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1.
Breast J ; 26(9): 1680-1687, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-33443786

RESUMEN

Margin status is one of the significant prognostic factors for recurrence in breast-conserving surgery (BCS). The issue that merits consideration for oncologic safety and cost-effectiveness about the modalities to assure clear margins at initial surgical intervention remains controversial after neo-adjuvant chemotherapy (NAC). The presented study aimed to assess the impact of intraoperative ultrasound (IOUS)-guided surgery on accurate localization of tumor site, adequacy of excision with clear margins, and healthy tissue sacrifice in BCS after NAC. Patients who had IOUS-guided BCS ater NAC were reviewed. No patient had preoperative localization with wire or radiotracer. Intraoperative real-time sonographic localization, sonographic margin assessment during resection, macroscopic and sonographic examination of specimen, and cavity shavings (CS) were done as the standard procedure. No frozen assessment was performed. One hundred ninety-four patients were included, in which 42.5% had pCR. IOUS-guided surgery accomplished successful localization of the targeted lesions in all patients. Per protocol, all inked margins on CS specimens were reported to be tumor-free in permanent histopathology. No re-excision or mastectomy was required. For a setting without CS, the negative predictive value (NPV) of IOUS rate was 96%. IOUS was found to over and underestimate tumor response to NAC both in 2% of patients. IOUS-guided surgery seems to be an efficient modality to perform adequate BCS after NAC with no additional localization method. Especially, when CS is integrated as a standard to BCS, IOUS seems to provide safe surgery for patients with no false negativity and a high rate of NPV.


Asunto(s)
Mastectomía Segmentaria , Mastectomía , Terapia Neoadyuvante , Ultrasonografía Mamaria/métodos , Neoplasias de la Mama/diagnóstico por imagen , Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/cirugía , Femenino , Humanos , Recurrencia Local de Neoplasia/diagnóstico por imagen , Ultrasonografía
2.
Int J Nephrol ; 2019: 1063514, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31871786

RESUMEN

OBJECTIVE: Sulphur, similar to phosphorus, is easily attached to organic compounds. The inadequate elimination of sulphate may cause high sulphate concentrations in hemodialysis (HD) patients because sulphate is low in free form in plasma. Although we are well aware of the accumulation of phosphorus in chronic dialysis patients, we do not have an adequate knowledge database about the sulphur compounds. This study was designed to determine the level of sulphate in hemodialysis patients. MATERIALS AND METHODS: Ninety-four prevalent HD patients and 33 patients without renal failure were included in the study. The serum inorganic sulphate levels were measured by turbidimetric technique. Moreover, the serum level of urea, creatinine, albumin, calcium, phosphorus, and parathyroid hormone concentrations was simultaneously recorded. RESULTS: Mean levels of plasma sulphate were significantly higher (0.56 ± 0.17 mM vs 0.31 ± 0.13 mM, p < 0.001) in HD patients. Serum sulphate level correlated with patient's age, serum albumin, serum BUN and creatinine, and serum phosphorus level in HD patients. Serum sulphate levels were not associated with serum parathyroid hormone levels. CONCLUSION: Serum sulphate levels were approximately twofold higher in HD patients than in the normal control group. Inorganic sulphate does not seem to accumulate in long-term dialysis patients, and mild increased serum levels of sulphate has no poor clinical outcome in these patients.

