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Objective: To investigate the relationship between serum Vitamin D (VD) level and the change of hematological parameters after chemotherapy in patients with breast cancer (BC) who received adjuvant Adriamycin and Cyclophosphamide (AC). Material and Methods: A total of 74 BC patients who were treated with adjuvant 60 mg/m2 Adriamycin and 600 mg/m2 Cyclophosphamide (AC) were included in the study. VD levels, complete blood count (CBC) findings after 1st cycle AC were retrospectively recorded. The relationship between changes in CBC parameters according to VD levels and the presence of hematological toxicity was examined. Results: The mean age was 55.11±9.97 years and the median VD level was 12.78 (4-53.40) ng/mL. In all patient groups, there was a significant decrease in the values of lymphocytes and monocytes after chemotherapy (p=0.030, p=0.024 respectively). In the correlation analysis, there was no correlation between VD levels and hemoglobin levels, the number of cells in CBC-1, and the amount of change in the number of cells in after chemotherapy. However, there was a negative correlation between VD level and platelet/lymphocyte ratio-1 (PLR-1), monocyte/lymphocyte ratio-1 (MLR-1) (p=0.025, r:-0.237; p=0.001, r:-0.370, respectively), but there was no correlation with PLR-2 and MLR-2 (p>0.05 all). Conclusion: There was no relationship between VD levels and changes in hematological parameters and hematological toxicity related to AC chemotherapy in the patient with BC. VD level was inversely correlated with PLR-1 and MLR-1, which is generally accepted as inflammatory markers. This result showed that the levels of VD do not have a significant role in the development of hematological toxicity after AC chemotherapy in BC.

The new second-generation tyrosine kinase inhibitors (TKIs) have superior survival outcome and worse toxicity profile when compared with first-generation TKIs according to the results of clinical trials. However, there are limited studies that investigate the efficacy and safety of the new generation TKIs in real-world patients. Thus, we aimed to compare the efficacy and safety of the afatinib, an irreversible inhibitor of ErbB family receptor, and first-generation TKIs in real-world patients. We included advanced nonsmall cell lung cancer (NSCLC) patients who had EGFR exon 19del mutation and treated with afatinib or first-generation TKIs as upfront treatment between 2016 and 2020. All patient's information was collected retrospectively. The study cohort was divided as afatinib arm and erlotinib/gefitinib arm. A total of 283 patients at the 24 oncology centers were included. The 89 and 193 of whom were treated with afatinib and erlotinib/gefitinib, respectively. After 12.9 months (mo) of follow-up, the median PFS was statistically longer in the afatinib arm than erlotinib/gefitinib arm (19.3 mo vs. 11.9 mo, p: 0.046) and the survival advantage was more profound in younger patients (

In our study, we aimed to evaluate the pathological response rates and side effect profile of adding pertuzumab to the treatment of HER2+ locally advanced, inflammatory, or early-stage breast cancer. This study was conducted by the Turkish Oncology Group (TOG) with data collected from 32 centers. Our study was multicentric, and a total of 364 patients were included. The median age of the patients was 49 years (18-85 years). Two hundred fifteen (60%) of the cases were hormone receptor/HER2+ positive(ER+ or PR+, or both), and 149 (40%) of them were HER2-rich (ER and PR negative). The number of complete responses was 124 (54%) in the docetaxel+trastuzumab+pertuzumab arm and 102 (45%) in the paclitaxel+trastuzumab+pertuzumab arm, and there was no difference between the groups in terms of complete response. In 226 (62%) patients with complete response, a significant correlation was found with DCIS, tumor focality, removed lymph node, and ER status P < 0.05. Anemia, nausea, vomiting, myalgia, alopecia, and mucosal inflammation were significantly higher in the docetaxel arm, P < 0.05. In our study, no statistical difference was found between the before-after echocardiography values. DCIS positivity in biopsy before neoadjuvant chemotherapy, tumor focality; the number of lymph nodes removed and ER status were found to be associated with pCR. In conclusion, we think that studies evaluating pCR-related clinicopathological variables and radiological imaging features will play a critical role in the development of nonsurgical treatment approaches.

Self-esteem refers to a person's positive and negative attitudes towards the self, and metacognition is an upper system providing awareness and direction of events and mental functions. Coping refers to the specific and psychological efforts used to deal with stressful events or the negative effects of the agents of these. The aim of this study was to evaluate self-esteem, metacognition status and coping attitudes in patients with cancer, which is known to have severely destructive psychological effects.Fifty adult cancer patients who were followed up in the medical oncology clinic between July 2018 and June 2019 and 50 age- and gender-matched healthy controls as control group were included in this study. All the participants were applied with a sociodemographic data form, the Rosenberg self-esteem scale, the Metacognition Assessment Scale, and the Copying Orientation to Problems Experienced (COPE) inventory, and their results were compared between the groups.The groups comprised 50% females with a median age of 58 (33-82) years. The values related to the degree of participation in discussions, problem-focused coping, active coping, planning, and state of emotional vulnerability were low in the cancer patient group compared to the control group (P0.005 for all). The sustaining of their self-image, feeling threatened in interpersonal relationships, and degree of daydreaming were higher, and in the metacognition tests, the positive beliefs related to anxiety, uncontrolled or dangerous negative thoughts, nonfunctional coping, religious coping, joking, reckless behavior, substance use, denial, and mental disengagement scores were higher (P0.05 for all).Self-esteem was lower in cancer patients and upper level cognitive functions and problem-focused coping were determined to be worse compared to healthy controls. In the light of these results, psychosocial support given to cancer patients in this respect could contribute to quality of life and social conformity.

