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Aim: To demonstrate the prognostic importance of glucose-to-lymphocyte ratio (GLR) and uric acid (UA) in patients with metastatic breast cancer (MBC) receiving Cdk 4/6 inhibitors. Materials & methods: Neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, GLR, UA and CA15-3 were analyzed to assess their prognostic value using Kaplan–Meier curves and Cox regression analysis in 101 patients with MBC, retrospectively. Results: Importantly, both progression-free survival and overall survival were shorter in the group with high neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), GLR and UA. In the multivariate analysis, GLR and UA levels were independent prognostic factors for both progression-free survival and overall survival. Conclusion: In patients with MBC, GLR and UA are independent factors that predict survival times.

Background: Ribociclib, palbociclib and abemaciclib are currently approved CDK4/6 inhibitors along with aromatase inhibitors as the first-line standard-of-care for patients with hormone receptor-positive, HER2-negative metastatic breast cancer. Methods: The authors report retrospective real-life data for 600 patients with estrogen receptor- and/or progesterone receptor-positive and HER2-negative metastatic breast cancer who were treated with ribociclib and palbociclib in combination with letrozole. Results & conclusion: The results demonstrated that the combination of palbociclib or ribociclib with letrozole has similar progression-free survival and overall survival benefit in real life for the patient group with similar clinical features. Specifically, endocrine sensitivity may be a factor to be considered in the treatment preference.

The accumulation of excess glutamate in the synapse leads to excitotoxicity, which is the underlying reason of neuronal death in intracranial tumors. We identified the expression levels of glutamate dehydrogenase, glutamine synthetase and sirtuin 4 in U87 cell line and various intracranial tumors. mRNA expressions of glutamate dehydrogenase (GDH), glutamine synthetase (GS) and sirtuin 4 (SIRT4) were analyzed in various intracranial tumors using qPCR. GDH, GS and SIRT4 protein expressions were analyzed in glioblastoma (U87) and glial (IHA-immortalized human astrocytes) cell lines via western blotting. The protein expressions of SIRT4 and GS were shown to be elevated and GDH protein expression was reduced in U87 cells in comparison to IHA cells. All types of intracranial tumors displayed lower GS mRNA expressions compared to controls. SIRT4 mRNA expressions were also shown to be lower in all the tumors and grades, although not significantly. GDH mRNA expression was found to be similar in all groups. The molecular mechanisms of glutamate metabolism and excitotoxicity should be discovered to develop therapies against intracranial tumors.

We present a case of concomitant c-ros oncogene 1 (ROS1) and anaplastic lymphoma kinase (ALK) and fusion in non small cell lung cancer (NSCLC) in a 59-year-old patient and review the treatment efficacy of co-mutations. The choice of the treatment and its effectiveness with rare co-mutations is a subject of considerable interest. This review will provide clues to the optimal treatment approach to NSCLC patients with more than one driver mutations. However, randomized studies are needed to clarify which patients with concurrent mutations may benefit from chemotherapy or related tki.

To evaluate prognostic significance of the new index, designed by formulating hemoglobin, albumin, lymphocyte, and platelet (HALP) counts in patients with metastatic renal cell carcinoma (RCC).Descriptive study.Department of Medical Oncology, Celal Bayar University, Manisa, Turkey and Adnan Menderes University, Aydin, Turkey, from January 2014 to April 2020.Patients with metastatic RCC and sufficient follow-up data were included in the study as a retrospective cohort. HALP score was calculated as hemoglobin (g/L) × albumin (g/L) levels × lymphocyte count (/L)/platelet count (/L). The cut-off value was determined by examining the area under the ROC curve for the HALP value. The endpoints of this study included overall survival (OS) and progression-free survival (PFS).The mean overall survival (OS) of the patients with low HALP score was 17.7 months (95% CI, 2.21 - 33.18), while the OS of the patients with high HALP score was 89.7 months (95% CI, 55.62 - 123.77) and reached statistical significance (p=0.001). The results of univariate (p = 0.009) and multivariate (p=0.012) analyses were statistically significant as well.The HALP score in metastatic RCC patients was closely related to the prognosis. Worse OS was found in patients with a low HALP score. Key Words: HALP score, Overall survival, Progression-free survival, Renal cell carcinoma.