3.
J BUON ; 23(7): 116-121, 2018 12.
Artículo en Inglés | MEDLINE | ID: mdl-30722120

RESUMEN

PURPOSE: Gemcitabine is among the standard first-line agents for the treatment of metastatic pancreatic cancer. However, as the median survival with gemcitabine monotherapy is 6 months, different combinations are being studied for better, prolonged survival. In this multicenter study, we aimed to compare the results of gemcitabine monotherapy with those of gemcitabine and cisplatin combination therapy as first-line treatments for metastatic pancreatic cancer. METHODS: Data of 664 patients diagnosed with metastatic pancreatic cancer between January 2007 and December 2016 from seven oncology centers in Turkey were retrospectively evaluated, and 319 patients with gemcitabine alone (n=138) or gemcitabine and cisplatin combination (n=181) as first-line treatment were included. RESULTS: The median patient age was 62 years (range 42-79), being 60 years (42-75) in the gemcitabine/cisplatin arm and 67 years (52-79) in gemcitabine alone arm. no complete response was observed in either arm, whereas partial response rates were 30.1% in gemcitabine/cisplatin arm and 15.3% in gemcitabine alone arm (p=0.001). median overall survival was 8 months (95% CI:7.7-10.2) and was significantly longer in the gemcitabine/cisplatin arm than in the gemcitabine alone arm (10 vs. 6 months, p=0.004). CONCLUSION: The cemcitabine and cisplatin combination therapy as first-line treatment of metastatic pancreatic cancer yields significantly prolonged survival over gemcitabine monotherapy. In patients with favorable performance conditions, the combination therapy should be preferred.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias Hepáticas/tratamiento farmacológico , Neoplasias Pancreáticas/tratamiento farmacológico , Adulto , Anciano , Cisplatino/administración & dosificación , Desoxicitidina/administración & dosificación , Desoxicitidina/análogos & derivados , Femenino , Estudios de Seguimiento , Humanos , Neoplasias Hepáticas/secundario , Metástasis Linfática , Masculino , Persona de Mediana Edad , Neoplasias Pancreáticas/patología , Pronóstico , Estudios Retrospectivos , Tasa de Supervivencia , Gemcitabina
4.
Clin Cases Miner Bone Metab ; 14(1): 35-39, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28740523

RESUMEN

INTRODUCTION: There are controversial results in the risk of atrial fibrillation as well as arrhythmogenic potential of bis-phosphonates. METHOD: 37 patients and 40 healthy controls were evaluated prospectively with regard to the cardiac side effects related to the use of zoledronic acid (ZA) and its effects on electrocardiography (ECG) parameters. RESULT: As the basal ECG results of the patients diagnosed with cancer compared with the control group, it was determined that QT maximum was significantly lower, QT minimum was significantly higher. However; it was determined that QT disp, P max, P min, and P disp values were not significantly different. There was no statistically significant difference in P max, P min, P disp, QT max, QT min, QT disp values of the ECG parameters measured from cancer patients, before and 60 minutes after ZA therapy. CONCLUSION: There were no significant alterations in ECG in the acute period, indicated that ZA had no arrhythmia potential in the early period in patients with no underlying cardiac disease. However: patients receiving ZA should be monitored more closely because of the risk of arrhythmia which may ensue due to hypocalcemia, hypomagnesemia, or other chemotherapeutics.

5.
Indian J Hematol Blood Transfus ; 32(4): 481-487, 2016 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-27812260

RESUMEN

Venous thromboembolism (VTE) is generally classified as provoked or unprovoked. This dichotomy is important for following patients, mortality rate, prognosis and whether more efficient therapy is needed. In VTE patients, during initial diagnosis, it is not known exactly whether red cell distribution width (RDW) have a predictable value for this differentiation and pathogenesis. In this study, 298 patients with VTE and 197 control subjects were included. Patients with VTE were defined as provoked or unprovoked with respect to physical examination findings and laboratory values. Changes in RDW were tested between VTE patients and control subjects, provoked and unprovoked VTE patients, and separately with control subjects. RDW was found to be high in provoked and unprovoked groups compared with control group (p < 0.001, p = 0.003 respectively). RDW was significantly high in provoked VTE patients group compared with unprovoked patients (p < 0.001) and a cut-off value was found to be 13.6 %. In ROC analysis, sensitivity was 90.19 % and specificity was 82 % (95 % CI 85.4-93. 8 % and 95 % CI 72.3-89. 6 % respectively). RDW could be used as a simple, costeffective and a reliable test independent of age in differentiation of provoked and unprovoked VTE. In order to better understand its role, prospective large homogenized population studies in different regions are necessary.

