL, TÜRKKAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Onkoloji Anabilim Dalı.; 0000-0002-7846-0870; 0000-0001-7537-1699; ACW-2157-2022; AAJ-8314-2021; AEC-2238-2022; AAM-4927-2020
Kaposi sarcoma (KS) is a rare disease, and especially for classic KS, a gap exists in the literature about which chemotherapeutics should be given. Here we present our institutional data on the demographic characteristics, treatment, and treatment efficacy in 16 patients with KS treated with chemotherapy. We retrospectively analyzed the demographic and clinical characteristics of and the chemotherapeutic agents administered to the 16 patients with KS diagnosed in our center based on the medical records obtained. The median age, gender, KS type, involved site, cytotoxic agents administered, progression-free survival (PFS), overall survival (OS), objective response rate (ORR), disease control rate (DCR), and safety profiles of the patients were evaluated. The median age at disease onset was 61.07 years (range, 39.4-85.8 years). Among the patients, one had immunosuppression-related KS, four had acquired immune deficiency syndrome-related KS, and 11 had classic KS. Regarding the first-line cytotoxic therapy, seven patients received pegylated liposomal doxorubicin (PLD), six received paclitaxel, two received oral etoposide, and one received the doxorubicin, bleomycin, and vincristine regimen. The Kaplan-Meier analysis showed that the PFS was 39.9 months (95% confidence interval (CI), 7.7-72.0). In the first-line setting, a significant difference in PFS was observed between the PLD-and paclitaxel-treated groups (unreached vs. 12.8 months; p = 0.033). The OS was 66.1 months (95% CI, 30.2-102.0). The ORR and DCR of the 16 patients were 43.8%, and 81.3%, respectively. No grade 3 or 4 toxicity was observed. This retrospective study showed that among the most preferred chemotherapeutic agents, PLD seems better than paclitaxel in terms of PFS and response rates, and it showed a good safety profile in patients with KS.
Evaluation of prognostic factors on survival in non-small-cell lung cancer patients treated with postoperative radiotherapy
(Kare Publ, 2009-01-01) Sarıhan, Süreyya; SARIHAN, SÜREYYA; Gebitekin, Cengiz; ERCAN, İLKER; GEBİTEKİN, CENGİZ; Bayram, Ahmet Sami; BAYRAM, AHMET SAMİ; EVRENSEL, TÜRKKAN; Evrensel, Turkkan; Akyıldız, Elif Ülker; AKYILDIZ, ELİF ÜLKER; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyasyon Onkolojisi Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Cerrahisi Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Onkoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; 0000-0003-4816-5798; 0000-0003-0684-0900; 0000-0002-2382-290X; ABB-7580-2020; AAJ-1027-2021; JCE-0097-2023; AAH-4970-2021; AAE-1069-2022
OBJECTIVESTo investigate the prognostic factors on survival in non-small-cell lung cancer patients treated with postoperative radiotherapy.METHODSSixty-five patients treated with a median dose of 59 Gy (50-66.6 Gy) between October 1995 and January 2005 were included in the study. Clinical and categorical variables were analyzed.RESULTSOn multivariate analysis, presence of clinical N2 and brain metastasis at first relapse and absence of chemotherapy (p=0.02, p=0.004, p=0.004) had a negative impact on overall survival, while presence of pathological nodal involvement and absence of chemotherapy (p=0.02, p=0.04) were effective on disease-free survival. Regarding categorical variables, type of resection was found related with positive margin and N1, right-sided location with N1-e and N2, and systematic nodal dissection with N1. The number of involved lymph nodes was found related with N2 skip metastasis and involved N1-10 was related with N1-e.CONCLUSIONPresence of metastatic lymph nodes was found to be a poor prognostic factor and delivery of chemotherapy was seen to positively affect overall and disease-free survival rates.
