Browsing by Author "Ocak, Birol"

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Altmış beş yaş üstü metastatik yumuşak doku sarkom hastalarında pazopanib tedavisinin etkinliğinin retrospektif değerlendirilmesi
(Bursa Uludağ Üniversitesi, 2019-02-06) Çubukçu, Erdem; Ocak, Birol; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Tıbbı Onkoloji Bilim Dalı.
Yumuşak doku sarkomları (YDS) mezenşimal hücrelerden köken alan tümörlerin nadir ve heterojen grububudur ve tüm erişkin kanserlerin yaklaşık %1 ini oluşturmaktadır. YDS lerin 50 den fazla farklı histolojik tipi mevcuttur. Pazopanib, Vasküler endotelyal büyüme faktörü reseptör 1 (VEGFR-1), VEGFR-2, VEGFR-3, trombosit kökenli büyüme faktörü a (PDGFR-a) ve c-kit bloke eden oral kullanılan tirozin kinaz inhibitörüdür. İlerlemiş yumuşak doku sarkoması olan yaşlı hastalarda oral multi-tirozin kinaz anjiyogenez inhibitörü pazopanib ile tedavi sonuçlarını geriye dönük olarak inceledik. Medyan yaş 72 (65-79) olan toplam 13 hasta dosyası Ocak 2014-Eylül 2018 arasında retrospektif olarak incelendi. Kapesitabin ve Pazopanib tedavisi kemoterapi sonrasında progrese olan yumuşak doku sarkomlu yaşlı hastalarda etkili ve iyi tolere edilmiştir.
Chemo-immunotherapy with atezolizumab in extensive-stage small-cell lung cancer; single-center experience
(Akad Doktorlar Yayınevi, 2020-01-01) Şahin, Ahmet Bilgehan; Çubukcu, Erdem; Ocak, Birol; Deligönül, Adem; Kaçan, Turgut; Orhan, Sibel Oyucu; Evrensel, Türkkan; ŞAHİN, AHMET BİLGEHAN; ÇUBUKÇU, ERDEM; OCAK, BİROL; DELİGÖNÜL, ADEM; OYUCU ORHAN, SİBEL; EVRENSEL, TÜRKKAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Onkoloji Anabilim Dalı; 0000-0002-7846-0870; 0000-0001-7537-1699; 0000-0001-8217-3471; 0000-0002-9732-5340; AAJ-8314-2021; AAJ-1027-2021; AAM-4927-2020; ETP-1691-2022; HHA-1866-2022; ESM-4544-2022
Chemo-immunotherapy (CIT) with platin, etoposide and monoclonal antibodies targeting the PD-1/PDL-1 pathway has recently improved survival in extensive-stage small-cell lung cancer (SCLC) after decades. We aimed to investigate the efficacy and safety of CIT with atezolizumab in extensive-stage SCLC in chemotherapy naive patients. Eleven patients who were treated and followed in our center were included in this retrospective observational study. All the patients received carboplatin, etoposide and atezolizumab in the induction phase and atezolizumab in the maintenance phase. The Kaplan-Meier test was used to determine progression-free survival (PFS) and overall survival (OS), and the effects of the sites of metastasis were analyzed using the log-rank test. The median age was 69.9 years, and 81.8% were male. The median number of CIT and total atezolizumab cycles was 4 and 7, respectively. 63.6% received maintenance therapy. Median PFS was 5.2 months (95% CI: 3.4-6.9), and median OS was 11.3 months (95% CI: 1.0-21.5). The overall response rate was 63.6%. There was no significant difference between patients with and without liver metastasis in terms of PFS and OS. We observed toxicity higher than grade 2 in more than half of the patients, and hematological toxicities were prominent. CIT with carboplatin, etoposide and atezolizumab is efficient and safe in extensive-stage SCLC considering the PFS, OS, response rates, 12-month survival rate, and side effects. The progression of liver lesions was remarkable. Cranial and thoracic radiation are issues that should be discussed in the future with data from clinical studies.