6.
Clin Genitourin Cancer ; 14(4): e347-53, 2016 08.
Artículo en Inglés | MEDLINE | ID: mdl-27236771

RESUMEN

BACKGROUND: We aimed to investigate the outcomes of interferon alfa and sequencing tyrosine kinase inhibitors (TKIs) in patients with metastatic renal cell carcinoma. PATIENTS AND METHODS: This multicenter study assessing the efficacy of TKIs after interferon alfa therapy in the first-line setting in patients with metastatic renal cell carcinoma. Patients (n = 104) from 8 centers in Turkey, who had been treated with interferon alfa in the first-line setting, were included in the study. Prognostic factors were evaluated for progression-free survival (PFS). RESULTS: The median age of the patients was 57 years. The median PFS of the patients treated with interferon alfa in the first-line was 3.6 months. A total of 61 patients received TKIs (sunitinib, n = 58; sorafenib, n = 3) after progression while on interferon alfa. The median PFS among the TKI-treated patients was 13.2 months. In the univariate analysis for interferon alfa treatment, neutrophil and hemoglobin level, platelet count, and Karnofsky performance status were the significant factors associated with PFS. In the univariate analysis for TKI treatment, neutrophil and hemoglobin levels were the significant factors for PFS. The median total PFS of the patients who had been treated with first-line interferon alfa and second-line TKIs was 24.9 months. CONCLUSION: This study showed that first-line interferon alfa treatment before TKIs may improve the total PFS in patients with metastatic renal cell carcinoma.


Asunto(s)
Carcinoma de Células Renales/tratamiento farmacológico , Interferón-alfa/administración & dosificación , Neoplasias Renales/tratamiento farmacológico , Inhibidores de Proteínas Quinasas/administración & dosificación , Adulto , Anciano , Anciano de 80 o más Años , Esquema de Medicación , Quimioterapia Combinada , Femenino , Humanos , Interferón-alfa/uso terapéutico , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Metástasis de la Neoplasia , Inhibidores de Proteínas Quinasas/uso terapéutico , Análisis de Supervivencia , Resultado del Tratamiento , Turquía
7.
J BUON ; 20(4): 1137-41, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26416068

RESUMEN

PURPOSE: To develop a large Turkish National Melanoma registry in order to define demographic and clinicopathologic characteristics of patients with melanoma. METHODS: The data was collected from 1635 patients with melanoma through a web-based registry system in 22 centers. Herein we present the results of 1157 patients with cutaneous melanoma. RESULTS: The patient median age was 56.4 years and 646 (55.8%) were males. The commonest subtype was superficial spreading type (357, 30.9%). The commonest primary site was the lower extremities (N=353, 30.5%). The most common Breslow thickness was 1-2 mm (361 patients, 43.5%). Only 104 (12.5%) patients had a thickness <1mm. Among 694 patients with available data, 136 (19.6%) presented with stage 4 disease while the most frequent stage was stage 3, encountered in 393 (56.6% patients). CONCLUSION: Our melanoma registry is the largest in our country providing a snapshot view of cutaneous melanoma and its care. Our patients presented with more advanced stages and they had worse prognosis compared to SEER database.


Asunto(s)
Melanoma/patología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Melanoma/mortalidad , Persona de Mediana Edad , Estadificación de Neoplasias , Neoplasias Cutáneas , Turquía , Melanoma Cutáneo Maligno
8.
Oncol Lett ; 9(6): 2819-2824, 2015 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-26137154

RESUMEN

Obesity appears to be associated with an increased risk of breast cancer (BC) and an inferior oncological outcome at the time of diagnosis, with poor outcomes most prominent in cases of triple-negative BC (TNBC). The present study analyzed serum tumor necrosis factor (TNF)-like weak inducer of apoptosis (TWEAK) and TNF receptor associated factor-6 (TRAF) protein expression levels in 48 patients with non-metastatic BC and 26 obese control patients (without BC). The mean age of the cohort was 52.5 years (range, 35-78 years) and the patients had a median body mass index of 33.5 kg/m2 (range, 30-47 kg/m2). In the study population, 27.1% of BC patients were triple negative and 70.8% were hormone receptor (HR)-positive. Median serum TRAF6 expression was 0.90 ng/ml (range, 0.55-1.53 ng/ml) in the 13 TNBC patients and 0.63 ng/ml (range, 0.49-1.22 ng/ml) in the 35 HR-positive BC patients; thus, TRAF6 expression was significantly higher in the TNBC patients compared with the obese control group (0.90 vs. 0.73 ng/ml; P=0.033). Furthermore, median serum TRAF6 expression levels were significantly higher in HR-negative patients compared with HR-positive patients (0.83 vs. 0.62 ng/ml; P=0.002). The present study demonstrated that serum TRAF6 expression levels were increased in TNBC and HR-negative patients with non-metastatic BC compared with HR- and human epidermal growth factor receptor 2-positive cases or the obese healthy control group. Therefore, elevated TRAF6 expression may be a poor prognostic factor in non-metastatic BC. In addition, we propose that progesterone (PR) negativity may be a more useful poor prognosis factor than estrogen receptor (ER) negativity, as TRAF6 expression levels were higher in the PR-negative patients compared with the ER-negative patients.