Investigation of FGFR4 (Gly388Arg) gene Polymorphism in primary lung cancer Patients
(Kamla-Raj Enterprises, 2015-03-01) Türe, Mehmet; Yakut, Tahsin; Deligönül, Adem; Karkucak, Mutlu; Sağ, Şebnem Özemri; Hartavi, Mustafa; Çubukcu, Erdem; Gülten, Tuna; Evrensel, Türkkan; Türe, Mehmet; Yakut, Tahsin; DELİGÖNÜL, ADEM; ÖZEMRİ SAĞ, ŞEBNEM; Hartavi, Mustafa; ÇUBUKÇU, ERDEM; Gülten, Tuna; EVRENSEL, TÜRKKAN; Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Genetik Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Onkoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; 0000-0002-9732-5340; AAJ-1027-2021; AAH-8355-2021; ECY-8582-2022; GIS-1493-2022; ESM-4544-2022; CUI-5353-2022; ETP-1691-2022; EYU-9227-2022
Several studies have shown relationships between predisposition to various types of cancer and polymorphisms of the fibroblast growth factor receptor 4 (FGFR4) gene. In the present study, researchers investigated the relationship between primary lung cancer and (PLC) FGFR4 Gly388Arg polymorphism in regard to tendency, histopathologic sub-type, early onset, and metastatic status. The present study included 124 PLC patients and 100 healthy controls. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to identify gene polymorphism of FGFR4 Gly388Arg. Statistical significance was considered when p < 0.05, and a statistically significant difference was not found in FGFR-4 polymorphism between the patient group and control group in regard to tendency, histopathologic sub-type, early onset, and metastatic status (p > 0.05). The findings in this study demonstrated that there was no relationship between polymorphism of FGFR4 Gly388Arg gene and PLC. However, these results should be confirmed in larger studies and in specific histopathological sub-types of PLC.
Placement technique and the early complications of balloon breast brachytherapy - magee-womens hospital experience
(Lippincott Williams & Wilkins, 2007-04-01) Soran, Atilla; Beriwal, Sushil; Mogus, Robert; Keenan, Donald; Kelley, Joseph L.; Balkan, Mujdat; Harlak, Ali; Bonaventura, Marguerite A.; Johnson, Ronald; Falk, Jeffrey S.; Evrensel, Türkkan; EVRENSEL, TÜRKKAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Onkoloji Anabilim Dalı.; 0000-0002-3398-7230; 0000-0002-9015-5617; AAJ-1027-2021
Backgrounds and Objectives: Open (OT) and percutaneous closed (PCT) techniques have been described for placement of the MammoSite catheter to deliver accelerated partial breast brachytherapy. We report early complications of both techniques.Methods: A total of 125 patients underwent catheter placement for MammoSite high-dose rate brachytherapy, with 108 patients successfully completing treatment. The OT was used in 85 patients and PCT in 40 patients. The mean distance between the balloon surface and breast skin was 1.44 cm and 1.31 cm, respectively. Average skin dose was 278 cGy in the OT group and 295 cGy in the PCT group (P > 0.05). Average gross specimen size was 43.16 cm(3) in the OT group and 62.19 cm(3) in the PCT group. Median follow-up was I I months for the OT group and 5 months for the PCT group.Results: In 17 cases, the catheter was subsequently removed without the patient completing treatment. Two of the patients in the OT group (3%) developed a delayed abscess. The overall incidence of persistent seroma (>6 months) was 20% with all occurring in the OT group, 30% of those patients. There were no acute skin toxicities higher than grade 2. The overall cosmesis is excellent or good in 95% of patients.Conclusion: Despite short follow-up and a small sample size in this study, it seems that the MammoSite brachytherapy was well tolerated by patients with early stage breast cancer when using either the OT or PCT.