Background: Oxidative stress status in different cancer types was investigated before, but not studied in gastric intestinal metaplasia to the best of our knowledge. Purpose of this study is to examine whether there is a difference between oxidative stress status in patients with intestinal metaplasia (IM) compared to individuals without IM, we compared the serum levels of disulfide (SS), total thiol (TT) and native thiol (NT). Methods: This was a prospective, non-randomized casecontrol study including 67 patients with histopathologically confirmed IM and 60 individuals demographically matched in terms of age, gender, BMI, smoking status, and chronic diseases as control group. Results: The mean NT, TT and NT to TT (NT/TT) ratios were statistically significantly higher in IM group compared to controls ((351.71 ± 81.9 _mol/L vs. 271.82 ± 54.13 _mol/L, p=0.000), (391.5 ± 92.69 _mol/L vs. 308.59 ± 55.53 _mol/L, p=0.000) and (0.89 ± 0.6 vs. 0.87 ± 0.29, p=0.022), respectively). The mean SS to TT (SS/TT) ratio was significantly lower in IM group than control group (0.050 ± 0.31 vs. 0.060 ± 0.014, P=0.022). Median SS and mean SS/NT ratio was similar in both groups (16.3 (3.3-78) vs. 18.3 (10-32.7), p=0.271 and 0.055 ± 0.041 vs. 0.070 ± 0.019, p=0.068, respectively). In ROC analysis, cut off value of SS/NT for IM was found 0.062, in regression analysis, SS/NT

Introduction Thiol and disulphide levels are biomarkers that provide useful information about oxidative stress and antioxidant capacity, showing a different homoeostasis in inflammatory and proliferative diseases. We aimed to clarify the possible aetiology of this disease by using thiol and disulphide levels in patients with fibromyalgia, the basis of which has not yet been clearly elucidated. Material and methods A total of 156 individuals: 86 patients with fibromyalgia and 70 age-matched controls were included in this prospective non-randomised case-control study. Demographic characteristics including smoking status, body mass index (BMI), the duration of complaints, and pain levels were carefully recorded. Dynamic thiol-disulphide homoeostasis in blood samples was determined by an automatic-spectrophotometric method. The Mann-Whitney U and Student's t-test were used to determine the differences between the groups. Results Sex, BMI, and smoking status were similar between the groups (p = 0.62, p = 0.09, and p = 0.64, respectively). While native thiol levels were found to be high in patients with fibromyalgia (p = 0.018), disulphide levels and the rates of disulphide/native thiol and disulphide/total thiol were significantly low (p = 0.049, p = 0.007, and p = 0.007, respectively). Correlation analysis showed no significant relationship between thiol-disulphide levels and duration of complaints or pain level. Conclusions Thiol-disulphide balance in fibromyalgia was found to be similar to benign proliferative diseases, suggesting that the underlying mechanism is more likely to be of proliferative pattern rather than inflammatory. Additionally, fibromyalgia is not directly associated with increase in oxidative stress. The molecular mechanisms need to be elucidated.

Small cell lung cancer (SCLC) patients unresponsive or relapsing within 90 days following frontline chemotherapy have poor prognosis and they should be treated with different chemotherapy regimens other than those used in the first-line regimen. Currently there is no globally accepted standard chemotherapeutic regimen for the treatment of these patients. This retrospective study was designed to compare CAV (Cyclophosphamide, Doxorubicin, Vincristine), weekly topotecan and weekly irinotecan regimens and to evaluate the efficacy of the three regimens in patients with chemotherapy resistant/refractory (CRR) SCLC.A total of 67 CRR-SCLC patients, who were treated with CAV, weekly topotecan and weekly irinotecan were reviewed for weekly irinotecan (27 for 60 mg/m2 intravenously on days 1, 8 and 15 of a 28-day cycle,24 for CAV (Cyclophosphamide 750 mg/m² on day 1, Doxorubicin 50 mg/m² on day 1 and Vincristine 1.4mg/m2 on day 1 every 3 weeks), 16 for weekly topotecan (4 mg/m2 intravenously on days 1, 8 and 15 of a 28-day cycle).The median follow-up time was 12.45 months, there was no difference about disease control rates (DCR) between three chemotherapy regimens (DCR; 25.9% with irinotecan, 29.2% with CAV and 31.3% with topotecan, p=0.92). Objective response rates (ORR) for irinotecan, CAV and topotecan groups were 3,7%, 8,8%, and 0%, respectively (p=0.63). Median progression free survival (PFS) and overall survival (OS) were similar according to irinotecan, CAV, and topotecan (PFS: 1.93 months, 2.30 months and 3.45 months; OS: 2.89 months, 4.79 months and 5.81 months, respectively). The adverse events were generally mild and manageable for both hematological and nonhematological toxicities in all three arms.Weekly irinotecan, CAV and weekly topotecan are similarly effective and safe chemotherapy protocols for the treatment of CRR-SCLC patients.