9.
J BUON ; 20(2): 608-13, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26011357

RESUMEN

PURPOSE: Hepatocellar carcinoma (HCC) remains a major health problem being the third leading cause of deaths due to cancer worldwide. Because HCC is known to be highly resistant to conventional systemic therapies, single-agent or combination of systemic therapies have been investigated. Today, sorafenib, a multikinase inhibitor, is the only approved systemic agent for the first line treatment of advanced HCC. In this study, we aimed to investigate the influence of different concentrations of cisplatin, doxorubicin, pegylated doxorubicin (PLD), oxaliplatin and gemcitabine by applying these agents either single or in combinations on mahlavu cell line. METHODS: HCC mahlavu cell line was used for the experiments. Cell death was measured by flow cytometry at 48 hrs after incubation with various concentrations (0.1 µg/ml, 1.0 µg/ml and 10 µg/ml) of the drugs. RESULTS: Cell death due to gemcitabine was found to be significantly higher than cell deaths caused by the other single agents including cisplatin, oxaliplatin, doxorubicin and PLD (p<0.001, p<0.001, p<0.001 and p=0.0049, respectively). There was no significant difference between gemcitabine and both the gemcitabine combination with doxorubicin and PLD (p=0.992 and p=0.441, respectively). CONCLUSION: This is a preliminary analysis evaluating the effect of the conventional chemotherapeutic agents on mahlavu cell line in vitro. The findings of this study suggest that gemcitabine-based therapies keep on being the prefered therapeutic approach for the treatment of HCC.


Asunto(s)
Antineoplásicos/farmacología , Carcinoma Hepatocelular/tratamiento farmacológico , Neoplasias Hepáticas/tratamiento farmacológico , Carcinoma Hepatocelular/patología , Línea Celular Tumoral , Cisplatino/farmacología , Desoxicitidina/análogos & derivados , Desoxicitidina/farmacología , Doxorrubicina/farmacología , Humanos , Neoplasias Hepáticas/patología , Compuestos Organoplatinos/farmacología , Oxaliplatino , Gemcitabina
10.
Med Oncol ; 32(3): 56, 2015 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-25638467

RESUMEN

We wanted to investigate the possible etiologic factors of cachexia. Forty-six patients diagnosed with cancer cachexia and 34 healthy controls were included in the study. Serum total testosterone, free testosterone, interleukin 1 (IL) alpha and beta, IL6, tumor necrosis factor (TNF) alpha, orexin, galanin, neuropeptide Y, tumor necrosis factor-like weak inducer of apoptosis and tumor necrosis factor receptor-associated factor 6, and C-reactive protein (CRP) levels were investigated. There were 36 male and 10 female patients in the cachexia group, and 24 male and 10 female patients in the control group. Median overall survival (OS) of the cachexia group after the diagnosis of cachexia was 8 (1-25) months. There were statistically significant relationships between OS and BMI, serum CRP, TRAF-6, albumin, and LDH levels in the cachexia group. In addition to cachexia, serum CRP, testosterone, and TNF alpha levels were statistically significantly correlated with OS in refractory cachexia. TRAF-6 levels was significantly correlated with type of cancer (P = 0.02). Although cachexia presents with a multifactorial ethio-pathogenesis, few of them affect the OS. Our novel results were that serum CRP, albumin, LDH, and TRAF-6 levels have a higher association with OS in patients with cancer cachexia compared to the many other parameters. An ongoing cachexia also called refractory cachexia is a recent definition. This end-stage term of cancer duration may be predicted by decreasing serum testosterone and increasing serum TNF alpha levels, as well as serum CRP levels.