Prognostic significance of estrogen receptor, progesterone receptor, her2/neu, ki-67, and nm23 expression in patients with invasive breast cancer
(Imprimatur Publications, 2013-04-01) Ölmez, F.; Çubukçu, E.; ÇUBUKÇU, ERDEM; DELİGÖNÜL, ADEM; Kanat, O.; Ölmez, O. Fatih; Kabul, S.; KABUL, SELVA; Canhoroz, M.; Avcı, N.; Deligönül, A.; Hartavi, M.; Çubukçu, S.; ÇUBUKÇU, SİNEM; Kurt, E.; Evrensel, T.; EVRENSEL, TÜRKKAN; Gökgöz, S.; GÖKGÖZ, MUSTAFA ŞEHSUVAR; Manavoğlu, O.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Onkoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Genel Cerrahi Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; AAJ-1027-2021
Purpose: To determine the prognostic significance of estrogen receptor (ER), progesterone receptor (PR), HER2/neu, Ki-67, and nm23 immunohistochemical expression with respect to progression free survival (PFS) and overall survival (OS) in Turkish patients with invasive breast cancer (IBC).Methods: Patients with IBC (n = 81; mean age = 51.9 +/- 11.1 years) were prospectively enrolled at the Department of Oncology, Uludag University Medical Center, Bursa, Turkey. Immunohistochemistry was performed on formalin-fixed, paraffin-embedded tissue sections.Results: We did not find any significant association between immunohistochemical expression of ER, PR, HER2/neu, Ki-67, and nm23 and the baseline characteristics of IBC patients. The median patient PFS was 30 months (range 22-45), and the median OS was 32 months (range 23-46). Stratification of the patient population according to nm23 immunohistochemical expression revealed a statistically significant difference in terms of both OS (p < 0.05) and DFS (p < 0.05). Multivariate Cox regression analysis indicated that tumor grade, axillary lymph node status, and nm23 immunohistochemical expression were the 3 main independent prognostic factors for PFS and OS in IBC patients.Conclusion: Reduced nm23 immunohistochemical expression is an independent negative prognostic factor for OS and PFS. Patients with negative nm23 expression may require a more intensive follow-up.
The effects of ankaferd hemostat on preventing oral mucositis in colorectal cancer patients receiving chemotherapy
(Springer, 2023-07-01) Haznedaroğlu, İbrahim Celalettin; Karacan, Yasemin; Yıldız, Hicran; YILDIZ, HİCRAN; Evrensel, Türkkan; EVRENSEL, TÜRKKAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Onkoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Sağlık Bilimleri Fakültesi.; 0000-0001-8616-4935; 0000-0003-4241-5231; AAK-5246-2021; GQR-0671-2022
IntroductionNew agents are introduced each day to be used in the prevention and treatment of mucositis in cancer treatment. One of those agents is the Ankaferd hemostat. Ankaferd hemostat has pleiotropic effects and anti-infective characteristics in tissue healing.MethodsThe study was designed as a randomized controlled experimental study. The sample of the study comprised a total of 66 patients (33 patients in the Ankaferd hemostat group and 33 patients in the sodium bicarbonate group) with colorectal cancer who received FOLFOX combination chemotherapy treatment in the first cycle of chemotherapy to prevent mucositis. Participants who met the criteria were randomly assigned to the groups. Before the patient received chemotherapy, ECOG performance score and Oral Mucositis Grading Scale were applied on the 7th day and 15th day. The Ankaferd hemostat group brushed teeth at least twice a day for 2 min and gargled with Ankaferd hemostat twice for 2 min for 2 weeks. The sodium bicarbonate group brushed teeth at least 2 min a day and gargled with sodium bicarbonate 4 times for 2 min for 2 weeks. The Consolidated Standards of Reporting Trials diagram was used to illustrate the randomization of patients.ResultsWhen the Ankaferd hemostat group is compared with the sodium bicarbonate group, there is a significant difference in favor of the Ankaferd hemostat group in the mucositis grade on the 7th day and 15th day after chemotherapy (p < 0.05). In the binary logistic regression analysis, among the factors affecting the formation of mucositis on the 7th day, only neutrophil and thyroid-stimulating hormone (TSH) were included in the model, while only the TSH variable is statistically significant.ConclusionsIt was determined that Ankaferd hemostat is effective in preventing oral mucositis due to chemotherapy in adult patients diagnosed with colorectal cancer. In addition, it has been suggested to conduct new studies on the effectiveness of Ankaferd hemostat in the prevention of mucositis in different groups.