Aim: Metaplastic breast cancer (MBC) is a rare subtype with unusual clinical features. We aimed to analyze treatment results and define patients' characteristic features in our large MBC patient series. Materials and Methods: Fifty-six patients with early MBC who received adjuvant radiotherapy (RT) in our center were included in the study. The age, sex, subtypes of MBC, histopathology, hormone and nodal status, tumor size, and types of treatment were retrospectively provided from hospital records. Results: The median tumor size was 4 (1.3–16.5) cm, and triple-negative MBC cases were 38 (67.8%) of all patients. Axillary nodal involvements were present in 25 (44.6%) patients. The median follow-up time was 45.8 (4.9–130) months; the overall survival (OS) and disease-free survival (DFS) for 5 years were 67% and 64%, respectively. While distant metastases were seen in 15 (26.7%) patients, local recurrences were seen in only 4 patients. The median OS and DFS were higher in patients with ≤5.2 cm tumor than >5.2 cm ([130 vs. 49 months, P = 0.01] and [130 vs. 30 months, P = 0.009], respectively). Nodal involvement, hormone receptor status, surgical treatment, and type of RT had no effect on survival. In multivariate analysis, tumor size was not an independent prognostic factor for OS (P = 0.068; hazard ratio [HR]: 3.4, 95% confidence interval [CI] = 0.91–12.8), whereas age >65 years was found an independent poor prognostic factor for OS ([HR: 4.25, 95% CI: 0.23–0.78, P = 0.021] and DFS [HR: 3.1, 95% CI: 0.02–0. 87; P = 0.04], respectively). Conclusions: Distant metastasis is at the forefront rather than local recurrence in MBC patients. More studies are needed to determine the factors that affect survival independently in MBC.

Literatürde ABO ve Rhesus (Rh) kan gruplarının kanser hastalığı ile ilişkisine dair yapılan çalışmalar incelendiğinde mutlak bir sonuç çıkarmak mümkün olmamakta, sonuçlar ülkelere ve çalışmanın yapıldığı merkezlere göre değişkenlik gösterebilmektedir. Bu çalışmanın amacı kliniğimizde ABO-Rh kan gruplarının kanser alt tiplerine göre dağılımını değerlendirmektir. Ocak 2015- Ocak 2020 tarihleri arasında Tıbbi Onkoloji kliniğinde kanser tanısıyla takip ve tedavi edilen hastaların kan gruplarının kanser tiplerine göre dağılımı incelendi ve veriler kanser olmayan kontrol grubu ile karşılaştırıldı. Katılımcıların yaş, cinsiyet gibi sosyodemografik verileri, kanser alt tipi ve kan grupları (ABO-Rh) retrospektif olarak hasta dosyası ve hastane otomasyon sisteminden tarandı. Çalışmaya 1894’ü (%22.1) kanser hastası, 6681’i (%77.9) kontrol grubu olmak üzere 8575 birey dahil edildi. Kontrol grubu ve kanser hastalarında kan gruplarının dağılımında istatistiksel olarak anlamlı farklılık saptandı (p, When studies on the relation of ABO and Rhesus (Rh) blood groups with cancer are examined in the literature, it is not possible to draw an absolute conclusion, the results may vary according to the countries and centers where the study was conducted. The aim of this study is to evaluate the distribution of ABO-Rh blood groups according to cancer subtypes in our clinic. The distribution of blood groups of patients who were followed up for cancer between January 2015 and 2020 according to their cancer types was examined and the data were compared with the non-cancer control group. Participants' sociodemographic data such as age and gender, cancer type and blood groups (ABO-Rh) were retrospectively scanned from the hospital automation system. The study included 1894 (22.1%) cancer patients and 6681 (77.9%) control group. There was a statistically significant difference in blood groups of control group and cancer patients (p

This study aimed to assess the effect of pretreatment albumin-bilirubin (ALBI) score on treatment outcomes in pancreatic cancer (PC) patients with liver metastasis at the time of diagnosis treated with chemotherapy (CT) in the first-line setting.This was a retrospective study of 273 PC patients ≥18 years of age who had liver metastasis at the time of diagnosis and received CT in the first-line. ALBI score was calculated through the following formula; [(log10 bilirubin (μmol/L)×0.66)+[albumin(g/l)×-0.0852]. Patients were stratified into 3 categories based on the ALBI score as follows; grade I:ALBI ≤-2.60, grade II:-2.60ALBI≤-1.39, and grade III:ALBI-1.39.A total of 273 patients, [180 (65.9%) men and 93 (34.1%) women], were evaluated. The median age was 60 years. ALBI grade was I in 45 (16.4%) patients, II in 156 (57.1%) patients, and III in 72 (26.5%) patients. Based on the ALBI grade, median progression-free survival (mPFS) was 9 months in grade I patients, 6 months in grade II patients, and 4 months in grade III patients (p=0.002), with median overall survival (mOS) durations of 12 months vs. 8 months vs. 5 months, respectively (p0.001). Multivariate analysis showed that ALBI grade II (HR,1.543) or III (HR,2.260) negatively affected survival.A higher pretreatment ALBI grade is related to worse OS and PFS in PC patients with liver metastasis treated with a first-line CT, and therefore it can help predict the treatment outcomes in these patients.

Trichobezoars present with stomach ache and with a mass in the stomach. It's common in the young and middle-aged women having psychiatric disorder, presenting with stomach ache and existence of mass in the stomach. Although it's one of the rare causes of anaemia it should be considered when dealing with cases of chronic and unresponsive anaemia.