Asunto(s)
Biomarcadores/sangre , Caquexia/etiología , Inflamación/metabolismo , Neoplasias/complicaciones , Índice de Masa Corporal , Proteína C-Reactiva/metabolismo , Estudios de Casos y Controles , Femenino , Humanos , Inflamación/complicaciones , Interleucina-6/sangre , L-Lactato Deshidrogenasa/sangre , Masculino , Persona de Mediana Edad , Neoplasias/mortalidad , Neoplasias/patología , Pronóstico , Albúmina Sérica/metabolismo , Factor 6 Asociado a Receptor de TNF/sangre , Testosterona/sangre , Factor de Necrosis Tumoral alfa/metabolismo
11.
Adv Hematol ; 2014: 473482, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-25214842

RESUMEN

Introduction. We designed this study to evaluate how coagulation parameters are changed in metastatic colorectal cancer (mCRC) patients treated with bevacizumab, irinotecan, 5-fluorouracil, and leucovorin (FOLFIRI). Methods. A total of 48 mCRC patients who initially received bevacizumab with FOLFIRI were eligible for this study. Thirty-four patients were analyzed at baseline and on the 4th, 8th, and 12th cycles of chemotherapy. Results. There were 19 male and 15 female patients. Baseline characteristics of the groups were similar, but women had better overall survival than men (14 months versus 12 months, P = 0.044). D-dimer levels decreased significantly after the 12th cycle compared with baseline in men but not in women. Men and women had increased levels of serum fibrinogen at the early cycles, but these increased fibrinogen levels continued after the 4th cycle of chemotherapy only in women. In addition, serum fibrinogen levels did not significantly change, but aPTT levels decreased in men. Discussion. The major finding of this study is that bevacizumab-FOLFIRI chemotherapy does not promote changes in the coagulation system. If chemotherapy treatment and the possible side effects of FOLFIRI-bevacizumab treatment are well managed, then alterations of the coagulation cascade will not have an impact on overall survival and mortality.

12.
Int Surg ; 99(1): 2-7, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24444261

RESUMEN

There is very little information about breast cancer characteristics, treatment choices, and survival among elderly patients. The purpose of this multicenter retrospective study was to examine the clinical, pathologic, and biologic characteristics of 620 breast cancer patients age 70 years or older. Between June 1991 and May 2012, 620 patients with breast cancer, recruited from 16 institutions, were enrolled in the retrospective study. Patients had smaller tumors at diagnosis; only 15% of patients had tumors larger than 5 cm. The number of patients who had no axillary lymph node involvement was 203 (32.7%). Ninety-three patients (15.0%) had metastatic disease at diagnosis. Patients were characterized by a higher fraction of pure lobular carcinomas (75.3%). The tumors of the elderly patients were also more frequently estrogen receptor (ER) positive (75.2%) and progesterone receptor (PR) positive (67.3%). The local and systemic therapies for breast cancer differed according to age. An association between age and overall survival has not been demonstrated in elderly patients with breast cancer. In conclusion, the biologic behavior of older patients with breast cancer differs from younger patients, and older patients receive different treatments.


Asunto(s)
Adenocarcinoma/patología , Neoplasias de la Mama/patología , Adenocarcinoma/mortalidad , Adenocarcinoma/terapia , Factores de Edad , Anciano , Anciano de 80 o más Años , Axila , Neoplasias de la Mama/mortalidad , Neoplasias de la Mama/terapia , Neoplasias de la Mama Masculina/mortalidad , Neoplasias de la Mama Masculina/patología , Neoplasias de la Mama Masculina/terapia , Terapia Combinada , Femenino , Humanos , Metástasis Linfática , Masculino , Metástasis de la Neoplasia , Pronóstico , Estudios Retrospectivos , Análisis de Supervivencia
14.
Med Glas (Zenica) ; 10(2): 298-303, 2013 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-23892848