The immunohistochemical expression of c-met is an independent predictor of survival in patients with glioblastoma multiforme
(Springer International Publishing Ag, 2014-02-01) Ölmez, O. F.; Çubukçu, E.; ÇUBUKÇU, ERDEM; Evrensel, T.; EVRENSEL, TÜRKKAN; Kurt, M.; Avcı, N.; Tolunay, S.; TOLUNAY, ŞAHSİNE; Bekar, Ahmet; BEKAR, AHMET; Deligönül, Adem; DELİGÖNÜL, ADEM; Hartavi, M.; Alkış, N.; Manavoğlu, O.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/ Onkoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/NöroPatoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyasyon Onkolojisi Anabilim Dalı.; ABX-9081-2022; AAJ-1027-2021; AAA-3961-2020; AAI-1612-2021
Because the outcome of glioblastoma multiforme (GBM) remains dismal, there is an urgent need for a better molecular characterization of this malignancy. The aim of this prospective study was to investigate the prognostic impact of the expression of c-mesenchymal-epithelial transition (c-Met) a receptor tyrosine kinase implicated in expression growth, survival, motility/migration, and invasion in GMB patients managed according to the established diagnostic and therapeutic protocols.Between May 2003 and March 2011, a total of 69 patients (33 males and 36 females; mean age: 52.2 +/- A 12.9 years, age range: 23-81 years) referred to our Department for the surgical removal of GBM were evaluated immunohistochemically for c-Met expression. Progression-free survival (PFS) and overall survival (OS) served as the main outcome measures.Compared with c-Met- subjects (n = 38), c-Met+ subjects (n = 31) had both a significantly lower OS (15.3 +/- A 2.3 vs. 22.6 +/- A 2.5 months, respectively, p < 0.01) and PFS (12.3 +/- A 2.1 vs. 19.1 +/- A 2.6 months, respectively, p < 0.05). After allowance for potential confounders, multivariate Cox regression analysis identified c-Met+ as an independent predictor of both OS (hazard ratio = 1.7; 95 % confidence interval = 1.2-1.9, p < 0.01) and PFS (hazard ratio = 1.6; 95 % confidence interval = 1.1-2.3, p < 0.05).Our findings suggest that c-Met immunohistochemical expression is an independent predictor of outcomes in patients with GBM treated by standard of care.
The impact of ki-67 index, squamous differentiation, and several clinicopathologic parameters on the recurrence of low and intermediate-risk endometrial cancer
(Assoc Basic Medical Sci Federation Bosnia & Herzegovina Sarajevo, 2021-01-01) Ocak, Birol; Atalay, Fatma Oz; Sahin, Ahmet Bilgehan; Ozsen, Mine; Dakiki, Bahar; Ture, Seray; Mesohorli, Merve; Odman, Hikmet Utku; Tanriverdi, Ozgur; Ocakoglu, Gokhan; Bayrak, Mehmet; Ozan, Hakan; Demiroz, Candan; Sali, Seda; Orhan, Sibel Oyucu; Deligönül, Adem; Çubukcu, Erdem; Evrensel, Turkkan; Ocak, Birol; OCAK, BİROL; Sahin, Ahmet Bilgehan; ŞAHİN, AHMET BİLGEHAN; Atalay, Fatma Oz; ÖZ ATALAY, FATMA; Ozsen, Mine; ÖZŞEN, MİNE; Dakiki, Bahar; DAKİKİ KORUCU, BAHAR; Ture, Seray; TÜRE AYDIN, SERAY; Mesohorli, Merve; Odman, Hikmet Utku; Ocakoglu, Gokhan; OCAKOĞLU, GÖKHAN; Bayrak, Mehmet; Ozan, Hakan; OZAN, HAKAN; Demiroz, Candan; DEMİRÖZ ABAKAY, CANDAN; Sali, Seda; SALİ, SEDA; Orhan, Sibel Oyucu; OYUCU ORHAN, SİBEL; Deligonul, Adem; DELİGÖNÜL, ADEM; Cubukcu, Erdem; ÇUBUKÇU, ERDEM; Evrensel, Turkkan; EVRENSEL, TÜRKKAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Onkoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; 0000-0001-7537-1699; 0000-0002-7188-6115; 0000-0002-7846-0870; 0000-0002-5771-7649; 0000-0001-9255-2475; 0000-0002-1114-6051; 0000-0003-1600-333X; AEC-2238-2022; ABA-2897-2021; AAH-5180-2021; AAM-4927-2020; AAJ-8314-2021