Serum Total Thiol (TT), Native Thiol (NT), and Disulfide (SS) levels were found significantly lower in benign proliferative pathologies and cancer disease compared to healthy subjects. We conducted this prospective study to investigate the possible predictive and prognostic significance of these markers in non-small cell lung cancer (NSCLC), which is one of the most associated cancers with oxidative stress. This was a non-randomized, prospective, and case-control study of 120 subjects, including 60 patients with metastatic or inoperable NSCLC at the time of diagnosis and 60 demographically-matched controls. Morning fasting venous blood serum samples from both NSCLC and control group were stored at -80 °C for equal periods and then TT, NT, and SS levels were measured spectrophotometrically. Serum TT, NT, and SS levels were compared between groups and their relationships with demographic features and survival of NSCLC patients were analyzed. In results, Serum TT, NT, and SS levels were significantly lower in NSCLC patients than those in control group, with a low SS level being an independent indicator of poor survival.

Several platelet indices have been linked to prognosis of various cancers, including metastatic colorectal cancer. The aim of this study was to investigate the prognostic effect of mean platelet volume (MPV) and platelet distribution width (PDW) in early colon cancer (CC) patients.This retrospective study included early CC patients who were followed up and treated between 2005 and 2017. Relapse free survival (RFS) and overall survival (OS) were determined with respect to several demographic and clinical characteristics of patients, including MPV and PDW. The cut-off value was determined as8.5 fL for MPV (sensitivity: 67.1%, specificity 54.5%) and ≤16% for PDW (sensitivity: 66.7%, specificity: 60.0%).The study included 394 patients, 53.3% of which were male. Stage I, II, and III patients constituted 8.9%, 46.4%, and 44.7% of the study population, respectively. Among all patients, RFS and OS were significantly longer in patients with MPV≤8.5 fL and PDW16 fL (p0.001 and p=0.011 for MPV, respectively; and p0.001 and p=0.026 for PDW, respectively). In patients with stage III disease, those with MPV≤8.5 fL had significantly longer RFS and OS compared to those with MPV8.5 fL (p0.001 and p=0.001, respectively). On the other hand, those with PDW16% had significantly longer RFS than that in those with PDW ≤16 fL among stage III patients (p0.001). In multivariate analysis, stage, perineural invasion, lymphovascular invasion, adjuvant treatment, CEA, CA19-9, PDW, and MPV were found the most significant factors affecting RFS.Our study suggests that elevated MPV and decreased PDW appear to be unfavorable prognostic factors in early CC, especially in patients with stage III disease. Considering the wide availability and accessibility of these indices, it is reasonable to designate further larger prospective studies to clarify and verify their potential roles in early CC.

Spinal Cord Injury (SCI) may often lead to significant disability in affected individuals and reduce life satisfaction. Herein we aimed to investigate the effects of the level of injury on disability and life satisfaction as well as the relation between life satisfaction and disability.Patients with at least one-year history of SCI were included. Demographic-clinical data of patients were recorded. The Craig Handicap Assessment and Reporting Technique-Short Form (CHART-SF) was used for quantifying the degree of patients' disability. Life satisfaction was assessed by the Satisfaction with Life Scale (SWLS).Of the 76 patients, 21 (27.6%) were tetraplegic and 55 (72.4%) were paraplegic. SWLS was found to be similar in tetraplegic vs. paraplegic patients (P=0.59), whereas CHART parameters such as physical independence, mobility, occupation, and total CHART value were significantly higher in paraplegic patients (P=0.04, P=0.04, P=0.001 and P=0.01, respectively). Social integration was found similarly high in both groups. There was a positive correlation between elapsed time after the injury and CHART physical independence, occupation and the level of economic sufficiency (P0.01, P0.01, P=0.01). Excluding the economic sufficiency (P=0.02), there was not any other association between the rest of CHART parameters and SWLS.According to our findings, although the level of injury seems to be influential on disability, it seems to have no significant effect on life satisfaction. Since the only thing that positively affects life satisfaction is economic sufficiency, more emphasis should be placed on regulations that increase the return to work in patients.A gerincvelő-sérülés gyakran szignifikáns mértékű rokkantságot eredményez, és csökkenti az élettel való elégedettséget. Tanulmányunkban megvizsgáltuk a gerincvelő-sérülés helye és a rokkantság, valamint az életminőség kapcsolatát, továbbá az élettel való elégedettség és a rokkantság kapcsolatát.A vizsgálatba olyan betegeket vontunk be, akik esetében a gerincvelő-sérülés legalább egy évvel korábban történt. Összegyűjtöttük a betegek demográfiai és klinikai adatait. A betegek rokkantsági fokát a Craig Handicap Assessment and Reporting Technique-Short Form (CHART-SF), míg az élettel való elégedettségüket a Satisfaction with Life Scale (SWLS) révén mértük fel.A 76 beteg közül 21 fő (27,6%) volt tetrapleg, míg 55 fő (72,4%) volt parapleg. Az SWLS-értékek hasonlóak voltak a tetrapleg és a parapleg betegcsoportbann (p = 0,59), míg a CHART-paraméterek (fizikális függetlenség, mobilitás, foglalkoztatottság és össz-CHART-pontszám) szignifikánsan magasabbak voltak a parapleg betegek körében (p = 0,04; p = 0,04; p = 0,001 és p = 0,01). A szociális integráció szintje mindkét csoportban hasonlóan magas volt. Pozitív korrelációt találtunk a sérülés óta eltelt idő mennyisége, valamint a CHART fizikális függetlenség és foglalkoztatottság pontszámok, valamint a pénzügyi elégedettség szintje között (p0,01; p0,01; p = 0,01). A pénzügyi elége­dettség kizárása után (p = 0,02) nem maradt további összefüggés a többi CHART-paraméter és az SWLS között.Bár úgy tűnik, hogy a gerincvelő-sérülés helye befolyásolja a rokkantság mértékét, eredményeink szerint a gerincvelő-sérülés helye és az élettel való elégedettség között nincs összefüggés. Mivel a pénz­ügyi elégedettség az egyetlen tényező, ami pozitívan befolyásolja az élettel való elégedettséget, nagyobb hangsúlyt kellene fektetni azoknak a szabályozási tényezőknek a kidolgozására, amelyek segítik a sérültek munkaerőpiacra való visszatérését.