Background: Gastric cancer is responsible for a considerable proportion of all cancer-related deaths. Elderly cancer patients are often ignored in prospective studies in which the efficacy of chemotherapy is evaluated, although more than half of all gastric cancer cases are over the age of 70 years. The present study aims to evaluate the efficacy and feasibility of capecitabine-based chemotherapies in geriatric patients with gastric cancer. Methods: A total of 81 patients over the age of 65 years who received chemotherapy for metastatic gastric cancer at two oncology centers between 2012 and 2017 were included in the study. The medical records of the patients were evaluated retrospectively, and the patients and their performance status were evaluated using the American Joint Committee on Cancer staging system and the World Health Organisation scale, respectively. Results: The mean age was 74 years. The male gender and the adenocarcinoma histological type were seen in higher rates. Most of the patients underwent capecitabine-cisplatin chemotherapy, and the mean follow-up was 42 months. The median overall survival of the groups of patients receiving capecitabine-cisplatin, capecitabine-oxaliplatin and capecitabine was 8 months, 10.7 months and 8.9 months, respectively, indicating no statistically significant differences between the groups (p=0.467). The median overall survival of all patients was found to be 8.7. The progression-free survival between the different chemotherapy subgroups was not statistically significant (p=0.59). The most common side effect was found to be anemia. Grade 3–4 adverse effects were similar between the arms of the study (p=0.725). A statistically significant increase was found in the mortality risk with an increased number of metastatic sites in a multivariate analysis (p=0.001). No correlation was found between the chemotherapy protocols and mortality risk (p=0.472). Adverse effects such as stomatitis, nausea/vomiting, neuropathy, neutropenic fever and nephrotoxicity, independent of chemotherapy, were statistically and significantly associated with the mortality risk (p=0.045, p=0.047, p=0.036, p=0.02 and p=0.049, respectively). Conclusions: Our study results show that adverse effects such as stomatitis, nausea/vomiting, neutropenic fever, nephrotoxicity and neuropathy increase the mortality risk which suggest that particularly oral health care, the application of appropriate antiemetic treatments, the close follow-up of kidney function tests and adequate hydration, protective infection barrier measures and effective treatment of neuropathy associated with chronic diseases are as important as chemotherapy in geriatric cases.

Aim: Although patients over 65 years of age are considered to be elderly patients with breast cancer, the performance status and comorbidity of patients aged 70 and over is not the same as patients aged 65–70 years. The aim of this study was to evaluate the treatment modalities, features of patients and disease in elderly early-stage breast cancer patients. Material and methods: Data of 87 patients were examined. Demographic data, disease data (tumor size, lymph node involvement, hormone receptor status, Her-2 status), comorbid diseases, and given treatments were evaluated. The patients were divided into two groups as 65–70 years of age and over 70 years of age. All the collected data was compared. Results: There was no difference in hormone receptor status between 2 groups (p > 0,05). Her-2 negativity was found to be significantly higher in patients ≥ 70 years (%61 vs %83, p = 0,024). There was no significant difference between two groups in terms of surgery (p > 0,05). The frequency of chemotherapy and radiotherapy was significantly lower in the older group (%37 vs %17, p = 0,009). OS and DFS were significantly shorter in triple negative disease (69.59 months,p = 0.039 and 53.95 months,p = 0.024 respectively). ER positive subtype has a significantly better DFS (164 vs 47 months, p = 0,037) and OS (170 vs 68 months, p = 0,046). Additionally, PR positive disease has a significantly better DFS (129 vs 84 months, p = 0,028) and OS (190 vs 96 months, p = 0,006). HER2-negative subtype had better OS than HER2-positive subtype (172 vs 91 months, p = 0,016). DFS was significantly shorter in ≥70years patients (161.1 months vs 102.1 months, p = 0.045), however OS was not different among the 2 groups. Adjuvant therapy prolongs DFS in both groups(65–70 years 107,5 vs 129,3 months, >70years 86,2 vs 95,7 months p = 0,034). Conclusion: Age is an important and independent risk factor for the treatment of the elderly patients, however patient age alone cannot be decisive. In current study, the pathological features of the tumor and the effects of these features on DFS and OS were similar in young breast cancer patients and patients over 70 years of age. In addition, we found that adjuvant treatment modalities affect OS and DFS positively as in the case of young patients. There is an absolute need for prospective studies involving elderly patients. Keywords: Elderly patient, Breast cancer, Surgery, Chemotherapy, Hormone receptor, Her-2

The Controlling Nutritional Status (CONUT) Score, a new parameter that reflects the immuno-nutritional status, has been closely associated with prognosis in many cancer types. However, the prognostic significance of the CONUT score in Glioblastoma Multiforme (GBM) is not known. In this study, we aimed to show the prognostic significance of the CONUT score in the postoperative period in patients with GBM.120 patients followed up with GBM were included in the study, retrospectively. According to the receiver operating characteristic (ROC) curve analysis, the optimal cut-off values were determined for the CONUT score, and the patients were divided into low (2.5) and high (≥2.5) CONUT groups. Systemic immune inflammation index (SII), prognostic nutritional index (PNI), and neutrophil-lymphocyte ratio (NLR) were grouped according to the cut-off point of 1111, 46.5, and 4.48, respectively. Cox regression analyzes were used to assess their prognostic significance for progression-free survival (PFS) and overall survival (OS).The high CONUT score group was found to have worse PFS and OS than the low CONUT score group (p 0.001, p 0.001). In univariate analysis, age, gender, comorbidity, CONUT score, SII, PNI, NLR were found to be significant for both PFS and OS. In multivariate analysis, only age and CONUT score were found as independent prognostic factors for both PFS (p: 0.040, p 0,001) and OS (p: 0,041, p 0,001).The CONUT score in the postoperative period in patients with GBM is an independent prognostic parameter that predicts progression and survival.