Clinical and laboratory outcomes of the solid cancer patients reinfected with sars-cov-2
(Future Medicine, 2021-11-26) Unsal, Oktay; Yazici, Ozan; Ozdemir, Nuriye; Uner, Aytug; Ozet, Ahmet; Cubukcu, Erdem; ÇUBUKÇU, ERDEM; Ocak, Birol; OCAK, BİROL; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Onkoloji Anabilim Dalı.; 0000-0001-7537-1699; 0000-0001-8731-9636; AEC-2238-2022
Lay abstract Solid cancer patients are at a higher risk than general population in terms of Coronavirus disease 2019 (COVID-19) infectivity and COVID-19-associated death and disease. It is also known that COVID-19 infection has a more severe course in immunocompromised patients. Solid cancer patients may be a vulnerable subgroup of patients to reinfection with COVID-19. The rate of reinfection was 3.1% (n = 32) in our study population of 1024 solid cancer patients who were tested positive on a COVID-19 PCR test. The death rate of the patients with solid cancer was 34.3% (n = 11). In addition, we demonstrated that intensive care follow-up is significantly longer during the reinfection period. It was demonstrated that the time between the last dose of chemotherapy for the patients and the reinfection COVID PCR positivity did not affect the death rate. The COVID-19 pandemic has affected people's daily lives and treatments in many aspects. Owing to the high death rate of reinfection, even if cancer patients have reinfection, our approach is to continue cancer treatment as soon as the patient is cured. Finally, we support the priority vaccination of cancer patients.Introduction: The objective of this study was to evaluate the clinical and laboratory outcomes of solid cancer patients who were reinfected with COVID-19. Methods: Patients who were tested negative on the Coronavirus disease 2019 (COVID-19) PCR test and those with improved clinical conditions after infection with COVID-19 were enrolled in this study. Patients who received a positive COVID-19 PCR test 28 days after the initial positive PCR test were considered as reinfected. Results: A total of 1024 patients with the diagnosis of solid malignancy and COVID-19 PCR positivity were examined. The reinfection rate was 3.1%. Mortality rate of reinfection was 34.3%. The serum ferritin and creatinine values in reinfection were found to be significantly higher than the first infection (respectively; p = 0.015, p = 0.014). Conclusion: This study has demonstrated one of the first preliminary clinical results of COVID-19 reinfection in solid cancer patients.
Efficacy of chemotherapeutics on classic and non-classic kaposi sarcoma: A single-center retrospective real-world study
(Assoc Basic Medical Sci Federation Bosnia & Herzegovina Sarajevo, 2021-01-01) Orhan, Sibel Oyucu; OYUCU ORHAN, SİBEL; Sahin, Ahmet Bilgehan; ŞAHİN, AHMET BİLGEHAN; Çubukcu, Erdem; ÇUBUKÇU, ERDEM; Deligonul, Adem; DELİGÖNÜL, ADEM; Ocak, Birol; OCAK, BİROL; Orhan, Bedrettin; ORHAN, BEDRETTİN; Evrensel, Turkkan; EVRENSEL, TÜRKKAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Onkoloji Anabilim Dalı.; 0000-0002-7846-0870; 0000-0001-7537-1699; ACW-2157-2022; AAJ-8314-2021; AEC-2238-2022; AAM-4927-2020
Kaposi sarcoma (KS) is a rare disease, and especially for classic KS, a gap exists in the literature about which chemotherapeutics should be given. Here we present our institutional data on the demographic characteristics, treatment, and treatment efficacy in 16 patients with KS treated with chemotherapy. We retrospectively analyzed the demographic and clinical characteristics of and the chemotherapeutic agents administered to the 16 patients with KS diagnosed in our center based on the medical records obtained. The median age, gender, KS type, involved site, cytotoxic agents administered, progression-free survival (PFS), overall survival (OS), objective response rate (ORR), disease control rate (DCR), and safety profiles of the patients were evaluated. The median age at disease onset was 61.07 years (range, 39.4-85.8 years). Among the patients, one had immunosuppression-related KS, four had acquired immune deficiency syndrome-related KS, and 11 had classic KS. Regarding the first-line cytotoxic therapy, seven patients received pegylated liposomal doxorubicin (PLD), six received paclitaxel, two received oral etoposide, and one received the doxorubicin, bleomycin, and vincristine regimen. The Kaplan-Meier analysis showed that the PFS was 39.9 months (95% confidence interval (CI), 7.7-72.0). In the first-line setting, a significant difference in PFS was observed between the PLD-and paclitaxel-treated groups (unreached vs. 12.8 months; p = 0.033). The OS was 66.1 months (95% CI, 30.2-102.0). The ORR and DCR of the 16 patients were 43.8%, and 81.3%, respectively. No grade 3 or 4 toxicity was observed. This retrospective study showed that among the most preferred chemotherapeutic agents, PLD seems better than paclitaxel in terms of PFS and response rates, and it showed a good safety profile in patients with KS.