Amaç: Onkolojik hastalıkların erken tanı ve tedavisinde yeni gelişmeler hayatta kalma oranlarının artmasına neden olsa da, artmış sağ kalım oranlarına bağlı olarak gelişen uzun takipler sırasında ikinci primer maligniteler ortaya çıkabilmektedir. İkincil primer tümörlerin gelişimi için birçok faktör vardır. En önemlisi, yaşlı hastalar ın uzun vadede kanserojenlere maruz kalma olasılıkları daha yüksektir. Çoklu primer tümörler, genellikle iki malignite tanısı arasındaki zaman çizelgesine bağlı olarak metakron veya senkron olarak görülür. Senkron hastalıklar sıklıkla benzer karsinojenlere maruz kalma sonucu oluşsa da, metakron olanlar daha çok primer tümörün tedavisine bağlı advers etkilerle ilişkili olabilir. Bu tek merkezli çalışma, Ocak 2007 ile Aralık 2016 arasında multipl primer tümörlü hastaların klinikopatolojik özelliklerini araştırmayı amaçladı ve bunlardan 20'si senkron, 36'sı metakron olarak toplam 56 hasta dahil edildi. En yaygın kanser çiftlerinin erkeklerde kolon-akciğer ve prostat-mesane, kadınlarda meme-kolon ve meme-tiroid olduğu tespit edilmiştir. Yöntemler: Ocak 2007 ile Aralık 2017 tarihleri arasında merkezimizde takip edilen ÇPT’ lü hastaların dosyaları retrospektif olarak incelendi, 56 hastada multiple primer tümör olduğu tespit edildi. Hastaların cinsiyetler, yaşları tespit edildi. Tümörün hangi organlarda oluştuğu, ne zaman geliştiği, bulunabilen etyolojik veriler, sağ kalım oranları araştırıldı. Tüm istatistiksel analizler Package for Social Sciences (SPSS v 15.0, SPSS Inc., Chicago, IL, USA) ile yapıldı. Sonuç: Senkron hastalıklar genellikle benzer kanserojenlere maruz kalmanın bir sonucu olarak ortaya çıkarken, metakronöz hastalıkların primer tümörlerin tedavisinin yan etkileri ile ilişkili olması muhtemeldir

Background:Body mass index (BMI) is defined as a poor prognostic factor in patients with breast cancer(BC). However, there are controversial results regarding the various effects of BMI on BC, hence the exactpathophysiology of the relation between obesity and BC is still under debate, and remains unclear. Thispaper aims to investigate the association between BMI at presentation and BC subtypes defined accordingto the immunohistochemical classification in both premenopausal and postmenopausal patients with BC.Patients and methods:This study is a retrospective and explorative analysis of the 3767 female BC pa-tients from a single center. All patients' BMI at the time of initial diagnosis and tumor demographics wererecorded. BMI was stratified into 3 groups as normal-weighted (BMI

Paclitaxel has been associated with serum aminotransferase elevations, however, paclitaxel induced hepatosteatosis has not been evaluated systematically. This study assessed the rate of paclitaxel-related hepatosteatosis.Forty one early breast cancer (BC) patients were included the study. Hepatic ultrasonograpy, demographic features and biochemical liver function tests before and after 12 weeks of paclitaxel were assessed.New-onset hepatosteatosis was developed in 26.7% of the patients. Baseline triglyceride200mg/dL (OR, 11.25; p=0.015), LDH at baseline191.48 IU/L (OR, 4.93; p=0.048), and total bilirubin0.51 mg/dL after paclitaxel (OR, 6.17; p=0.042) were found as independent prognostic markers for new-onset hepatosteatosis.Paclitaxel may induce hepatosteatosis in patients with BC.

To assess whether regorafenib and TAS-102 treatments are associated with a change in Skeletal Muscle Area (SMA) as well as to compare Skeletal Muscle Mass (SMM) loss levels between regorafenib and TAS-102 treatments and prognostic significance in the patients with metastatic colorectal cancer (mCRC).A total of 36 mCRC patients, who received regorafenib or TAS-102 in the third-line and subsequent settings were assessed in the analysis. SMM changes were assessed with CT scans findings, and they were categorized into two groups as SMM-loss (SMM decrease ≥2%) and SMM-stable (SMM change2%).The SMM change after regorafenib therapy was significantly worse compared with TAS-102 therapy (p=0.001). The median overall survival (OS) was longer in SMM-stable group than in SMM-loss group (12.8 months; 95%CI:9.8-15.7) vs. 6.4 months; 95%CI:5.2-7.7, respectively;p=0.04). Cox regression analysis showed that SMM loss was independent prognostic indicator for OS (HR, 2.87; 95%CI: 1.07-7.42, p=0.03).Although patients who received regorafenib had more SMM loss than those who received TAS-102, there was no difference in OS between drugs.