RESUMEN

AIM: To analyze the results of chemotherapy applied at the Bülent Ecevit University School of Medicine, Department of Medical Oncology, to elderly patients with metastatic gastric cancer (GC). METHODS: The study retrospectively investigated hospital records including pathological reports, imaging records, chemotherapy regimens, response and toxicity profile. All patients received systemic chemotherapy for pathologically proven metastatic GC at the Bülent Ecevit University School of Medicine, Department of Medical Oncology. RESULTS: From 2005 to 2012, 23 metastatic GC patients older than 70 years were treated with systemic chemotherapy as a first-line therapy. As the first-line chemotherapy, 17 (74%) patients received polychemotherapy and the remaining six (26%) patients received monotherapy. Overall, 113 cycles were administered. The median progression free survival (PFS) for the first-line chemotherapy was 6 months (95% CI, 0-16) and the median overall survival (OS) was 14 months (95% CI, 3-30). Multivariate analysis revealed that decreased OS was significantly associated with poor Eastern Cooperative Oncology Group (ECOG) performance status (p=0.045), elevated carcinoembryonic antigen (CEA) levels at the diagnosis time (p = 0.040) and decreased number of chemotherapy cycles (p=0.019) with R-Sq (adj) = 41, 6%. One patient had a complete response with docetaxel, cisplatin and fluorouracil combined (DCF) regimen and had 12 months of disease free survival (DFS). CONCLUSION: This is the first study investigating the outcomes of chemotherapy in Turkish elderly metastatic GC patients. Docetaxel, cisplatin and fluorouracil combination were the most common regimen, which is a tolerable and effective choice in elderly patients who had good performance status.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica , Neoplasias Gástricas , Anciano , Cisplatino , Supervivencia sin Enfermedad , Fluorouracilo , Humanos
15.
Ann Ital Chir ; 84(2): 143-8, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-23698146

RESUMEN

UNLABELLED: Several studies have now demonstrated that the lymph node ratio (LNR), as a superior indicator of axillary tumor burden to the number of excised nodes. While, about the prognostic value of LNR on the the survival of elderly patients is limited. The aim of this retrospective multicenter study is to evaluate the prognostic value of lymph node ratio in elderly patients with node positive breast cancer. METHODS: Onehundredeightyfour patient with operable breast cancer, recruited from 17 institutions, were enrolled into the retrospectively study. Eleven potential prognostic variables were chosen for analysis in this study. Univariate and multivariate analyses were conducted to identify prognostic factors associated with survival. RESULT: Among the eleven variables of univariate analysis, four variables were identified to have prognostic significance for Overall survival (OS): pathologic tumor size (T), No. of positive nodes (N), LNR and estrogen receptor-positive (ER). Among the eleven variables of univariate analysis, two variables were identified to have prognostic significance for Disease-free survival (DFS): N and LNR. Multivariate analysis by Cox proportional hazard model showed that T, LNR and ER were considered independent prognostic factors for OS. Furthermore, LNR was considered independent prognostic factors for DFS. CONCLUSION: In conclusion, the LNR was associated with the prognostic importance for DFS and OS in elderly patients who were administered adjuvant treatments.


Asunto(s)
Escisión del Ganglio Linfático , Estadificación de Neoplasias , Anciano , Neoplasias de la Mama/cirugía , Humanos , Ganglios Linfáticos , Metástasis Linfática , Oncología Médica , Estudios Retrospectivos
16.
J Cancer Res Clin Oncol ; 139(5): 829-35, 2013 May.
Artículo en Inglés | MEDLINE | ID: mdl-23400732

RESUMEN

PURPOSES: The overall prognosis for recurrent malignant glioma (MG) is extremely poor, and treatment options are limited. We evaluated our multicenter retrospective experience for patients with recurrent MG administering bevacizumab and irinotecan in combination therapy. METHODS: A total of 115 patients with grade IV glial tumor (n = 93) and grade III glial tumor (n = 22) were retrospectively evaluated at 14 centers in Turkey. Primary objectives of the study were to evaluate the efficacy and toxicity of the bevacizumab and irinotecan as salvage treatment based on response to therapy, progression-free survival (PFS), 6 months of PFS, overall survival (OS), and 6 months of OS (OS6). RESULTS: Bevacizumab and irinotecan were performed as second line (79.1 %) and third line treatment (20.9 %). Median chemotherapy cycle was 6 (range 1-37), and median follow-up was 6 months (range 1-36 months). Objective response rate was 39.1 %. Six-month PFS and OS6 were 46.3 % and 67.5 %, respectively. Median PFS was 6 months (95 % CI 2.5-9.5) and 6 months (95 % CI 4.9-7.1) in the grade III and IV groups, respectively (p = 0.773). Median OS was 9 months (95 % CI 7.1-10.9) and 8 months (95 % CI 6.6-9.4) in the grade III and IV groups, respectively (p = 0.450). Serious toxicities were observed in 7.8 % of patients. Treatment-related toxic death was observed in 3 patients. There was no treatment related to central nervous system hemorrhage or other serious hemorrhages. CONCLUSIONS: Present study results were consistent with previous studies. In addition, we detected similar outcomes in grade III and IV glial tumors.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Glioma/tratamiento farmacológico , Adulto , Anciano , Anticuerpos Monoclonales Humanizados/administración & dosificación , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Bevacizumab , Camptotecina/administración & dosificación , Camptotecina/análogos & derivados , Progresión de la Enfermedad , Femenino , Estudios de Seguimiento , Glioma/mortalidad , Glioma/patología , Humanos , Irinotecán , Masculino , Persona de Mediana Edad , Clasificación del Tumor , Estadificación de Neoplasias , Recurrencia , Estudios Retrospectivos , Resultado del Tratamiento , Adulto Joven
17.
Support Care Cancer ; 21(4): 1153-6, 2013 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-23104454