Endometrial endometrioid carcinoma (EEC) represents approximately 75-80% of endometrial carcinoma cases. Three hundred and thirty-six patients with EEC followed-up in the authors' medical center between 2010 and 2018 were included in our study. Two hundred and seventy-two low and intermediate EEC patients were identified using the European Society for Medical Oncology criteria and confirmed by histopathological examination. Recurrence was reported in 17 of these patients. The study group consisted of patients with relapse. A control group of 51 patients was formed at a ratio of 3:1 according to age, stage, and grade, similar to that in the study group. Of the 17 patients with recurrent disease, 13 patients (76.5%) were Stage 1A, and 4 patients (23.5%) were Stage 1B. No significant difference was found in age, stage, and grade between the case and control groups (p > 0.05). Body mass index, parity, tumor size, lower uterine segment involvement, squamous differentiation (SqD), and Ki-67 index with p<0.25 in the univariate logistic regression analysis were included in the multivariate analysis. Ki-67 was statistically significant in multivariate analysis (p = 0.018); however, there was no statistical significance in SqD and other parameters. Our data suggest that the Ki-67 index rather than SqD needs to be assessed for recurrence in patients with low- and intermediate-risk EEC.
The ki-67 index and neutrophile-lymphocyte ratio are prognostic factors in patients with low-risk endometrial cancer
(Mre Press, 2021-04-21) Çubukcu, Erdem; Şahin, Ahmet Bilgehan; Atalay, Fatma Öz; Ocak, Birol; Özşen, Mine; Abakay, Candan Demiröz; Özerkan, Kemal; Hasanzade, Ulviyya; Mesahorlı, Merve; Deligönül, Adem; Ozan, Hakan; Evrensel, Türkkan; ÇUBUKÇU, ERDEM; ŞAHİN, AHMET BİLGEHAN; ÖZ ATALAY, FATMA; OCAK, BİROL; ÖZŞEN, MİNE; DEMİRÖZ ABAKAY, CANDAN; ÖZERKAN, KEMAL; HASANZADE, ULVIYYA; Mesahorlı, Merve; DELİGÖNÜL, ADEM; OZAN, HAKAN; EVRENSEL, TÜRKKAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Onkoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyasyon Onkolojisi Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Jinekolojik Onkoloji Anabilim Dalı.; 0000-0002-7846-0870; 0000-0001-7537-1699; 0000-0002-5771-7649; 0000-0001-5380-5898; AAH-9791-2021; K-2269-2016; AAM-4927-2020; ETP-1691-2022; JHC-4482-2023; HHA-1866-2022; AAI-1609-2021; AAH-3855-2021; EXU-7466-2022; FNB-4540-2022; ESM-4544-2022; DKZ-4159-2022; EXJ-0967-2022
Objective: To investigate the prognostic factors comparing clinical, histopathological, and laboratory parameters in low-risk endometrial cancer (EC). Methods: In the present single-center study, multivariate Cox regression analysis was performed on retrospective clinical and laboratory data and histopathological features obtained from the re-evaluation of 253 patients with low-risk EC. Receiver operating characteristic curves (ROC) were plotted for neutrophile-lymphocyte ratio (NLR), platelet-lymphocyte ratio, lymphocyte-monocyte ratio and Ki-67 index for recurrence. Kaplan-Meier analysis was employed for survival rates. Results: The median age was 58.5 years (32.0-75.4). Most of the patients were obese and post-menopausal. In