Amaç: Yakın zamanda, geçmişte metastatik kolon kanseri üzerinde yapılan çalışmaların geriye dönük verilerine dayanarak, primer tümör lokalizasyonunun sağ kalımı ve kemoterapi (KT) yanıtını etkileyen bir faktör olduğu görülmüştür. Bu çalışmaların çoğunda de-novo metastatik hastalar dahil edilmiştir. Bu çalışmada tanı anında erken evrede olan, cerrahi ve veya adjuvan tedaviler sonrası nükseden hastalarda primer tümörün lokalizasyonunun önemi olup olmadığını incelendi. Hastalar ve Metod: Tıbbi Onkoloji kliniğince 2013 ile 2017 yılları arasında kolorektal kanser tanısıyla takip edilmiş, tanı anında Evre II ve Evre III olup sonrasında metastaz gelişen 79 hasta çalışmaya dahil edildi. Hastalar primer tümörün lokalizasyonuna göre, sağ ve sol olarak iki gruba ayırıldı. Hastaların demografik verileri sağkalım süreleri primer tümör lokalizasyonuna göre karşılaştırıldı. Bulgular: Toplam 79 hastanın ortalama yaşları sağ ve sol grupta sırasıyla 60 ve 59 olarak benzerken (P = 0.965), demografik verilere bakıldığında iki grup arasında sağ kolonda Tip2 diabetes mellitus (Tip2DM) görülme oranının yüksekliği (sırasıyla %34.5 ve %4.4, P = 0.002) haricinde anlamlı fark saptanmadı. Neoadjuvan KT sol gurupta ve nodal tutulum varlığı ise sağ tarafta yüksek saptansa da fark istatistiksel olarak anlamlı değildi. Yine her iki gurup arasında adjuvan KT almış olma, adjuvan KT ve palyatif KT rejimleri arasında fark saptanmadı. Sağkalım analizinde, sağ ve sol guruplar arasında PS ve TS oranları benzerdi [PS sırasıyla 11.9 (6-17.9) ay’a karşı 16.7 (13.1-20.4) ay, P = 0.976 ve TS sırasıyla 36.1 (14.6-57) ay’a karşı 40.8 (35.3-46) ay, P = 0.636]. Tartışma ve Sonuç: Çalışmamızda tanı anında metastatik olmayan bu hasta gurubunda, primer tümör lokalizasyonunun sağ kalım üzerine etkili bir faktör olmadığı saptandı. Bu durum, cerrahi, neoadjuvan ve adjuvant tedavilerin etkinliklerinin, primer tümör lokalizasyonunun önemini gölgelediğini düşündürmektedir.

To investigate the effects of sidedness on survival and treatment outcomes in patients with metastatic colorectal cancer (mCRC), since the accumulated data have increasingly reported that patient with right-sided mCRC are found to be associated with worse overall survival (OS) and poor response to anti-epidermal growth factor receptor (anti-EGFR) agents.This was a multi-center retrospective analysis of 177 patients with mCRC, who were treated and followed between 2014 and 2018 in different parts of Turkey. Patients were divided into 2 groups according to the primary tumor localization as right or left colon cancer. Clinical and demographic characteristics, treatment outcomes, and survival were analyzed to determine whether there was any association with tumor localization.There were 53 (30%) patients with mCRC in the right group and 124 (70%) in the left group, with no difference between the groups in terms of clinical and demographic characteristics. There was no difference in OS between the left and right side localization in any RAS-mutant mCRC patients (22.1 vs. 27.9 months, respectively, p=0.19), whereas patients with all RAS-wild type tumor in the right colon were associated with a worse OS than left-sided counterparts (19.4 vs 29.9 months, respectively, p=0.01). Multivariate analysis revealed that the right-sided tumor (HR, 1.74; 95% CI: 1.165-2.608; p=0.007), the presence of comorbid disease (HR, 1.58; 95% CI: 1.079-2.321, p=0.019), body mass index (BMI)25 ( HR, 1.61; 95% CI: 1.108-2.352, p=0.013), grade III tumor (HR, 1.65; 95% CI: 1.109-2.457, p=0.014), and being unable to metastasectomy (HR, 2.10; 95% CI: 1.235-3582, p=0.006) were found to be independent predictors of worse survival.While right side localization was an independent negative predictor of survival in patients with mCRC, tumor sidedness was not found to be associated with response to treatment. The worse OS in right localization may be due to the aggressive nature of right-sided colon tumors which show faster progression, since their response to treatment does not appear to be different.

Due to the cytotoxic effects of old chemotherapy regimens used in the islet cell tumors, capecitabine plus temozolomide combination has now become the first choice in the treatment of malignant insulinoma (MIoma). We present this case to emphasize and remind that a durable complete response in advanced stage MIoma may be achieved with a short course of streptozotocin plus doxorubicin combination.

