Person: ŞAHİN, AHMET BİLGEHAN
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ŞAHİN
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AHMET BİLGEHAN
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Publication 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-2172-2015Dermatofibrosarcoma 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.Publication Efficacy and safety of trastuzumab emtansine in her2 positive metastatic breast cancer: Real-world experience(Taylor & Francis, 2021-06-05) Bahçeci, Aykut; Paydaş, Semra; Ak, Naziye; Ferhatoğlu, Ferhat; Saip, Pınar Mualla; Şeydaoğlu, Gülşah; Bilici, Mehmet; Şimşek, Melih; Tekin, Salim Başol; Çalıkuşu, Züleyha; Yavuz, Sinan; Şahin, Ahmet Bilgehan; Çubukcu, Erdem; Evrensel, Türkkan; Değirmencioğlu, Serkan; Demiray, Atike Gökçen; Yumuk, Perran Fulden; Alan, Özkan; Çıkman, Duygu İlke; Demirelli, Fuat Hulusi; Köstek, Osman; Gökyer, Ali; Doğan, Mutlu; Bal, Öznur; Çakar, Burcu; Gökmen, Erhan; Yamaç, Deniz; Korkmaz, Taner; Aliyev, Altay; Keskin, Özge; Urvay, Semiha; Buyukşimşek, Mahmut; Karadeniz, Cemile; Yıldız, Birol; Çınkır, Havva Yeşil; Demir, Hacer; Beypınar, İsmail; Karacin, Cengiz; Eser, Kadir; Baykara, Meltem; Kılıçkap, Saadettin; Okutur, Kerem; Bulut, Gülcan; Alkan, Ali; Arpacı, Erkan; Pilancı, Kezban Nur; Demir, Atakan; Işık, Deniz; Yıldırım, Nilgün; ŞAHİN, AHMET BİLGEHAN; ÇUBUKÇU, ERDEM; EVRENSEL, TÜRKKAN; 0000-0002-7846-0870 ; AAM-4927-2020; JGT-4101-2023 ; EXZ-0745-2022Aim The aim of this study is to evaluate the efficacy and toxicity of trastuzumab emtansine (T-DM1) in cases with metastatic breast cancer (mBC) in different lines of treatment. Method Retrospective analysis of T-DM1 results of human epidermal growth factor receptor 2 (Her2) positive 414 cases with mBC from 31 centers in Turkey. Findings Except 2, all of the cases were female with a median age of 47. T-DM1 had been used as second-line therapy in 37.7% of the cases and the median number of T-DM1 cycles was 9. Progression-free survival (PFS) and overall survival (OS) times were different according to the line of treatment. The median OS was found as 43, 41, 46, 23 and 17 months for 1st, 2nd, 3rd, 4th and 5th line, respectively (p = 0.032) while the median PFS was found as 37, 12, 8, 8 and 8 months, respectively (p = 0.0001). Treatment was well tolerated by the patients. The most common grade 3-4 adverse effects were thrombocytopenia (2.7%) and increased serum gamma-glutamyl transferase (2%). Discussion The best of our knowledge this is the largest real-life experience about the safety and efficacy of T-DM1 use in cases with mBC after progression of Her2 targeted treatment. This study suggests and supports that T-DM1 is more effective in earlier lines of treatment and is a reliable option for mBC.Publication 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-4927-2020Kaposi 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.Publication 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-8314-2021Endometrial 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.Publication Trastuzumab ± capecitabine maintenance after the first-line treatment of HER2-positive advanced gastric cancer: Retrospective observational real-life data of Turkish oncology group(Springer, 2021-01-24) Gürbüz, Mustafa; Akkuş, Erman; Sakin, Abdullah; Urvay, Semiha; Demiray, Atike Gökçen; Şahin, Süleyman; Sakalar, Teoman; Erol, Cihan; Şendur, Mehmet Ali Nahit; Şahin, Ahmet Bilgehan; Çubukcu, Erdem; Guven, Deniz Can; Kılıçkap, Saadettin; Ergün, Yakup; Uncu, Doğan; Turhal, Nazim Serdar; Uskent, Necdet; Çınkır, Havva Yeşil; Demir, Atakan; Acar, Ramazan; Karadurmuş, Nuri; Türker, Sema; Altınbaş, Mustafa; Karaoğlan, Mert; Şenler, Filiz Çay; ŞAHİN, AHMET BİLGEHAN; ÇUBUKÇU, ERDEM; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Onkoloji Anabilim Dalı.; 0000-0002-7846-0870 ; 0000-0002-0070-0889; AAM-4927-2020 ; JGT-4101-2023Purpose In the ToGA trial for HER2-positive advanced gastric cancer, cisplatin plus fluoropyrimidine was given for 6 cycles; trastuzumab was given until disease progression. However, there is a lack of real-life data about trastuzumab maintenance after 6 cycle chemotherapy. This study aims to present real-life data of trastuzumab +/- capecitabine maintenance after 6 cycles of platinum, fluoropyrimidine, and trastuzumab in non-progressive patients. Methods This is a retrospective multicenter study of the Turkish Oncology Group. A total of 35 HER2-positive, inoperable locally advanced, recurrent, or metastatic gastric adenocarcinoma patients being non-progressive at the end of 6 cycle chemotherapy and being given trastuzumab +/- capecitabine as maintenance treatment were included from sixteen oncology centers. Baseline characteristics, objective tumor responses, progression free and overall survival data, and toxicities were determined. Results About 68% of the patients were given CF, and 32% were given FOLFOX with trastuzumab as the first-line treatment. The best response in 6 cycle chemotherapy was complete 8 (22%), partial 24 (68%), and stable disease 3 (8%). All patients had trastuzumab maintenance (median cycle 13; range 7-51), and 49% of the patients had capecitabine with trastuzumab (median capecitabine cycle 6; range 2-30). The median PFS of the patients was 12.0 months (95% CI 10.3-13.7), and median OS was 17.4 months (95% CI 15.2-19.5). There were 2 patients with grade 1 cardiotoxicity. Conclusion Trastuzumab maintenance +/- capecitabine after 6 cycles of trastuzumab plus combined chemotherapy treatment revealed efficacy and safety in non-progressive HER2-positive advanced gastric cancer.Publication 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-0967-2022Objective: 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.