Low pan-immune-inflammation-value predicts better chemotherapy response and survival in breast cancer patients treated with neoadjuvant chemotherapy
(Nature Portfolio, 2021-06-06) Şahin, Ahmet Bilgehan; Çubukçu, Erdem; Ocak, Birol; Deligönül, Adem; Orhan, Sibel Oyucu; Tolunay, Şahsine; Gökgöz, Mustafa Şehsuvar; Çetintaş, Sibel; Yarbaş, Görkem; Şenol, Kazım; Göktuğ, Mehmet Refik; Yanaşma, Zeki Burak; Hasanzade, Ulviyya; Evrensel, Türkkan; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Onkoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Genel Cerrahi Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyasyon Onkolojisi Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; 0000-0002-7846-0870; 0000-0001-8217-3471; 0000-0002-5771-7649; AAM-4927-2020; ETP-1691-2022; AEC-2238-2022; ESM-4544-2022; AAJ-8314-2021; AAI-1612-2021; EWY-5692-2022; EOI-5652-2022; EHL-6662-2022; FVY-2168-2022; JJM-0407-2023; EHR-1518-2022; EXU-7466-2022; EXZ-0745-2022; 57188809248; 53986153800; 57219124259; 37088030300; 57203459665; 6602604390; 57203870909; 6505881756; 57226145851; 55632701500; 57226148550; 57226155008; 57226159463; 6603942124
Blood-based biomarkers reflect systemic inflammation status and have prognostic and predictive value in solid malignancies. As a recently defined biomarker, Pan-Immune-Inflammation-Value (PIV) integrates different peripheral blood cell subpopulations. This retrospective study of collected data aimed to assess whether PIV may predict the pathological complete response (pCR) to neoadjuvant chemotherapy (NAC) in Turkish women with breast cancer. The study consisted of 743 patients with breast cancer who were scheduled to undergo NAC before attempting cytoreductive surgery. A pre-treatment complete blood count was obtained in the two weeks preceding NAC, and blood-based biomarkers were calculated from absolute counts of relevant cell populations. The pCR was defined as the absence of tumor cells in both the mastectomy specimen and lymph nodes. Secondary outcome measures included disease-free survival (DFS) and overall survival (OS). One hundred seven patients (14.4%) had pCR. In receiver operating characteristic analysis, optimal cut-off values for the neutrophile-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte (PLR), PIV, and Ki-67 index were determined as >= 2.34, >= 0.22, >= 131.8, >= 306.4, and >= 27, respectively. The clinical tumor (T) stage, NLR, MLR, PLR, PIV, estrogen receptor (ER) status, human epidermal growth factor receptor-2 (HER-2) status, and Ki-67 index were significantly associated with NAC response in univariate analyses. However, multivariate analysis revealed that the clinical T stage, PIV, ER status, HER-2 status, and Ki-67 index were independent predictors for pCR. Moreover, the low PIV group patients had significantly better DFS and OS than those in the high PIV group (p=0.034, p=0.028, respectively). Based on our results, pre-treatment PIV seems as a predictor for pCR and survival, outperforming NLR, MLR, PLR in predicting pCR in Turkish women with breast cancer who received NAC. However, further studies are needed to confirm our findings.
Malign peritoneal mezotelyoma hastalarının retrospektif değerlendirilmesi
(Bursa Uludağ Üniversitesi, 2020-03-24) Ocak, Birol; Şahin, Ahmet Bilgehan; Dakiki, Bahar; Odman, Hikmet Utku; Deligönül, Adem; Çubukçu, Erdem; Evrensel, Türkkan; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Onkoloji Bilim Dalı.