RESUMEN

BACKGROUND: Malignant ascites is a manifestation of end-stage events in a variety of cancers. There is significant lack of possible survival predictors in patients with malignancy-related ascites. Since the Model for End-Stage Liver Disease (MELD)-Na score has been shown to be a feasible and independent prognostic predictor for both short- and long-term outcome in HCC patients, we decided to test its prognostic role in other cancer types with ascites. MATERIAL AND METHODS: This is a retrospective study. The outpatient oncology clinic's records were screened for the period between 2004 and 2011. Eighty-two pancreatic and gastric cancer patients were enrolled into the study. RESULTS: The median age of patients was 59 (±12). Fifty-nine patients had gastric cancer and 23 had pancreatic cancer. Overall survival (OS) was 16.8 (IR, 1-98) months in gastric cancer and 16.3 (IR, 0.5-81) months in pancreatic cancer. There was no statistically significant difference between OS of gastric and pancreatic cancer. Progression-free survival (PFS) was statistically significantly longer in gastric cancer than pancreatic cancer with 16.5 (IR, 0.5-90) vs 6.5 (IR, 0.4-34) months (P = 0.04). Further analysis of data included stepwise multiple regression analysis with the dependent variable "overall survival." The model had two independent predictors and an R(2) of 82 % and a predicted R(2) of 81 %. Predictors for time to remission were PFS and MELD-Na. The regression equation for the model was: Overall survival =17.4- 0.522 MELD-Na + 0.902 PFS CONCLUSION: In this study we showed that progression-free survival and MELD-Na score are significantly related with overall survival. MELD-Na score can be one of the predictors of the survival and PFS in pancreatic and gastric cancer patients with ascites.


Asunto(s)
Ascitis/mortalidad , Neoplasias Pancreáticas/mortalidad , Neoplasias Gástricas/mortalidad , Anciano , Ascitis/tratamiento farmacológico , Ascitis/etiología , Biomarcadores/sangre , Supervivencia sin Enfermedad , Femenino , Humanos , Hepatopatías/mortalidad , Masculino , Auditoría Médica , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Turquía
18.
Asian Pac J Cancer Prev ; 14(12): 7645-9, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-24460347

RESUMEN

BACKGROUND: Immune functions and their relation to prognosis in breast cancer patients have become areas of great interest in recent years. Correlations between survival outcomes and peripheral blood flow cytometry parameters are therefore of interest. Here we focused on patients with non-metastatic breast cancer (BC). MATERIALS AND METHODS: A total of 29 patients with pathological confirmed breast carcinoma and flow cytometry data were assessed for overall survival (OS) and progression free survival (PFS). RESULTS: The median age of the patients was 54 years (range, 29-83). Multivariate analysis revealed that OS was significantly associated with absolute cytotoxic T cell count (95%CI, coef 2.26, p=0.035), tumor size (95%CI, coef -14.5, p 0.004), chemotherapy (95%CI, coef 12.9, p 0.0001), MFI of CD4 (95%CI, coef -5.1, P 0.04), MFI of HLA DR (95%CI, coef -5.9, p 0.008) and tumor grade (95%CI, coef -13, P 0.049) with R-Sq(adj)=67%. Similar findings were obtained for PFS. CONCLUSIONS: OS and PFS were significantly associated with tumor grade, tumor size, chemotherapy, MFI of CD4, HLA DR and absolute cytotoxic T cell count. The study revealed that MFI of basic CD markers and absolute cytotoxic T cell number may be a prognostic factors in women with non-metastatic BC.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias de la Mama/patología , Citometría de Flujo/métodos , Leucocitos Mononucleares/patología , Ganglios Linfáticos/patología , Subgrupos Linfocitarios/patología , Adulto , Anciano , Anciano de 80 o más Años , Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/mortalidad , Femenino , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Clasificación del Tumor , Pronóstico , Estudios Retrospectivos , Tasa de Supervivencia
19.
Eur Cytokine Netw ; 23(2): 68-71, 2012 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-22728324

