Person: EVRENSEL, TÜRKKAN
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EVRENSEL
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TÜRKKAN
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Publication 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; Sağlık Bilimleri Enstitüsü; Tıbbi Onkoloji Ana Bilim Dalı; 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-0745-2022Background 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.Publication Retrospective comparison of the efficacy of therapeutic agents in metastatic soft-tissue sarcomas(Kare Yayınevi, 2023-03-02) Caner, Burcu; Ocak, Birol; Şahin, Ahmet Bilgehan; Salı, Seda; Çoban, Eyüp; Deligönul, Adem; Çubukçu, Erdem; Evrensel, Türkkan; CANER, BURCU; SALİ, SEDA; ÇOBAN, EYÜP; DELİGÖNÜL, ADEM; ÇUBUKÇU, ERDEM; EVRENSEL, TÜRKKAN; Tıp Fakültesi; Tıbbi Onkoloji Ana Bilim Dalı; 0000-0003-1591-3323 ; HJH-6371-2023; DPO-3759-2022; JIS-1916-2023; JHC-1731-2023; JGT-4101-2023; EXZ-0745-2022OBJECTIVEThere are few agents used in soft-tissue sarcoma treatment. We compared the efficacy of therapies, aiming to identify the best therapy sequence, and reveal the factors affecting the risk of progression or death.METHODSFifty-five patients were included in the study. Data such as age, gender, tumor primary site, histological type, tumor grade, the Ki67 percentage score, treatments, radiotherapy, and metastasectomy history, the dates of diagnosis, metastasis, progression, and death were retrospectively evaluated. Progression-free survival (PFS) and overall survival (OS) for therapies, and the risk factors for the progression or death were analyzed.RESULTSIn the first-line, gemcitabine-docetaxel provided longer PFS than the doxorubicin-ifosfamide combination (7.4 months vs. 4.8 months, p=0.035), although this did not result in OS difference. In the second line, the efficacy of trabectedin and pazopanib were similar, whereas trabectedin showed less activity in liposarcomas. In the third-line and beyond, trabectedin, pazopanib and eribulin showed similar PFS and OS. The only factor that affected the risk of death was metastasectomy (HR for death: 0.35, 95% CI: 0.18-0.66, p=0.001). CONCLUSIONWe found that agents used in soft-tissue sarcoma have similar efficacy, which is not affected by the previous therapies. However, it should be noted that soft-tissue sarcomas include many histological types, and to choose the optimal drug, the histological type must be one of the major factors considered. Furthermore, all patients should be evaluated for possible metastasectomy, which came out as the only factor reducing the risk of death in our study.Publication 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; Tıp Fakültesi; Onkoloji Ana Bilim Dalı; 0000-0002-3398-7230; 0000-0002-9015-5617; AAJ-1027-2021Backgrounds 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.Publication 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-1027-2021Bu çalışma, 1-4 Temmuz 2015 tarihlerinde Barcelona'da düzenlenen ESMO 17. Dünya Gastrointestinal Kanser Kongresinde bildiri olarak sunulmuştur.Publication 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.; Tıp Fakültesi; Onkoloji Ana Bilim Dalı; ABX-9081-2022; AAJ-1027-2021; AAA-3961-2020; AAI-1612-2021Because 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.Publication 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; Tıp Fakültesi; Tıp Fakültesi; Onkoloji Bilim Dalı; Z-1463-2018; AAJ-1027-2021; X-3647-2018; AAH-9701-2021; JRQ-2583-2023; JRU-4028-2023; DQW-9819-2022Aim: 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.Publication 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; Tıp Fakültesi; Biyoistatistik Ana Bilim 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-1069-2022OBJECTIVESTo 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.Publication 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.; Tıp Fakültesi; Patoloji Ana Bilim Dalı; AAJ-1027-2021Purpose: 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.Publication 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; Tıp Fakültesi; Onkoloji Ana Bilim 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-2172-2015Dermatofibrosarcoma 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.Publication Platin-based chemotherapy does not improve survival in patients with non-metastatic resected typical carcinoid tumors(Spandidos Publ Ltd, 2022-10-01) Şahin, Ahmet Bilgehan; Melek, Hüseyin; Ocak, Birol; Oyucu Orhan, Sibel; Erkan, Buket; Caner, Burcu; Deligönül, Adem; Çubukcu, Erdem; Bayram, Ahmet Sami; Akyıldız, Elif Ülker; Evrensel, Türkkan; ŞAHİN, AHMET BİLGEHAN; MELEK, HÜSEYİN; OCAK, BİROL; OYUCU ORHAN, SİBEL; ERKAN ÖZMARASALI, BUKET; CANER, BURCU; DELİGÖNÜL, ADEM; ÇUBUKÇU, ERDEM; BAYRAM, AHMET SAMİ; AKYILDIZ, ELİF ÜLKER; EVRENSEL, TÜRKKAN; Tıp Fakültesi; Tıbbi Onkoloji Ana Bilim Dalı; 0000-0002-7846-0870; 0000-0003-0684-0900; 0000-0003-1822-8153; 0000-0001-8217-3471; 0000-0003-1591-3323; AAM-4927-2020; AAI-5039-2021; AEC-2238-2022; AAJ-8314-2021; CPN-8681-2022; HJH-6371-2023; ESM-4544-2022; ETP-1691-2022; ABB-7580-2020; ELN-4128-2022; EXZ-0745-2022Chemotherapy is controversial in non-metastatic typical carcinoid (TC) tumors. Therefore, it was aimed to evaluate the impact of platin-based chemotherapy on the survival of patients with lung TC. The medical records of patients who underwent surgical resection for non-metastatic TC from 2002 to 2020 at our institution were retrospectively reviewed. Multivariate regression analysis was performed for chemotherapy and prognostic factors in disease-free survival (DFS) in 72 patients. The pathological stages of patients were as follows: 73.6% of the patients were in stage I, 15.3% in stage II and 11.1% in stage III. A total of 5 patients (6.9%) received platin-based chemotherapy and 6 patients (8.3%) had recurrences. The DFS rates at 12, 36 and 60 months were 98.5, 95.1 and 92.5%, respectively. Log-rank testing showed that patients who received chemotherapy and had stage III disease had shorter DFS (P=0.021 for chemotherapy and P<0.001 for stage). However, multivariate analysis revealed that the pathological stage was the only statistically significant factor affecting DFS (P=0.016). Platin-based chemotherapy did not improve DFS, and the eighth edition of TNM (tumor, nodes, metastases) staging did have prognostic value for patients with non-metastatic TC. Although resection has satisfying long-term outcomes, studies on new agents are needed to decrease the recurrence rate, particularly in patients with stage III disease.