The purpose of our study was to investigate the mRNA expression profile of glutamate transporter 1 (GLT-1) in different types and grades of brain tumors, such as glioblastoma multiforme, astrocytomas (pilocytic, diffuse, anaplastic), oligodendrogliomas, ependydomas, medulloblastomas, and meningiomas using Real Time Quantitative PCR technique (qRT-PCR).A total of 66 surgically removed primary brain tumors were collected retrospectively and the total RNA was isolated from each tumor sample. cDNA was generated and GLT-1 mRNA expression was evaluated with quantitative qRT-PCR.The mRNA expression of GLT-1 was significantly lower in primary brain tumors when compared to control brain tissues. GLT-1 expression was inversely correlated with the tumor grade, implicating its potential role in tumor progression. GLT-1 mRNA expression was lowest in grade 4 tumors, such as glioblastoma multiforme and medulloblastomas. The tumors with grade 3 and 4 combined displayed lower expression compared to tumors with grades 1 and 2. In grade 4 tumors, female patients displayed lower GLT-1 expression compared to male patients. In addition, glioblastoma multiforme patients older than 65 years of age showed lower GLT-1 expression when compared to the patients younger than 65.qRT-PCR was found to be a sensitive method in detecting GLT-1 expression in brain tumors. This study may lay the foundation for the future research about the excitotoxicity and brain tumors and GLT-1 might be a potential biomarker. Targeted therapies based on excitotoxic molecular pathways against gliomas should be designed to effectively combat these diseases.

Amaç: Bu çalışmanın amacı erken ve ileri evre kolon kanserihastalarında tümör lokalizasyonunun etkilerini incelemektir.Gereç ve Yöntem: 2013-2017 arasında Adnan MenderesÜniversitesi'nin tıbbi onkoloji bölümüne başvuran primer kolorektal kanser tanılı hastalarıretrospektif olarak taradık ve 249 hastayı çalışmaya dahil ettik.Bulgular: Erken evrede, sol taraftaki kolorektal kanserler erkeklerde anlamlı olarak daha yaygındı (p =0.027). Sağ taraftaki tümörlerde nüks kadın hastalarda daha erken gelişti (p =0.043) ve kadın cinsiyet, genç yaş nüks süresi için bağımsız prognostikfaktörlerdi. PANRAS pozitif ve bilinmeyen mutasyon durumunun her iki taraftakitümörler için olumsuz prognostik faktörler olduğu bulundu.Metastatik evrede, sol taraftaki tümörlerde PANRAS mutant olanhastalar daha uzun süre yaşadılar (sırasıyla 49.0'a 25.5 ay, p, Purpose:Theaim of this study was to examine the effects of tumor localization in early andadvanced stage colon cancer patients. Materials and Methods :This retrospective study enrolled 249 primary colorectal cancer (CRC) patientsat medical oncology department of Adnan Menderes University between 2013-2017. Results:Inearly stage, left sided tumors were significantly more common inmales(p=0.027). In right sided tumours recurrence developed earlier in femalepatients(p=0.043) and female sex,young age were unfavorable prognostic factorsfor the relapse time. Positive andunknown PANRAS mutation status were found to be unfavorable prognostic factorsfor both side. In metastatic stage, patients with PANRAS mutant left sidedtumors lived longer than PANRAS negative patients(49.0 vs 25.5 monthsrespectively, p

Gastroenteropancreatic tumors (GEPNETs) is a heterogeneous disease with variable clinical course. While promising therapeutic options exist for other adult cancers, there are no new molecular-based treatments developed for GEPNETs. One of the main targets of cancer immunotherapy is the Programmed Cell Death Ligand-1 (PD-L1) pathway. Our purpose was to investigate the profile of PD-L1 expression in different organs of GEPNETs and compare the conventional immunohistochemistry (IHC) with the RNA expression analysis via real time polymerase chain reaction (RT-PCR) in order to determine which patients might be appropriate for immune check point-targeted therapy.A total of 59 surgically or endoscopically resected GEPNET tissues were retrospectively collected. The expression of PD-L1 and mRNA was evaluated with IHC.The expression of PD-L1 was significantly associated with the high-grade classification (p=0.012). PD-L1 mRNA expression in tumor samples appeared to be higher compared to the corresponding normal tissues. In appendix, stomach and small intestine, the expression of PD-L1 mRNA was higher in the tumor tissues compared to the respective controls. In pancreas and colon, control tissues tend to have a higher PD-L1 mRNA expression compared to tumor tissues. PD-L1 mRNA expression was higher in GEP carcinomas (p=0.0031).RT-PCR was found to be more sensitive in detecting PD-L1 expression than conventional IHC. This study may provide an important starting point and useful background information for future research about immunotherapy for appendix, stomach and small intestine neuroendocrine carcinomas.