nearly half of the patients, lymphadenectomy was performed in addition to hysterectomy and oophorectomy. The median tumor size was 30 mm (range 2-80), and the median Ki-67 index was 25 (1-90). According to the ROC curve analysis, the cut-off values for the Ki-67 index, NLR, PLR, and LMR were determined as >= 22, >= 1.98, >= 115.3, and >= 4.71, respectively. The log-rank test revealed that the patients with a Ki67 index lower than 22% and NLR lower than 1.98 had statistically longer recurrence-free survival (RFS) (p = 0.002 for Ki-67 index and p = 0.004 for NLR). The multivariate analysis revealed that the Ki-67 index and NLR were statistically significant factors for RFS (p = 0.012 and p = 0.029, respectively). Conclusion: The present study highlights the prognostic implications of both the Ki-67 index and NLR in lowrisk EC.
The ki-67 proliferation index predicts recurrence-free survival in patients with dermatofibrosarcoma protuberans
(Assoc Basic Medical Sci Federation Bosnia & Herzegovina Sarajevo, 2021-01-01) Tanriverdi, Ozgur; Ozsen, Mine; ÖZŞEN, MİNE; Deligonul, Adem; DELİGÖNÜL, ADEM; Yazici, Serkan; YAZİCİ, SERKAN; Cetintas, Sibel Kahraman; Yalcinkaya, Ulviye; YALÇINKAYA, ÜLVİYE; Sahin, Ahmet Bilgehan; ŞAHİN, AHMET BİLGEHAN; Orhan, Sibel Oyucu; OYUCU ORHAN, SİBEL; Ocak, Birol; OCAK, BİROL; Evrensel, Turkkan; EVRENSEL, TÜRKKAN; Kahveci, Ramazan; KAHVECİ, RAMAZAN; Cubukcu, Erdem; ÇUBUKÇU, ERDEM; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Onkoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Plastik Cerrahi ve Estetik Anabilim Dalı.; 0000-0001-6407-0962; 0000-0002-5771-7649; 0000-0002-7846-0870; 0000-0002-0598-7284; 0000-0001-7537-1699; AAJ-8314-2021; AEC-2238-2022; AAM-4927-2020; M-2172-2015
Dermatofibrosarcoma protuberans (DFSP) is an uncommon soft tissue sarcoma that originates from the dermis or subcutaneous tissue in the skin. While its prognosis is generally favorable, disease recurrence is relatively frequent. Since morbidity after repeated surgery may be significant, an optimized prediction of recurrence-free survival (RFS) has the potential to improve current management strategies. The purpose of this study was to investigate the prognostic value of the Ki-67 proliferation index with respect to RFS in patients with DFSP We retrospectively analyzed data from 45 patients with DFSP. We calculated the Ki-67 proliferation index as the percentage of immunostained nuclei among the total number of tumor cell nuclei regardless of the intensity of immunostaining. We constructed univariate and multivariate Cox proportional hazards regression models to identify predictors of RFS. Among the 45 patients included in the study, 8 developed local recurrences and 2 had lung metastases (median follow-up: 95.o months; range: 5.2-412.4 months). The RFS rates at 60, 120, and 240 months of follow-up were 83.8%, 76.2%, and 65.3%, respectively. The median Ki-67 proliferation index was 14%. Notably, we identified the Ki-67 proliferation index as the only independent predictor for RFS in multivariate Cox proportional hazards regression analysis (hazard ratio = 1.106, 95% confidence interval = 1.019-1.200, p = 0.016). In summary, our results highlight the potential usefulness of the Ki-67 proliferation index for facilitating the identification of patients with DFSP at a higher risk of developing disease recurrences.