Mezotelyoma plevra, periton, perikard ve tunica vaginalisin serozal yüzeylerinden gelişen malignitedir. Özellikle asbest maruziyeti ile ilişkilendirilmiştir. Malign peritoneal mezotelyoma (MPM) plevral tutulumdan sonra ikinci sıklıkta görülür. Çalışmamızda MPM tanısı alan hastalarda demografik özelliklerin, kullanılan tedavi seçeneklerinin incelenmesi amaçlandı. Çalışmamızda 12 erkek, 4 kadın toplamda 16 hastanın medyan yaşı 66 (46-93) yıldı. 15 hasta epiteolid, 1 hasta bifazik histopatolojiye sahipti. 2 hastaya hipertermik intraperitoneal kemoterapi (HİPEK) yapılmıştı. Birinci seçim kemoterapi alan 16 hasta, ikinci seçim kemoterapi alan 13 hasta, üçüncü seçim kemoterapi alan 4 hasta, dördüncü seçim kemoterapi alan 1 hasta mevcuttu. Birinci seçim kemoterapi alan hastaların medyan progresyonsuz sağkalımı 14,4 ay (CI %95 7,4:21,4) saptandı. Hastaların medyan toplam sağkalımı 22,0 aydı (CI %95 16:27,9). Standart tedavi seçenekleri arasında olan sitoredüksiyon cerrahisi + HİPEK, sistemik kemoterapi ve immünoterapinin optimal kullanımı ve bu tedavilere uygun hasta seçimi için prospektif, multidispliner, daha fazla hasta sayısı içeren çalışmalara ihtiyaç vardır.
Metastatik endometrioid endometrial karsinom hastalarında tedavi seçeneklerinin sağkalım üzerine etkisi
(Bursa Uludağ Üniversitesi, 2022) Ocak, Birol; Şahin, Ahmet Bilgehan; Abakay, Candan Demiröz; Sali, Seda; Dakiki, Bahar; İşlek, Gizem; Caner, Burcu; Özerkan, Kemal; Deligönül, Adem; Çubukçu, Erdem; Evrensel, Türkkan; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı/Tıbbi Onkoloji Bilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyasyon Onkolojisi Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; 0000-0002-7846-0870; 0000-0001-5380-5898; 0000-0001-8575-5477; 0000-0001-9255-2475; 0000-0003-4851-7036; 0000-0003-1591-3323; 0000-0003-1460-6524; 0000-0002-3669-6391; 0000-0002-0070-0889; 0000-0002-9732-5340
Endometrium kanseri (EK) gelişmiş ülkelerde en sık görülen jinekolojik kanserdir. Obezite en önemli risk faktörü olarak kabul edilmektedi r. Endometrium kanserleri içerisinde en sık görülen alt tip endometrioid endometrial karsinomdur (EEK). Çalışmamızda metastatik EEK hastalarının demografik ve klinikopatolojik özelliklerini, kullanılan tedavi yöntemlerinin sağ kalıma etkisini incelemeyi amaçladık. Hastaların medyan yaşı 58 (39,4-81,9) idi. On altı hastanın hastaneye başvuru şikayeti vajinal kanamaydı. Medyan takip süresi 43 (0,2- 104,3) aydı. Hastaların medyan progresyonsuz sağkalım (PS) süresi 39,9 ay (%95 güven aralığı (GA): 35,0-79,1), medyan genel sağkalım (GS) süresi 59,1 ay (%95 GA: 39,1-80,8) saptandı. Kemoradyoterapi alan hastaların PS ve GS süresi sadece kemoterapi ile tedavi edilen hastalara göre istatistiksel anlamlı olarak daha uzundu (log-rank testi, PS için p=0,012, GS için p=0,015). Çalışmamız metastatik evrede seçilmiş hasta grubunda kemoradyoterapinin tercih edilebileceğini desteklemektedir.
Metastatik meme kanseri tedavisinde lapatinib kapesitabin kombinasyonun etkinliğinin retrospektif değerlendirilmesi
(Uludağ Üniversitesi, 2018-12-20) Ölmez, Ömer Fatih; Deligönül, Adem; Kaçan, Turgut; Çubukçu, Erdem; Ocak, Birol; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Onkoloji Bilim Dalı.