To compare the efficacy and adverse effect profiles of the first-line treatment of patients with KRAS wild type metastatic colorectal cancer (CRC) in Turkey who were treated based on regimens including bevacizumab, cetuximab and panitumumab.This retrospective multicenter observational study involved a total of 238 patients who received chemotherapy in combination with either bevacizumab or cetuximab or panitumumab as first-line therapy for KRAS wild-type metastatic colorectal cancer. Patients with full medical records having pathological diagnosis of CRC adenocarcinoma were included in the study. The demographic, laboratory, histopathological and clinical characteristics of the patients were determined, and three groups were compared based on the study variables.The mean age of the entire sample (n=238) was 58±11 years, 64% of which were male. The most frequent tumor localization was the rectum (37%) and G2 was the most common tumor grade (59.7%). About 63% of the patients had metastatic disease at diagnosis, with the most common site of metastasis being lung (14.7%) and liver (52.5%). Overall survival (OS) was 63.9%, while 1-, 3- and 5-year survival rates were 91.7, 56.6 and 36.9%, respectively. The expected mean survival was 49.1 months (95% CI, 42.9-55.3). The 1-, 3- and 5-year progression-free survival (PFS) rates following first-line treatment were 65.3, 26.1 and 5.6%, respectively, while disease free survival (DFS) in patients without metastasis at diagnosis was 68.5%. An analysis carried out disregarding which treatment the patients received (FOLFOX or FOLFIRI) revealed that a panitumumab-containing combination resulted in poorer prognosis compared to bevacizumab or cetuximab-containing combination (p0.001). With regard to the adverse effect profile, the most common adverse effects were neuropathy and neutropenia in patients receiving FOLFOX-bevacizumab; neutropenia and perforation in patients receiving FOLFIRI-bevacizumab; rash and pustular infection in patients receiving FOLFIRI-cetuximab; and diarrhea in patients who received FOLFIRI-panitumumab combination.This is the first multicenter study performed in Turkey evaluating the response to treatment and adverse effects in patients with KRAS wild-type metastatic colorectal cancer.

Objectives: Lung cancer is the most common cause of cancer-related deaths worldwide. The use of tobacco and tobacco products is among the leading risk factors with proven association with lung cancer, although various environmental and dietary factors have been also implicated. Vitamin D deficiency has been identified as a poor prognostic factor in advanced stage colon cancer and breast cancer. The aim of the present study was to compare 25-hydroxyvitamin D [25(OH)D] levels between patients with non-small cell lung cancer (NSCLC) at the time of diagnosis and healthy controls and to evaluate the differences in serum 25(OH)D levels across the subgroups and stages of NSCLC., Methods: A total of 462 patients with NSCLC who were followed and treated in three participating centers were compared retrospectively with and age- and sex-matched 462 healthy controls who underwent testing for serum calcium, lactate dehydrogenase (LDH), magnesium, phosphorus, creatinine, and vitamin D levels in the between January 2016 and June 2018. The patients with NSCLC were further classified according to the histological subtype., Results: The mean age was 63.46 +/- 8.86 years. The patient group was composed of 58 females (12.6%) and 404 males (87.4%). Serum 25(OH)D, calcium, LDH, and magnesium levels were significantly different between the patient and the control group (p=0.0001, p=0.0001, p=0.0001, p=0.0001, respectively). Among patients with NSCLC, serum 25(OH) D was significantly lower in patients with adenocarcinoma subtype than in patients with squamous-cell carcinoma subtype (p=0.001). There was a significant correlation between advanced stage with decreased serum 25(OH)D and increased LDH levels (p=0.0001, p=0.0001, respectively)., Conclusion: The study is the most extensive study in our region in terms of the number of participating patients. Demonstration of a difference in serum 25(OH)D levels between histological subtypes also contributes to the literature.

Objectives: Lung cancer is the most common cause of cancer-related deaths worldwide. The use of tobacco and tobacco products is among the leading risk factors with proven association with lung cancer, although various environmental and dietary factors have been also implicated. Vitamin D deficiency has been identified as a poor prognosticfactor in advanced stage colon cancer and breast cancer. The aim of the present study was to compare 25-hydroxyvitamin D [25(OH)D] levels between patients with non-small cell lung cancer (NSCLC) at the time of diagnosis and healthycontrols and to evaluate the differences in serum 25(OH)D levels across the subgroups and stages of NSCLC.Methods: A total of 462 patients with NSCLC who were followed and treated in three participating centers were compared retrospectively with and age- and sex-matched 462 healthy controls who underwent testing for serum calcium,lactate dehydrogenase (LDH), magnesium, phosphorus, creatinine, and vitamin D levels in the between January 2016and June 2018. The patients with NSCLC were further classified according to the histological subtype.Results: The mean age was 63.46±8.86 years. The patient group was composed of 58 females (12.6%) and 404 males(87.4%). Serum 25(OH)D, calcium, LDH, and magnesium levels were significantly different between the patient andthe control group (p=0.0001, p=0.0001, p=0.0001, p=0.0001, respectively). Among patients with NSCLC, serum 25(OH)D was significantly lower in patients with adenocarcinoma subtype than in patients with squamous-cell carcinomasubtype (p=0.001). There was a significant correlation between advanced stage with decreased serum 25(OH)D andincreased LDH levels (p=0.0001, p=0.0001, respectively).Conclusion: The study is the most extensive study in our region in terms of the number of participating patients.Demonstration of a difference in serum 25(OH)D levels between histological subtypes also contributes to the literature.