Introduction: The relation between Behçet's disease (BD) and breast cancer (BC) is unclear. Our purpose is to investigate whether BD has an important effect on BC or vice versa. Patients and Methods: A total of 12 female BC patients with a diagnosis of BD were identified from a cohort including 5050 BC patients. The demographic data of the selected patients including previous chemotherapy (CT), radiotherapy (RT), hormonal therapy (HT), drugs used for BD, history of thrombotic events, and overall survival were examined. Results: The rate of BD in the entire cohort was found to be 0.25% (12/4800), and all had early BC at the time of BC diagnosis, with a median age of 47 years (range: 38–51). All patients underwent curative surgery for BC. In the adjuvant setting, CT, RT, and HT were administered in 11 (91%), 10 (83.4%), and 9 (75%) patients, respectively. All patients received acetylsalicylic acid and colchicine for BD. No serious adverse event associated with BC and/or BD was observed. Clinical symptoms in 11 patients with BD were observed to be improved following the BC treatment. Only one patient developed disease progression and then expired. Conclusion: Unlike the natural behavior of BD, which is well-defined to have an increased risk of thrombosis, BC patients with BD in this study did not have any adverse event. However, due to small sample size, it is difficult to drive any definite conclusion regarding the relation between these two pathologies.

AIM: Patients with cancer die not only from the primary cancer disease, die also from many of reasons like bleeding, thromboembolism and sepsis. We aimed to research death reasons and major factors which affects survival who die from cancer in our clinic.MATERIAL AND METOD: 46 patient ( 34 men and 12 women) are included to our research whom death comfirmed with hospital registers in last two years. Statical analysis practiced with SPSS 18 version (SPSS inc., Chicago, IL)RESULTS: Patients in our assessment were stage 4 cancer in the percentage of %91.3 and %84.4 with III and over performance status in their last hospitalizations. %76.1 of these patients practiced chemotherapy and %41.3 of them had radiotheraphy. %31.4 of patients undergone to surgery. There is no difference in survival of patients regardless to their stages and performance scores although women have a long survival compared with men (p, Amaç: Kanser hastaları, kanser dışında kanama, tromboemboli, sepsis gibi bir çok nedenden dolayı ölürler. Bu çalışmamızda kanserden kaybettiğimiz hastalarımızın ölüm nedenlerini ve sağ kalımlarını etkileyen başlıca faktörleri araştırmak istedik. Hasta ve Yöntem: Çalışmaya iki yıl içinde hastanede ölmüş olduğu dosya kayıtlarından saptanan 34 erkek ve 12 kadın toplam 46 hasta dahil edildi. İstatistik analizi SPSS versiyon 18 (SPSS inc., Chicago, IL) programında yapıldı. Bulgular: Değerlendirmeye alınan hastalarımız son yatışlarında %91.3 oranında evre IV hastalık ve %84.4 oranında performans statüsü (PS) III ve üzerinde idi. Ölen hastaların %76.1'i kemoterapi (KT) ve %41.3'ü radyoterapi (RT) almış idi. Hastalar %31.4 oranında cerrahi geçirmişti. Hastaların sağ kalımları evrelere ve performans skorlarına farksız çıkarken kadın hastalar erkeklere kıyasla daha uzun yaşamışlardır (p

Backgrounds: The serum leptin level (SLL) has been shown to increase in patients with nonsmall cell lung cancer (NSCLC). However, available data regarding the relation between SLL and tumor subtypes, survival, cachexia, and tumor respectability in NSCLC are still under debate. The aim of this study is to evaluate SLL in NSCLC patients with and without cachexia. Materials and Methods: A total of 71 patients with early stage NSCLC were enrolled in this prospective study. SLL was measured by enzyme-linked immunosorbent assay. The relationship between SLL and clinicopathological factors including histopathological subtypes, weight loss, overall survival, and tumor resectability were evaluated. Results: Of the 71 patients, 57 (81%) were male with a mean age of 63.3 ± 8.2 years. The rates of histological subtypes of NSCLC were as follows: Squamous cell carcinoma 60.5%, adenocarcinoma 32%, and others 7.2%. Mean SLL was 12.9 ± 38.4 pmol/mL. There was no distinctive difference between SLL, weight loss, and survival. However, when stratifying the groups according to the lung cancer histological subtypes, mean SLL was significantly higher in patients with adenocarcinoma than those with squamous cell subtype (26.9 ± 6.2 pmol/mL vs. 5.1 ± 9.1 pmol/mL, P = 0.004). Conclusions: SLL might be beneficial as a useful biomarker in preclinical setting of NSCLC to guide detecting the lung cancer subtypes as well as monitoring the patients.

It is well-known that tumor phenotype may change during the progression of breast cancer (BC). The purpose in this study was to compare the discordance in estrogen receptor (ER), progesterone receptor (PgR) and human epidermal growth factor receptor 2 (HER2) between primary and recurrent/metastatic lesions (RML) and also to evaluate the prognostic significance of change in tumor phenotype on survival in patients with metastatic BC.The medical records of 6638 patients with BC from two breast centers treated between 1992 and 2015 were retrospectively analyzed. Of the 6638 patients, 549 cases in whom recurrence was histologically proven by biopsy or by surgical resection were enrolled into this study.Our presentation 13.5% of the patients had metastatic disease. Biopsy on recurrence was obtained from distant metastasis sites in 250 (63.6%) patients or from locoregional soft tissues/lymph-nodes in 143 (36.4%). Receptor discordance in ER, PgR and HER2 expressions between primary and RML were 27.2% (p=0.32), 38.6% (p0.001) and 14.4% (p=0.007), respectively. Subsequent gain of ER and PgR showed significantly higher overall survival (OS) and post-recurrence survival (PRS) compared to the corresponding concordant-negative patients (119 vs 57 months, p=0.001 and 56 vs 31 months, p=0.03 for ER, 148 vs 58 months, p=0.003 and 64 vs 31 months, p=0.01 for PgR, respectively), hormone receptor (HR) loss was associated with worse OS. Similarly, HER2-loss cases experienced poorer PRS and OS outcomes, compared with those having stable HER2 expression (median 26 vs 60 months, p=0.009 for PRS and median 60 vs 111 months, p=0.06 for OS, respectively).This study confirmed the receptor discordance in ER/PgR and HER2 receptor expressions between primary and RML in patients with metastatic BC. As the loss of receptor expression is the most responsible factor for the discordance, treatments of recurrent/metastatic tumors should be individualized on the basis of molecular and genomic properties.