RESUMEN

BACKGROUND/AIM: despite the rapidly accumulating histopathological data reporting differences in the expression of members of the angiopoietin family on the surface of various normal and tumour cells, data for these growth factors in plasma from cancer patients, including colon cancer, are scarce. The aims of the present study were to measure the plasma concentrations of Ang-1, Ang-2 and Tie-2 in colon cancer patients, and to assess the correlation between the concentrations of these factors and the stage of the tumor. PATIENTS AND METHODS: the study cohort included 36 patients (18 male, 18 female) with colon cancer (mean age 52.6 ± 15.0), and 36 sex- and age-matched, healthy controls who were free of inflammatory, neoplastic, atherosclerotic and connective tissue disease, recruited from hospital staff and attendees at hospital for check-up. Concentrations of Ang-1, Ang-2 and Tie-2 were measured using the enzyme-linked immunosorbent assay (ELISA) method. RESULTS: concentrations of Ang-2 (median 3,188.0 pg/mL, min: 1,070.5-max: 5,765.5) and Tie-2 (median 22 ng/mL, min:12-max:46) were significantly higher in patients with colon cancer, while concentrations of Ang-1 were not statistically different between the groups. Furthermore, concentrations of Ang-2 (median 4,292.0 pg/mL, min: 3,090.0-max: 5,765.5) were found to be significantly higher in stage III patients compared to stage II patients, whereas no difference was found between the concentrations of Ang-1 and Tie-2 in different colon cancer stages. CONCLUSION: plasma concentrations of Ang-1, Ang-2 and Tie-2 may be valuable, additional, tumor markers in colon cancer that should be tested in further trials.


Asunto(s)
Angiopoyetina 1/sangre , Angiopoyetina 2/sangre , Neoplasias del Colon/sangre , Receptor TIE-2/sangre , Biomarcadores de Tumor/sangre , Estudios de Cohortes , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias
20.
Asian Pac J Cancer Prev ; 13(1): 131-3, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-22502655

RESUMEN

BACKGROUND: We aimed to investigate the relationship between blood groups and pancreatic cancer in a Turkish population in Western Blacksea region. METHODS: This is a retrospective study. Zonguldak Karaelmas University outpatient oncology clinic records were screened for the period between 2004 and 2011. RESULTS: The median age of patients were 56 (± 16) and 132 of 633 study population had pancreatic cancer. Pancreatic cancer patients had significantly higher rates of blood group A compared to controls (OR 1.8, 95%CI, p 0.005). Rates of blood group AB was significantly lower than the control group (OR 0.37, 95% CI, p 0.04). The median survival (IR) time in subjects having the blood groups A, B, AB and O were 7.0 (1-28), 7.0 (2-38), 10 (2-36) and 9.0 (2-48) months respectively; the blood group 0 had significantly higher overall survival (OS) compared to the non-0 groups (p 0.04). CONCLUSIONS: Pancreatic cancer patients had more common blood group A in our population. Moreover, blood group AB appeared to be a protective factor against pancreatic cancer in our population. Blood group 0 had a significantly longer survival compared to non-0, regardless of prognostic factors.


Asunto(s)
Sistema del Grupo Sanguíneo ABO , Neoplasias Pancreáticas/etiología , Neoplasias Pancreáticas/mortalidad , Estudios de Casos y Controles , Susceptibilidad a Enfermedades , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias Pancreáticas/epidemiología , Neoplasias Pancreáticas/prevención & control , Pronóstico , Estudios Retrospectivos , Medición de Riesgo , Encuestas y Cuestionarios , Tasa de Supervivencia , Turquía/epidemiología
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