WOS: 000453452300046 PubMed ID: 30539871 Aims: In this study, we investigated the expression of thyroid transcription factor-1 (TTF-1) in lung adenocarcinoma patients' samples and analyzed the association of TTF-1 with clinicopathological parameters, prognosis, and treatment options in patients with lung adenocarcinoma. Subjects and Methods: This retrospective study enrolled 200 patients who were histologically confirmed lung adenocarcinoma with Stage I-IV disease, between 2008 and 2015 years. The cytological archive of these hospitals' Pathology Department was searched. The available slides and the clinical information were reviewed and correlated. All analyses were conducted by SPSS version 15.0 statistical software. Results: Sixty-five (32.5%) of the patients showed TTF-1 negativity and 135 (67.5%) of them showed TTF-1 positivity. The median survival for TTF-1 positive and negative patients was 19.6 and 12.2 months, respectively. We did not find any statistical significance in-between the parameters in terms of the survival data. In TTF-1-negative group, the survival time of epidermal growth factor receptor mutation positive (P = 0.049), cytokeratin 7 (CK7) positive (P = 0.009) patients and those who had received curative radiotherapy (P = 0.028) was significantly better as compared to TTF-1-positive group. We also analyzed the relation between TTF-1 and survival outcome or chemotherapy selection in Stage IV disease. We could not identify any correlation between TTF-1 and survival outcome or treatment selection. Conclusions: This study suggests that TTF-1 is not a favorable prognostic factor in lung adenocarcinoma patients. The prognostic role of CK7 and relationship between TFF-1 expression in lung adenocarcinoma and predictive role of TTF-1 expression for the selection of first-line treatment in Stage IV lung adenocarcinoma should be validated in prospective and randomized studies.

Cancer is one of the most common causes of death all over the World (Rahib et al. in Cancer Res 74(11):2913–2921, 2014; Silbermann et al. in Ann Oncol 23(Suppl 3):iii15–iii28, 2012). It is crucial to diagnose this disease early by effective screening methods and also it is very important to acknowledge the community on various aspects of this disease such as the treatment methods and palliative care. Not only the oncologists but every medical doctor should be educated well in dealing with cancer patients. Previous studies suggested various opinions on the level of oncology education in medical schools (Pavlidis et al. in Ann Oncol 16(5):840–841, 2005). In this study, the perspectives of medical students on cancer, its treatment, palliative care, and the oncologists were analyzed in relation to their educational status. A multicenter survey analysis was performed on a total of 4224 medical school students that accepted to enter this study in Turkey. After the questions about the demographical characteristics of the students, their perspectives on the definition, diagnosis, screening, and treatment methods of cancer and their way of understanding metastatic disease as well as palliative care were analyzed. The questionnaire includes questions with answers and a scoring system of Likert type 5 (absolutely disagree = 1, completely agree = 5). In the last part of the questionnaire, there were some words to detect what the words “cancer” and “oncologist” meant for the students. The participant students were analyzed in two study groups; “group 1” (n = 1.255) were phases I and II students that had never attended an oncology lesson, and “group 2” (n = 2.969) were phases III to VI students that had attended oncology lessons in the medical school. SPSS v17 was used for the database and statistical analyses. A value of p < 0.05 was noted as statistically significant. Group 1 defined cancer as a contagious disease (p = 0.00025), they believed that early diagnosis was never possible (p = 0.042), all people with a diagnosis of cancer would certainly die (p = 0.044), and chemotherapy was not successful in a metastatic disease (p = 0.003) as compared to group 2. The rate of the students that believed gastric cancer screening was a part of the national screening policy was significantly more in group 1 than in group 2 (p = 0.00014). Group 2 had a higher anxiety level for themselves or their family members to become a cancer patient. Most of the students in both groups defined medical oncologists as warriors (57% in group 1 and 40% in group 2; p = 0.097), and cancer was reminding them of “death” (54% in group 1 and 48% in group 2; p = 0.102). This study suggested that oncology education was useful for the students’ understanding of cancer and related issues; however, the level of oncology education should be improved in medical schools in Turkey. This would be helpful for medical doctors to cope with many aspects of cancer as a major health care problem in this country. © 2018, American Association for Cancer Education.

Objectives: In this study, we investigated whether mean thrombocyte volume (MPV) and MPV/platelet count ratio have a prognostic significance in advanced NSCLC or not Methods:A total of 496 NSCLC patients at stage IIIB/IV and did not meet exclusion criteria were included in the study. The demographic fetaures (age, gender, smoking habit), clinical characteristics (performance status, weight loss, disease stage, first-line treatment regimen), laboratory tests (levels of hemoglobin, lactate dehydrogenase and calcium as well as MPV, MPV/platelet count ratio and counts of white blood cell, platelet), and histological features (histologic type, tumor grade) were recorded. Results:The MPV levels of all patients were determined as 10.2 {plus minus} 3.4 (range, 6.4-14.1 fL). With ROC curve analysis, the MPV/PC ratio was associated with a sensitivity of 67.8% and a specificity of 84.8% at a cutoff value of 0.47424 for presence of brain metastasis at the time of diagnosis. Univariate analysis showed that OS was significantly shorter in the group with an increased MPV level than in the other group (median OS time 6.8 months vs. 11.5 months, log-rank, P=0.032). Multivariate analysis confirmed that an increased MPV level was an independent poor prognostic factor for OS (HR: 1.704, 95% CI: 1.274 - 3.415, P=0.014). Conclusions: Unlike results of previous studies, the study showed that increased MPV was an important prognostic factor in patients with NSCLC. Hence, an increased MPV level may be used as a prognostic biomarker to estimate for poor overall survival in patients with NSCLC. This article is protected by copyright. All rights reserved.