HER2-amplified breast cancer (BC) has a poor prognosis. The combination of trastuzumab with chemotherapy in the adjuvant setting decreases recurrence and improves overall survival in HER2-positive BC. However, the role of adjuvant treatment in patients with HER2-amplified small BC without lymph node involvement is still under debate. The purpose of this study was to investigate the safety of adjuvant paclitaxel and trastuzumab (APT) in this group of patients.A total of 87 operated early BC patients without lymph node involvement (N0) were treated with APT for 12 weeks followed by trastuzumab alone for a total of 9 months. Clinicopathological features and adverse events were analyzed.The median patient age was 50 years (range 28- 82), and 51% of them were postmenopausal. The median tumor diameter was 2.4 cm (range 0.5-6), with 51% of the patients having tumor size between 2 and 3 cm. Eighty-one percent of patients had invasive ductal carcinoma (IDC), and 64% had grade 3 tumors. Adjuvant hormone therapy and adjuvant radiotherapy were administered to 65 and 54% of patients, respectively. At a median follow up of 13 months (range 6-38), one patient (1.1%, 95% CI 0-3.4) experienced an asymptomatic decrease in left ventricular ejection fraction (LVEF) and 3 patients (3.4%, 95% CI 0-6.9) experienced grade 3 neuropathy.APT appears to be a safe combination in early-stage, HER2-amplified and node-negative BC.

The risk of breast cancer (BC) increases in parallel with increasing age. Despite the increased disease burden in elderly patients, there is still a great uncertainty regarding "how to manage" BC in aging-population. The purpose of this study was to investigate the clinicopathological features and treatment approaches of patients with BC aged 70 years or over.The medical records of 4413 patients with BC followed between 1994-2015 were retrospectively analyzed. Of the 4413 patients, 238 with stage I to III disease aged 70 years or over at BC diagnosis were enrolled into this study. Patients were divided into 2 groups according to the age as group 1 (70-79 years, N=192) and group 2 (80 or over, N=46). Clinicopathological features of patients including tumor histology, grade, estrogen (ER) and progesterone receptor (PgR) status, human epidermal growth factor receptor 2 (HER2) status, tumor size, lymph node involvement (LNI), lymphovascular invasion (LVI), perineural invasion (PNI), clinical stage, type of surgery, treatments and comorbid diseases were evaluated.The median age was 74 for group 1 (range 70-79) and 82 for group 2 (range 80-92). Excluding tumor size and grade, no statictically significant difference was found between the two groups according to histopathological characteristics. Patients in group 2 had more commonly larger T stage (T4), and less frequently presented with grade I tumor (p=0.014 and p=0.044, respectively). Modified radical mastectomy and adjuvant chemotherapy were more commonly performed in group 1 (p=0.001 and p=0.001, respectively). In contrast, neoadjuvant treatment was more frequently applied in group 2 (p=0.003). There was no difference in disease-free survival (DFS) between the groups (p=0.012), however, median overall survival (OS) was significantly higher in group 1 (p=0.03).Excluding the tumor grade and tumor size, both groups had similar histopathological features. However, patients aged between 70-79 years were likely to receive more agressive treatments for BC, indicating that treatment choice in patients over the age of 80 years was likely to be based on age-related factors rather than tumor characteristics.

The aim of this study is to measure and compare the dynamic thiol and disulphide homeostasis between patients with Uterine Myoma (UM) and healthy subjects.A total of 54 patients with UM who were diagnosed by transvaginal ultrasonography and 37 age- and body mass index-matched healthy individuals were included in this study. Thiol/disulphide homeostasis was measured by a novel automatic spectrophotometric method.The mean serum native thiol, disulphide, and thiol levels were statistically lower in UM group than those in the control group [(284.66±59.41μmol/L vs. 320.98±56.17μmol/L, P0.0001), (17.27±5.59μmol/L vs. 22.38±6.93μmol/L, P0.0001) and (319.21±61.69 vs. 365.76±61.46μmol/L, P0.0001), respectively]. There were no statistically significant differences in ratios of the disulphide/native thiol, native thiol/total thiol, and disulphide/total thiol among patients with UM versus healthy control group (P=0.096, 0.092, 0.092, respectively).It was found that the native thiol, total thiol, and disulphide levels in patients with UM decreased while the ratio of native thiol/disulphide remained unchanged.It is necessary to investigate whether these findings have a role in the etiology and clinical course of the UM.

Diskapi Education & Research Hospital, Department of Medical Oncology, Ankara, Turkey *Author for correspondence: Tel.: +90 312 596 2854; Fax: +90 312 318 6690; m_f_karatas@hotmail.com