Are Syrian refugee breast cancer patients diagnosed at advanced stage and do they have treatment delays?

Aim: To compare the clinicopathological features and time to reach treatment of patients with breast cancer among Syrian refugees (SR) and Turkish citizens (TC). Methods: Retrospective data from 2014 to 2021 were extracted from the hospital database. Student's t-test, Mann-Whitney U test and χ2 test were used to compare the two groups. Results: Data of 88 SR and 402 TC patients were analyzed. The mean age was 45 years for SRs and 50 years for TCs. Breast cancer subtypes were similar in both groups. The de novo metastatic ratio was 23% in SRs and 21.3% in TCs and the time to reach treatment was similar between the two groups. Conclusion: Provided the absence of any obstacle in the healthcare system, SRs are diagnosed and treated like the citizens of their host nation.

Factors influencing HER2 discordance in nonmetastatic breast cancer and the role of neoadjuvant therapy.

Objective: The rates of and the factors influencing HER2 discordance in patients receiving neoadjuvant therapy for breast cancer are investigated. Methods: This study retrospectively examines the rates of HER2 and hormone receptor discordance between the biopsy and postoperative resection specimens of 400 female early-stage breast cancer patients. Results: 133 (33.3%) patients had received neoadjuvant therapy. The rate of HER2 discordance between biopsy and resection specimens was 1.7% in the control group and 5.3% in the neoadjuvant therapy group (p = 0.018). The rate of HER2 discordance was higher in younger patients and in patients with T1 tumors in the neoadjuvant therapy group. Conclusion: Neoadjuvant therapy, age <40 years and smaller tumor size were independent risk factors for HER2 discordance.

HER2 is an important and targetable molecule in breast cancer. In the early stages of breast cancer, a treatment modality called neoadjuvant therapy, which now includes anti-HER2 therapies, is administered before surgery in order to achieve disease regression and make the patient suitable for a more minor operation. In breast cancer, HER2 status may be positive in the initial biopsy specimen and negative in the surgical specimen. HER2 status plays an important role in treatment decisions. In this study, we investigated the factors causing HER2 status to change in early-stage breast cancer. This study has a retrospective design and includes 400 female patients with early-stage breast cancer. The results of the study identified the factors causing HER2 status to change to negative as receipt of neoadjuvant therapy, small tumor size and younger age.

The Efficacy and Safety of Treatment Regimens Used in the First-Line Setting in Metastatic Pancreatic Cancer Patients: A Multicenter Real-Life Study.

OBJECTIVE: The aim of the study is to compare the efficacy and safety of 3 chemotherapy regimens used as first-line treatments in the real-life management of metastatic pancreatic cancer. METHODS: A total of 218 patients were included in this multicenter study. Gemcitabine (Gem, n = 71), gemcitabine-cisplatin (Gem-Cis, n = 91), and FOLFIRINOX (a combination of leucovorin, 5-fluorouracil, irinotecan, and oxaliplatin [FFX], n = 56) treatments were compared. RESULTS: Overall response rate was significantly higher in the FFX group (50.0%) than in the Gem (28.2%) and Gem-Cis (27.5%) groups (P = 0.010). Median progression-free survival (8.4 vs 4.6 and 5.5 months, respectively, P < 0.001) and overall survival (16.4 vs 8.1 and 8.7 months, respectively, P = 0.002) were significantly longer in the FFX group than in the Gem and Gem-Cis groups. Toxicity of any grade was noted in 46 (64.8%), 56 (61.5%), and 49 (87.5%) patients in the Gem, Gem-Cis, and FFX groups, respectively (P = 0.003). CONCLUSIONS: In our study, FFX regimen provides a significant advantage over the other treatment regimens in terms of response rates and survival. Treatment toxicity was more frequent but manageable with the FFX regimen.

Prognostic importance of tumor location and anti-EGFR therapy in patients with K-RAS wild type metastatic colorectal cancer.

PURPOSE: To compare anti-EGFR and anti-VEGF agents in patients with K-RAS wild-type metastatic colorectal cancer (mCRC) with regards to tumor location. METHODS: 450 patients diagnosed with mCRC, who applied to our center were included in this retrospective study. Of 450 patients, 303 underwent K-RAS mutation tests, assessed as having right-sided or left-sided mCRC and grouped according to localization of right and left colon. Sixty-five Patients with K-RAS wild-type mCRC, who were treated with first line anti-EGFR or anti-VEGF containing combination therapies of fluorouracil with leucovorin and either irinotecan or oxaliplatin were compared. RESULTS: 393 (87%) out of 450 mCRC patients had left-sided colon cancers, and 57(13%) had right-side colon cancers. K-RAS analysis was performed in 303 of 450 patients with mCRC, 186 (61.4%) patients had K-RAS wild-type and 117 (38,6%) had K-RAS mutant. Median survival for right-sided cancers was 23.3 months and 29.4 months for left-sided cancers (p=0.309). Median progression-free survival (PFS) was 10.4 months (95% CI 7.3-13.4) in the anti-EGFR containing regimens group and 9.7 months (8.2-11.1) in the anti-VEGF containing regimens group (p=0.037); however, median overall survival (OS) was 18.4 months (95% CI 11.7-25.1) in the anti-EGFR containing regimens group and 19.3 months (95% CI 15.7-22.9) in the anti-VEGF containing regimens group (p=0.635). CONCLUSION: Addition of anti-EGFR in left sided K-RAS wild-type mCRC regarding PFS was beneficial, however there was no difference in terms of OS.