WOS: 000336834500036, PubMed ID: 24815463, Background: Unlike for fit elderly metastatic colorectal cancer (mCRC) patients, general approaches to initial treatment for the frail older mCRC patients are not clear. Our aim was to evaluate the efficiency and safety of first-line single-agent treatment in one such group. Materials and Methods: We retrospectively evaluated mCRC patients aged 70 or older with an Eastern Cooperative Oncology Group performance score of 2. They had no prior treatment and underwent first-line single-agent capecitabine or other monotherapies until disease progression or unacceptable toxicity. Results: Thirty-six patients were included. Most (n:28, 77.8%) were treated with capecitabine. One patient achieved a complete response and 5 patients had a partial response for an overall response rate of 16.6%. Twelve patients (33.3%) remained stable. Median progression free survival was 5 months (confidence interval (CI), %; 3.59-6.40) and median overall survival was 10 months (95 CI%; 8.1-11.8). Grade 3-4 toxicity was found in 6 patients (16.6%). Febrile neutropenia was not observed and there were no toxicity-associated deaths. Conclusions: Capecitabine is a safe chemotherapeutic agent with moderate activity for first-line treatment of older metastatic colorectal cancer patients with limited performance status.

WOS: 000399505100004 PubMed ID: 28333566 Background: There are insufficient predictive markers for renal cell carcinoma (RCC). Methods: A total of 308 metastatic RCC patients were analyzed retrospectively. Results: The increased hemoglobin (Hb) group had significantly higher progression-free survival and overall survival (OS) compared with the decreased Hb group at 11.5 versus 6.35months (p < .001) and 21.0 versus 11.36months (p < .001) respectively. The 1- and 3-year OS rates were higher in the Hb increased group, i.e., 84% versus 64% and 52% versus 35% respectively. Conclusions: The present study showed that increased Hb levels after tyrosine kinase inhibitor therapy could be a predictive marker of RCC.

To determine the predictive value of the mean platelet volume (MPV) and the MPV/platelet count ratio on the development of isolated bone metastasis in patients with breast cancer.A total of 121 previously untreated female patients with isolated bone metastases from breast cancer (group 1) were included in this retrospective cohort study. The patients enrolled in this study had similar age, biological subtypes, and duration of follow-up after diagnosis. Group 1 was compared with both 71 previously untreated women with breast cancer with no metastases at all (group 2) and 39 healthy women (group 3). Demographic data, laboratory tests and histological features of all of the patients in groups 1 and 2 were recorded and the study variables from each of the three groups were compared.In group 1, the cut-off value (9.2 fL) for the MPV was determined and patients were stratified into 4 subgroups. The MPV was higher in group 1 than in either group 2 or group 3. Group 1 patients had a MPV of 8.8±3.1 fL (mean 5.1, range: 6.1-15.6) and the cut-off value for MPV was 9.2 fl. For patients in group 1, the MPV distribution was stratified into 4 groups as follows: group A included MPV values6.08 fL, in group B values ranged from 6.09 to 8.46 fL, group C included values from 8.47 to 10.05 fL, and group D included patients with MPV values10.06 fL. MPV and the presence of lymphovascular invasion were found to be independent risk factors for the development of isolated bone metastases.We concluded that MPV can be used to predict the development of isolated bone metastases.

e18552Background: To examine the rates of depression and anxiety among nurses working in oncology units and the situations in which these ratios may be related. Methods: A descriptive study. Nurses...

The aim of the present study was to examine the frequency and genetic diversity of Blastocystis in cancer patients of a Medical Oncology Department in Aydin, Turkey. Patients' stool samples were examined between January 2013 and February 2014 by both microscopy and culture methods. Culture positive samples were subjected to DNA isolation and Sequence Tagged Site (STS)-PCR analysis. Possible etiological factors and clinical features of Blastocystis infection were also analyzed and compared between Blastocystis infected and non-infected subgroups. Blastocystis was detected in 15 (6.5%) of 232 stool samples by microscopy and in 25 (10.8%) by culture methods. Out of 25 culture positive isolates, the most prevalent subtype was ST3 (59%), followed by ST1 (23%) and ST2 (18%). Blastocystis frequency was higher in the male patients than the females (19% vs. 6.5%, p