The predictive probability of two different breast cancer nomograms for non sentinel axillary lymph node metastasis in positive sentinel lymph node biopsy
(Aves, 2008-07-01) Gür, Akif Serhat; Ünal, Bülent; Johnson, Ronald; Ahrendt, Gretchen; Bonaventura, Marguerite; Evrensel, Türkkan; Soran, Atilla; EVRENSEL, TÜRKKAN; Uludağ Üniversitesi/Tıp Fakültesi/Medikal Onkoloji Anabilim Dalı.; 0000-0002-9732-5340; AAJ-1027-2021
INTRODUCTION: Non sentinel axillary lymph node metastasis (NSLNM) occurs in 35-50% of breast cancer (BC) patients having positive sentinel lymph nodes (SLN). A nomogram which includes 8 variables was developed at Memorial Sloan Kettering Cancer Center (MSKCC) in 2003 and it has been validated at sources outside that institution. The Stanford University group recently reported their nomogram which evaluated 3 variables. AIM: The aim of this study is to evaluate the predictability of two different scoring systems wherein 3 or 8 variables are used in the same patient groups.MATERIALS and METHODS: We identified 201 patients who had a positive SLN biopsy and completion axillary lymph node dissection at Magee-Womens Hospital of UPMC over a 5 year period. The computerized BC nomograms developed by MSKCC and Stanford University were used to calculate the probability of non-sentinel lymph node metastases. Area Under (AUC) Receiver Operating Characteristics Curve (ROC) was calculated for each nomogram and the values more than 0.70 have been accepted that presents considerable discrimination.RESULTS: Sixty-six of 201 patients (32.8%) had positive axillary NSLNM. The mean predicted probability of positive NSLNM was 25.4% (3-93), and 66.3% (7-100) for the MSKCC and Stanford nomograms, respectively. The AUC values were 0.73 and 0.67 for MSKCC and Stanford nomograms, respectively.DISCUSSION and CONCLUSION: Nomograms for predicting the probability of NSLNM in BC patients have been in use for 5 years. It is clear there are discrepancies in the results of nomograms among the studies using the same scoring system. Notwithstanding the Stanford nomogram is easier to implement as it considers only 3 variables in our study, we found the MSKCC nomogram to be more predictive than the Stanford nomogram Nomograms developed at outside institutions should be used with caution when counseling patients regarding the risk of additional nodal disease.
The survival effect of resection of cranial metastatic lesions in patients with lung cancer
(Elsevier Science, 2015-09-01) Deligönül, Adem; Taşkapılıoğlu, Özgür; Melek, Hüseyin; Bekar, Ahmet; Çetinkaya, Gamze; Sarihan, Süreyya; Bayram, Ahmet Sami; Gebitekin, Cengiz; Evrensel, Türkkan; DELİGÖNÜL, ADEM; TAŞKAPILIOĞLU, MEVLÜT ÖZGÜR; MELEK, HÜSEYİN; BEKAR, AHMET; Çetinkaya, Gamze; SARIHAN, SÜREYYA; BAYRAM, AHMET SAMİ; GEBİTEKİN, CENGİZ; EVRENSEL, TÜRKKAN; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı/Tıbbi Onkoloji Bilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Beyin ve Sinir Cerrahisi Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Radyasyon Onkolojisi Anabilim Dalı.; 0000-0001-5472-9065; 0000-0003-4816-5798; 0000-0003-0684-0900; AAI-5039-2021; ABX-9081-2022; AAH-4970-2021; AAE-1069-2022; JDW-2654-2023; AAJ-1027-2021; JCE-0097-2023; ABB-8161-2020; ABB-7580-2020