Tüm dünyada meme kanseri kadınlarda kanserin ve kanser ilişkili ölümlerin en sık nedenidir. Meme kanserli hastaların %17-30 HER2 overekspresyonu olup hastalık, kötü prognoz, hastalık progresyon riskinde artış, genel sağkalım ve progresyona kadar geçen sürenin her ikisinde azalma ile birliktedir. Lapatinib, HER2 ve epidermal büyüme faktör reseptör(EGFR) ün ilk dual tirozin kinaz inhibitörüdür. Bu çalışma da antrasiklin, taksan ve trastuzumab tedavisi sonrasında progrese olan metastatik meme kanserli hastalarda kapesitabin ve lapatinib kombinasyonunun etkisini ve tolerabilitesini inceledik. Medyan yaş 56 (34-76) olan toplam 24 hasta dosyası Eylül 2010-Mayıs 2018 arasında 3 merkezde retrospektif olarak incelendi. Tüm hastalar taksan ve antrasiklin içeren kemoterapi ve trastuzumab sonrası progrese olan HER2 pozitif metastatik meme kanseri hastalardı. Genel cevap oranı %29.1, 2 komplet yanıt (CR, 8.3%), 5 parsiyel yanıt (PR, 20.8%) ve 7 stabil hastalık (SD, 29.1%) olmak üzere sağlandı. Kapesitabin ve lapatinib kombinasyon tedavisi antrasiklin, taksan ve trastuzumab tedavisi sonrasında progrese olan metastatik meme kanserli hastalarda etkili ve iyi tolere edilmiştir.
Metastatik yumuşak doku sarkomlarında trabektedin kullanımının retrospektif değerlendirilmesi: Tek merkez deneyimi
(Bursa Uludağ Üniversitesi, 2022-06-29) Orhan, Sibel Oyuncu; Ocak, Birol; Şahin, Ahmet Bilgehan; Caner, Burcu; Asan, Buşra; Deligönül, Adem; Çubukçu, Erdem; Evrensel, Türkkan; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı/Tıbbi Onkoloji Bilim Dalı.; 0000-0003-1591-3323; 0000-0002-9845-6289; 0000-0002-3669-6391; 0000-0002-0070-0889; 0000-0002-9732-5340
Çalışmada metastatik yumuşak doku sarkomu tanısıyla trabektedin tedavisi alan hastaların tedavi yanıtları, sağkalım sonuçları, ilaç yan etkilerinin değerlendirilmesi amaçlanmıştır. Sarkom tanısıyla trabektedin tedavisi alan 16 hastanın dosyaları retrospektif olarak tarandı. Hastaların demografik özellikleri, tedavi süreleri, tedavi yanıtları, ilaç yan etkileri kaydedildi. 16 hastanın 9’u erkek (%56,2), 7’si kadındı (%43,7). Trabektedin için medyan progresyonsuz sağkalım (progression-free survival, PFS) 2,9 ay, genel sağkalım (overall survival, OS) 6,7 ay saptandı. Sağkalım üzerine etkili olan tek faktör trabektedin tedavi sırası olarak belirlendi. Trabektedini 2. ya da 3.sıra tedavi olarak alan hastalar daha iyi PFS süresine (medyan PFS 10,3 aya karşı 1,6 ay, %95 GA: 0-21.9, p= 0.003) ve OS süresine (medyan 26,7 ay’a karşı 5,7 ay, %95 GA: 16.9-36.5, p= 0.003) sahipti. Sarkom çalışmalarında objektif yanıt değerlendirme kriteri olarak kullanılan büyüme modülasyon indeksi (growth modulation index, GMI) değeri 1,33’ün üzerinde olan hastaların PFS ve OS süreleri istatiksel anlamlı olarak daha iyiydi (medyan PFS 19,8 ay, p=0.002; medyan OS 26,7 ay, p=0.047). Tüm hastalarda yan etki gözlendi, grad 3/4 yan etkiler hematolojik yan etkiler %62,5 ve alanin aminotransferaz (ALT)/ aspartat aminotransferaz (AST) artışı %50 sıklıkta oldu. Çalışmada saptanan PFS, OS, yanıt oranları ve yan etkiler diğer çalışmalar ile benzer saptanmış, trabektedini 2.ve 3.sıra tedavi olarak alan hastaların ilaçtan daha fazla fayda gördüğü belirlenmiştir.