Non-small cell lung cancer (NSCLC) is one of the most common cancers. Most of the patients are inoperable at the time of diagnosis, and the prognosis is poor. Many prognostic factors have been identified in prior studies. However, it is not clear which factor is more useful. In this study, we investigated whether uric acid, the last breakdown product of purine metabolism in humans, has a prognostic significance in advanced NSCLC. A total of 384 NSCLC patients at stage IIIB/IV and who did not meet exclusion criteria were included in this retrospective cross-sectional study. The patients' serum uric acid levels before first-line chemotherapy and demographic (age, gender, smoking), clinical (performance status, weight loss, disease stage, first-line treatment regimen), laboratory (hemoglobin, lactate dehydrogenase), and histologic (histologic type, tumor grade) characteristics were recorded. First, a cut-off value was determined for serum uric acid level. Then, the patients were stratified into four groups (quartiles) based on their serum uric acid levels. Descriptive statistics, univariate and multivariate analyses, and survival analyses were used. Majority of the patients were males, smokers and metastatic at time of diagnosis and had history of weight loss and adenocarcinoma upon pathological examination. The serum uric acid levels of all patients were determined as 4.9±2.9 (range 1.9-11.3). The patients were stratified according to quartiles of serum uric acid concentration with cutoff values defined as3.08 mg/dL (lowest quartile, Group 1), 3.09-5.91 mg/dL (Group 2), 5.92-7.48 mg/dL (Group 3), and7.49 mg/dL (highest quartile, Group 4). Among the patients who had serum uric acid levels over 7.49, it was observed that those who also had squamous cell carcinoma had a greater rate of brain metastasis, a shorter time lapse until brain metastasis, and lower overall survival rate. It can be assumed that NSCLC patients who had histologically shown squamous cell carcinoma display brain metastasis and poor prognosis. It can be recommended to repeat this study with larger patient series including immunohistochemical, molecular, and wider laboratory investigations.

Brain metastasis in colorectal cancer is highly rare. In the present study, we aimed to determine the frequency of brain metastasis in colorectal cancer patients and to establish prognostic characteristics of colorectal cancer patients with brain metastasis. In this cross-sectional study, the medical files of colorectal cancer patients with brain metastases who were definitely diagnosed by histopathologically were retrospectively reviewed. Brain metastasis was detected in 2.7 % (n = 133) of 4,864 colorectal cancer patients. The majority of cases were male (53 %), older than 65 years (59 %), with rectum cancer (56 %), a poorly differentiated tumor (70 %); had adenocarcinoma histology (97 %), and metachronous metastasis (86 %); received chemotherapy at least once for metastatic disease before brain metastasis developed (72 %), had progression with lung metastasis before (51 %), and 26 % (n = 31) of patients with extracranial disease at time the diagnosis of brain metastasis had both lung and bone metastases. The mean follow-up duration was 51 months (range 5–92), and the mean survival was 25.8 months (95 % CI 20.4–29.3). Overall survival rates were 81 % in the first year, 42.3 % in the third year, and 15.7 % in the fifth year. In multiple variable analysis, the most important independent risk factor for overall survival was determined as the presence of lung metastasis (HR 1.43, 95 % CI 1.27–4.14; P = 0.012). Brain metastasis develops late in the period of colorectal cancer and prognosis in these patients is poor. However, early screening of brain metastases in patients with lung metastasis may improve survival outcomes with new treatment modalities. © 2014, Springer Science+Business Media New York.