Clinicopathologic and Prognostic Differences between Three Different Age Groups (Child/Adolescent, Young Adults, and Adults) of Colorectal Cancer Patients: A Multicentre Study.

BACKGROUND: Colorectal cancer (CRC) is a rare disease amongst children and adolescents. Previous studies have reported a number of differences between children/adolescents, young adults, and adult patients with CRC. However, none of these studies compared these age groups according to their clinicopathologic and prognostic characteristics. In the current study, we compare these three age groups. METHODS: A total of 173 (1.1% of 15,654 patients) young CRC patients (≤25 years) were included in the study. As a control group, 237 adult CRC patients (>25 years) were also included. Patients were divided into three age groups: child/adolescent (10-19 years), young adult (20-25 years), and adult (>25 years). RESULTS: Statistical differences amongst the three groups in terms of gender (p = 0.446), family history (p = 0.578), symptoms of presentation (p = 0.306), and interval between initiation of symptoms and diagnosis (p = 0.710) could not be demonstrated. Whilst abdominal pain (p < 0.001) and vomiting (p = 0.002) were less common in young adults than in other groups, rectal bleeding and changes in bowel habits were relatively less common in adolescents than in other groups. Rectal localisation (p = 0.035), mucinous adenocarcinoma (p < 0.001), and a poorly differentiated histologic subtype (p < 0.001) were less common in the adult group than in other groups. The percentage of patients with metastasis and sites of metastasis (e.g., peritoneum and lung) differed between groups. The median overall survival was 32.6 months in the adolescent group, 57.8 months in the young adult group and was not reached in the adult group (p = 0.022). The median event-free survival of the adolescent, young adult, and adult groups was 29.0, 29.9, and 61.6 months, respectively (p = 0.003). CONCLUSIONS: CRC patients of different age groups present different clinicopathologic and prognostic characteristics. Clinicians should be aware of and manage the disease according to these differences.

Diagnostic serum vitamin D level is not a reliable prognostic factor for resectable breast cancer.

AIM: There are inconsistent results about the effects of vitamin D level on breast cancer prognosis. We aimed to investigate the effect of vitamin D levels on the prognosis of resectable breast cancer in a patient group with highly different clothing styles. PATIENTS & METHODS: A total of 186 breast cancer patients were enrolled in the study. RESULTS: Vitamin D level was sufficient, insufficient and deficient in 17.2, 52.2 and 30.6% of patients, respectively. There was a significant relationship between clothing style and serum 25 (OH) D levels. We could not establish any relation between vitamin D level and tumor characteristics or survival. CONCLUSION: Vitamin D supplementation can be more important than diagnostic serum vitamin D level on prognosis of breast cancer.

Widespread Metastatic Prostate Carcinoma Shown by 68Ga-PSMA PET/CT.

We present the F-FDG and Ga prostate-specific membrane antigen PET/CT images of a 61-year-old patient with a newly diagnosed prostate carcinoma (4 + 4 Gleason score) and high serum prostate-specific antigen levels (460 ng/mL). In F-FDG PET/CT, minimal uptake was demonstrated in the prostatic mass without any accompanying pathological uptake. However, Ga prostate-specific membrane antigen PET/CT revealed multiple pathological uptake in the lung nodules, mediastinal nodes, abdominal-pelvic lymph nodes, bone lesions, and prostatic mass.

Evaluating the curriculum of the veterinary school of Firat University, Turkey, in terms of professional and technical skills.

A significant portion of the problems faced by veterinarians is related to communication. These problems are intensely experienced between veterinary practitioners and animal owners; yet no lectures or courses aiming to improve professional skills are available in the curriculum of veterinary schools in Turkey. In this study, all students currently enrolled at, and 1992 and 1998 graduates of, the Veterinary School of Firat University (VSFU), Turkey, were surveyed to evaluate the attitudes of veterinary students and graduates toward technical and professional skills. Data were collected from 581 students and 61 recent graduates via personal interviews with students and questionnaires mailed to graduates; information was obtained about participants' technical and professional skills. The overall response rate was 85%. The results show that learning about technical and professional skills is highly valued; competence and comfort in skill sets are associated with comfort in establishing communication with instructors. Positive correlations were also noted between feeling comfortable with and feeling competent in both skill sets. In conclusion, it appears to be essential to introduce courses addressing improvement of professional skills to the curriculum of veterinary schools in Turkey, given that a successful veterinarian profile requires feeling competent in and comfortable with both technical and professional skills.