The impact of ki-67 index, squamous differentiation, and several clinicopathologic parameters on the recurrence of low and intermediate-risk endometrial cancer
(Assoc Basic Medical Sci Federation Bosnia & Herzegovina Sarajevo, 2021-01-01) Ocak, Birol; Atalay, Fatma Oz; Sahin, Ahmet Bilgehan; Ozsen, Mine; Dakiki, Bahar; Ture, Seray; Mesohorli, Merve; Odman, Hikmet Utku; Tanriverdi, Ozgur; Ocakoglu, Gokhan; Bayrak, Mehmet; Ozan, Hakan; Demiroz, Candan; Sali, Seda; Orhan, Sibel Oyucu; Deligönül, Adem; Çubukcu, Erdem; Evrensel, Turkkan; Ocak, Birol; OCAK, BİROL; Sahin, Ahmet Bilgehan; ŞAHİN, AHMET BİLGEHAN; Atalay, Fatma Oz; ÖZ ATALAY, FATMA; Ozsen, Mine; ÖZŞEN, MİNE; Dakiki, Bahar; DAKİKİ KORUCU, BAHAR; Ture, Seray; TÜRE AYDIN, SERAY; Mesohorli, Merve; Odman, Hikmet Utku; Ocakoglu, Gokhan; OCAKOĞLU, GÖKHAN; Bayrak, Mehmet; Ozan, Hakan; OZAN, HAKAN; Demiroz, Candan; DEMİRÖZ ABAKAY, CANDAN; Sali, Seda; SALİ, SEDA; Orhan, Sibel Oyucu; OYUCU ORHAN, SİBEL; Deligonul, Adem; DELİGÖNÜL, ADEM; Cubukcu, Erdem; ÇUBUKÇU, ERDEM; Evrensel, Turkkan; EVRENSEL, TÜRKKAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Onkoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; 0000-0001-7537-1699; 0000-0002-7188-6115; 0000-0002-7846-0870; 0000-0002-5771-7649; 0000-0001-9255-2475; 0000-0002-1114-6051; 0000-0003-1600-333X; AEC-2238-2022; ABA-2897-2021; AAH-5180-2021; AAM-4927-2020; AAJ-8314-2021
Endometrial endometrioid carcinoma (EEC) represents approximately 75-80% of endometrial carcinoma cases. Three hundred and thirty-six patients with EEC followed-up in the authors' medical center between 2010 and 2018 were included in our study. Two hundred and seventy-two low and intermediate EEC patients were identified using the European Society for Medical Oncology criteria and confirmed by histopathological examination. Recurrence was reported in 17 of these patients. The study group consisted of patients with relapse. A control group of 51 patients was formed at a ratio of 3:1 according to age, stage, and grade, similar to that in the study group. Of the 17 patients with recurrent disease, 13 patients (76.5%) were Stage 1A, and 4 patients (23.5%) were Stage 1B. No significant difference was found in age, stage, and grade between the case and control groups (p > 0.05). Body mass index, parity, tumor size, lower uterine segment involvement, squamous differentiation (SqD), and Ki-67 index with p<0.25 in the univariate logistic regression analysis were included in the multivariate analysis. Ki-67 was statistically significant in multivariate analysis (p = 0.018); however, there was no statistical significance in SqD and other parameters. Our data suggest that the Ki-67 index rather than SqD needs to be assessed for recurrence in patients with low- and intermediate-risk EEC.
The ki-67 index and neutrophile-lymphocyte ratio are prognostic factors in patients with low-risk endometrial cancer
(Mre Press, 2021-04-21) Çubukcu, Erdem; Şahin, Ahmet Bilgehan; Atalay, Fatma Öz; Ocak, Birol; Özşen, Mine; Abakay, Candan Demiröz; Özerkan, Kemal; Hasanzade, Ulviyya; Mesahorlı, Merve; Deligönül, Adem; Ozan, Hakan; Evrensel, Türkkan; ÇUBUKÇU, ERDEM; ŞAHİN, AHMET BİLGEHAN; ÖZ ATALAY, FATMA; OCAK, BİROL; ÖZŞEN, MİNE; DEMİRÖZ ABAKAY, CANDAN; ÖZERKAN, KEMAL; HASANZADE, ULVIYYA; Mesahorlı, Merve; DELİGÖNÜL, ADEM; OZAN, HAKAN; EVRENSEL, TÜRKKAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Onkoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyasyon Onkolojisi Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Jinekolojik Onkoloji Anabilim Dalı.; 0000-0002-7846-0870; 0000-0001-7537-1699; 0000-0002-5771-7649; 0000-0001-5380-5898; AAH-9791-2021; K-2269-2016; AAM-4927-2020; ETP-1691-2022; JHC-4482-2023; HHA-1866-2022; AAI-1609-2021; AAH-3855-2021; EXU-7466-2022; FNB-4540-2022; ESM-4544-2022; DKZ-4159-2022; EXJ-0967-2022