The aim of this work is determining that the mathematics teaching skills of science and technology teachers and whether or not sixth grade students and science and technology teachers experience difficulty about teaching of subjects which contain mathematical concepts. In this work, the views of science and technology teachers about their mathematical teaching skills in the subject of speed in our lives and about this subject the views of sixth grade students about the mathematical teaching skills of science and technology teachers and whether or not these views are differentiated according to demographical variables were researched. In addition to these, the opinions of students and teachers were compared each other. The model of this research is scanning method. This research was performed in schools which are connected to the center of Erzincan in the academic year 20092010 on 346 sixth grade students and 41 teachers who lecture to sixth graduate students. In this research, science and technology teachers, and two different scales which are improved for sixth graduate students were used. In order to analyze data sets, average, standard deviation, frequency distribution, t-test between independent groups and Kruskal-Wallis test were used. As a result of data sets analysis, it was determined that science and technology teachers who participated in research feel sufficient in terms of mathematical teaching skills and sixth grade students find science and technology teachers sufficient about their mathematical teaching skills. In addition to these, it was also determined that the views of science and technology teachers about their mathematical teaching skills according to gender, period of service and department of graduation , and the views of sixth graduate students about science and technology teachers’ mathematical skills according to gender are not differentiated, but the views of science and technology teachers about their mathematical skills are differentiated according to higher education program of graduation., Bu çalışma, Fen ve Teknoloji dersinin “Yaşamımızdaki Sürat” konusunda, Fen ve Teknoloji öğretmenlerinin ve 6. sınıf öğrencilerinin, matematiksel kavramları içeren konuların öğretiminde sorun yaşayıp yaşamadıklarının tespiti amacıyla yapılmıştır. Araştırmada, Fen ve Teknoloji öğretmenlerinin “Yaşamımızdaki Sürat” konusundaki matematik öğretimi becerileriyle ilgili görüşleri ile bu konuda 6. sınıf öğrencilerinin Fen ve Teknoloji öğretmenlerinin matematik öğretimi becerilerine ilişkin görüşleri ve bu görüşlerin demografik değişkenlere göre farklılaşıp farklılaşmadığı araştırılmıştır. Ayrıca öğretmen ve öğrenci görüşleri de karşılaştırılmıştır. Araştırmanın modeli “tarama” yöntemidir. Araştırma, Erzincan ilinin merkeze bağlı ilköğretim okullarında (ortaokullarında), 2009-2010 Eğitim-Öğretim yılında 6. sınıflarda Fen ve Teknoloji dersini yürüten 41 öğretmen ve 6. sınıfta öğrenim görmekte olan 346 öğrenci üzerinde gerçekleştirilmiştir. Araştırmada veri toplama aracı olarak, Fen ve Teknoloji öğretmenleri ve 6. sınıf öğrencileri için araştırmacılar tarafından geliştirilmiş olan iki tür ölçek kullanılmıştır. Verilerin çözümlenmesinde ortalama, standart sapma, frekans dağılımı, bağımsız gruplar arası t-testi ve Kruskal-Wallis testinden yararlanılmıştır. Elde edilen verilerin analizi sonucunda, araştırmaya katılan Fen ve Teknoloji öğretmenlerinin, matematik öğretimi becerileri açısından kendilerini yeterli gördükleri ve 6. sınıf öğrencilerinin de Fen ve Teknoloji öğretmenlerinin matematik öğretimi becerilerini yeterli buldukları belirlenmiştir. Fen ve Teknoloji öğretmenlerinin matematik öğretimi becerilerine ilişkin görüşlerinin, hizmet süresine ve mezun olunan alana göre, 6. sınıf öğrencilerinin ise Fen ve Teknoloji öğretmenlerinin matematik öğretimi becerilerine ilişkin görüşlerinin Fen ve Teknoloji öğretmenlerinin görüşlerinin mezun olunan yükseköğretim programına göre farklılaştığı tespit edilmiştir.

Colorectal cancer (CRC) is among the most frequently diagnosed cancers and a major cause of cancer-related mortality worldwide. The aim of the present study was to determine whether there was an improvement in the time to disease progression (TTP) in patients with metastatic colorectal cancer (mCRC) treated with first-line bevacizumab plus chemotherapy, according to tumor characteristics and metastatic sites. Tumor characteristics and tumor burden were considered to be predictive markers of the therapeutic efficacy of bevacizumab. The medical records of 705 patients with mCRC were retrospectively reviewed in three oncology centers between January, 2005 and September, 2012. A total of 101 patients completed their first-line bevacizumab-containing treatment. The median TTP was 6.93 months [interquartile range (IQR)=4.20–9.80 months] in patients treated with irinotecan, 5-fluorouracil (5-FU) and bevacizumab vs. 7.42 months (IQR=6.08–10.68 months) in those treated with oxaliplatin, 5-FU and bevacizumab (P=0.589). When we compared patients with pulmonary metastases (median TTP, 9.9000 months) or other metastatic patients without pulmonary metastasis (median TTP, 6.9000 months), we observed a statistically significant difference (P=0.046). However, when the efficacy of bevacizumab was compared in terms of other tumor characteristics (tumor grade, size and lymph node involvement) and metastatic sites, the differences were not significant (P>0.05). We concluded that bevacizumab may be effective in all subgroups of patients with mCRC. Furthermore, bevacizumab with combination chemotherapy may be superior to combination chemotherapy only as the first-line treatment of patients with mCRC and pulmonary metastasis.

Trastuzumab treatment does not prevent intracranial seeding and is largely ineffective for established central nervous system metastasis in HER2 overexpressing breast cancer patients. Combination therapy of lapatinib and capecitabine may be an effective treatment option for brain metastasis of HER2-positive breast cancer. We report a patient with breast cancer overexpressing HER-2 where brain metastases were successfully treated with radiation and a combination of lapatinib and capecitabine.

Aim Procalcitonin is a marker of bacterial and fungal infection and sepsis. The present study evaluated the relationship between serum procalcitonin levels and disease activity in patients with ankylosing spondylitis (AS). Method A total of 61 patients who met the 1984 New York criteria for AS were studied. Twenty-four age- and sex-matched healthy volunteers were recruited to this study as a control group. Disease activity was assessed by the Bath AS Disease Activity Index (BASDAI). The functional status of patients was evaluated by the Bath AS Functional Index (BASFI). Spinal mobility was measured by the Bath AS Metrology Index (BASMI). Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and serum procalcitonin levels were measured. Results Thirty patients were on anti-tumor necrosis factor-alpha treatment and 31 patients were on conventional treatment. Seventeen (28%) of the AS patients were active (BASDAI > 4) and 44 (72%) of the AS patients were in remission. The median ESR was 14 (34–6) mm/h and 4 (7–2) mm/h (P