Objective: To investigate the prognostic factors comparing clinical, histopathological, and laboratory parameters in low-risk endometrial cancer (EC). Methods: In the present single-center study, multivariate Cox regression analysis was performed on retrospective clinical and laboratory data and histopathological features obtained from the re-evaluation of 253 patients with low-risk EC. Receiver operating characteristic curves (ROC) were plotted for neutrophile-lymphocyte ratio (NLR), platelet-lymphocyte ratio, lymphocyte-monocyte ratio and Ki-67 index for recurrence. Kaplan-Meier analysis was employed for survival rates. Results: The median age was 58.5 years (32.0-75.4). Most of the patients were obese and post-menopausal. In nearly half of the patients, lymphadenectomy was performed in addition to hysterectomy and oophorectomy. The median tumor size was 30 mm (range 2-80), and the median Ki-67 index was 25 (1-90). According to the ROC curve analysis, the cut-off values for the Ki-67 index, NLR, PLR, and LMR were determined as >= 22, >= 1.98, >= 115.3, and >= 4.71, respectively. The log-rank test revealed that the patients with a Ki67 index lower than 22% and NLR lower than 1.98 had statistically longer recurrence-free survival (RFS) (p = 0.002 for Ki-67 index and p = 0.004 for NLR). The multivariate analysis revealed that the Ki-67 index and NLR were statistically significant factors for RFS (p = 0.012 and p = 0.029, respectively). Conclusion: The present study highlights the prognostic implications of both the Ki-67 index and NLR in lowrisk EC.
The ki-67 proliferation index predicts recurrence-free survival in patients with dermatofibrosarcoma protuberans
(Assoc Basic Medical Sci Federation Bosnia & Herzegovina Sarajevo, 2021-01-01) Tanriverdi, Ozgur; Ozsen, Mine; ÖZŞEN, MİNE; Deligonul, Adem; DELİGÖNÜL, ADEM; Yazici, Serkan; YAZİCİ, SERKAN; Cetintas, Sibel Kahraman; Yalcinkaya, Ulviye; YALÇINKAYA, ÜLVİYE; Sahin, Ahmet Bilgehan; ŞAHİN, AHMET BİLGEHAN; Orhan, Sibel Oyucu; OYUCU ORHAN, SİBEL; Ocak, Birol; OCAK, BİROL; Evrensel, Turkkan; EVRENSEL, TÜRKKAN; Kahveci, Ramazan; KAHVECİ, RAMAZAN; Cubukcu, Erdem; ÇUBUKÇU, ERDEM; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Onkoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Plastik Cerrahi ve Estetik Anabilim Dalı.; 0000-0001-6407-0962; 0000-0002-5771-7649; 0000-0002-7846-0870; 0000-0002-0598-7284; 0000-0001-7537-1699; AAJ-8314-2021; AEC-2238-2022; AAM-4927-2020; M-2172-2015
Dermatofibrosarcoma protuberans (DFSP) is an uncommon soft tissue sarcoma that originates from the dermis or subcutaneous tissue in the skin. While its prognosis is generally favorable, disease recurrence is relatively frequent. Since morbidity after repeated surgery may be significant, an optimized prediction of recurrence-free survival (RFS) has the potential to improve current management strategies. The purpose of this study was to investigate the prognostic value of the Ki-67 proliferation index with respect to RFS in patients with DFSP We retrospectively analyzed data from 45 patients with DFSP. We calculated the Ki-67 proliferation index as the percentage of immunostained nuclei among the total number of tumor cell nuclei regardless of the intensity of immunostaining. We constructed univariate and multivariate Cox proportional hazards regression models to identify predictors of RFS. Among the 45 patients included in the study, 8 developed local recurrences and 2 had lung metastases (median follow-up: 95.o months; range: 5.2-412.4 months). The RFS rates at 60, 120, and 240 months of follow-up were 83.8%, 76.2%, and 65.3%, respectively. The median Ki-67 proliferation index was 14%. Notably, we identified the Ki-67 proliferation index as the only independent predictor for RFS in multivariate Cox proportional hazards regression analysis (hazard ratio = 1.106, 95% confidence interval = 1.019-1.200, p = 0.016). In summary, our results highlight the potential usefulness of the Ki-67 proliferation index for facilitating the identification of patients with DFSP at a higher risk of developing disease recurrences.