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Öğe Chylothorax due to tuberculosis lymphadenitis(2016) Demirbaş, Soner; Kutlu, Orkide; Sakin, AbdullahChylothorax is a rare clinical condition characterized by high triglyceride and low cholesterol levels in milky pleural aspirate. Generally, it occurs through leakage of chyle as result of trauma or malignancy. Chylothorax due to tuberculous lymphadenitis is very rare clinical condition that has only been documented in a few cases. Although precise pathogenesis is not known, enlarged mediastinal and hilar lymph nodes are thought to be associated with opening of collateral anastomosis between thoracic duct and the azygos and intercostal veins by creating pressure on thoracic duct and cisterna chyli. Presently described is case of chylothorax thought to be due to compression from mediastinal tuberculous lymphadenitis, and which had complete remission after antituberculosis treatment.Öğe Comparing the efficacy of regorafenib and 5-fluorouracil-based rechallenge chemotherapy in the third-line treatment of metastatic colorectal cancer(Bmc, 2024) Tasci, Elif Senocak; Oyan, Basak; Soenmez, Oezlem; Mutlu, Arda Ulas; Atci, Muhammed Mustafa; Sakin, Abdullah; Oener, IremBackground The optimal treatment for metastatic colorectal cancer (mCRC) after the second line is still controversial. Regorafenib has been the standard of care in this setting as it improved overall survival (OS) compared to placebo. In real-world practice chemotherapy rechallenge is also a preferred option even though supporting evidence is not enough. We aim to compare the efficacy of regorafenib and 5-fluorouracil-based (5-FU) rechallenge treatment in the third line setting of mCRC.Methods In this retrospective multi-institutional trial, mCRC patients from 21 oncology centers who progressed after 2 lines of chemotherapy were analyzed. Patients who were treated with regorafenib or rechallenge therapy in the third-line setting were eligible. Rechallenge chemotherapy was identified as the re-use of the 5-FU based regimen which was administered in one of the previous treatment lines. OS, disease control rate (DCR), progression free survival (PFS) and toxicity were analyzed.Results Three hundred ninety-four mCRC patients were included in the study. 128 (32.5%) were in the rechallenge, and 266 (67.5%) were in the regorafenib group. Median PFS was 5.82 months in rechallenge and 4 months in regorafenib arms (hazard ratio:1.45,95% CI, p = 0.167). DCR was higher in the rechallenge group than regorafenib (77% vs 49.5%, respectively, p = < 0.001). Median OS after the third-line treatment was 11.99 (95% CI, 9.49-14.49) and 8.08 months (95% CI, 6.88-9.29) for rechallenge and regorafenib groups, respectively (hazard ratio:1.51, 95% CI, p < 0.001). More adverse effects and discontinuation were seen with regorafenib treatment.Conclusion Our study revealed that higher disease control and OS rates were achieved with rechallenge treatment compared to regorafenib, especially in patients who achieved disease control in one of the first two lines of therapy.Öğe Comparing the efficacy of regorafenib and 5-fluorouracil-based rechallenge chemotherapy in the third-line treatment of metastatic colorectal cancer (vol 24, 16, 2024)(Bmc, 2024) Tasci, Elif Senocak; Oyan, Basak; Sonmez, Ozlem; Mutlu, Arda Ulas; Atci, Muhammed Mustafa; Sakin, Abdullah; Oner, Irem[Abstract Not Availabe]Öğe Is lymph node dissection necessary for staging while undergoing nephrectomy in patients with renal cell carcinoma?(Mosby-Elsevier, 2021) Demir, Tarik; Aliyev, Altay; Besiroglu, Mehmet; Araz, Murat; Kostek, Osman; Sakin, Abdullah; Shbair, Abdallah T. M.Objective: The essential treatment for patients with renal cell carcinoma is nephrectomy. As no lymph node dissection (LND) could be performed in the majority of these patients, healthy staging could not be carried out. In this study, we investigated the impact of LND during nephrectomy on patient survival. Methods: A total of 181 patients-58 (32%) were female and 123 (68%) were male-were included in the study. Median follow-up period was 48 months. The patients were separated into 4 groups according to their stage during diagnosis; group 1 (T1-3N0M0), group 2 (T1-3NXM0), group 3 (T1-3N1M0), and group 4 (T14N0/XM1). The disease-free survival of nonmetastatic patients and the overall survival of all groups were calculated. Results: Mean age was 58.4 +/- 12.0 years. Median survival for Group 1 could not be reached. Median survival was 89 months in Group 2, 50 months in Group 3, and 39 months in Group 4 (P <0.001). There was no statistically significant difference between the N1 and M1 groups (P = 0.297). For the NX patient group without LND, median survival was 89 months, which is worse than the N0 group and better than the N1 group (P = 0.002). Conclusions: Our study presumes that the patients without LND are not staged sufficiently, NX patients have worse survival rates when compared with N0 patients, node-positive patients have poor survival rates as do the metastatic patients, and it should be defined as TNM stage4. (c) 2020 Elsevier Inc. All rights reserved.Öğe Metastatik Pankreas Kanserli Hastalarda FOLFİRİNOX Rejiminin Etkinlik ve Tolerabilitesi(2018) Geredeli, Çağlayan; Cihan, Şener; Yaşar, Nurgül; Sakin, Abdullah; Can, Orçun; Artaç, Mehmet; Karaağaç, Mustafa; Koral, LokmanAmaç: Metastatik pankreas kanseri tedavisinde FOLFİ-RİNOX rejiminin kullanımı hem progresyonsuz sağ kalımıhemde genel sağ kalım süresini uzatmıştır. Türk popülasyonundametastatik pankreas kanserli hastalarda birinciseride FOLFİRİNOX rejimi kullanımının etkinlik ve güvenilirliğiniretrospektif olarak araştırmak istedik.Gereç ve Yöntem: Çalışma retrospektif çok merkezli olarakdizayn edilmiştir. 2012-2016 yılları arasında birinci seriFOLFİRİNOX rejimi ile tedavi edilen metastatik pankreaskanserli hastalar dahil edilmiştir.Bulgular: Çalışmaya 44 metastatik pankreas kanserli hastaalındı. Hastalardan 30’u erkek (%68,2), 14’ü kadındı(%31,8). Hastaların yaş ortalaması 58,7 (34-73) yıldı. Mediantakip süremiz 14 ay idi. Hastaların metastaz bölgelerinebakıldığında %72,7 karaciğere, %18,2 akciğere, %18,2peritona, %4,5 lenf nodlarına ve %4,5 kemiklere metastazyapmıştı. Tedaviye yanıt oranlarına bakıldığında %40,9hastada parsiyel yanıt, %13,6 hastada stabil yanıt, %45,4hastada progresyon mevcuttu. Median progresyonsuz sağkalım süresi 8 ay (%95 CI 4-12) olarak bulundu. Mediangenel sağ kalım süresi 14 ay (%95 CI 10.3-17.7), 6 aylıkgenel sağ kalım %76,2, 12 aylık genel sağ kalım %57,5, 24aylık genel sağ kalım %6 olarak bulundu. Toksisite oranlarınabakıldığında grade 3-4 Nöropeni %36,4 (grade 3%27,3, grade 4 %9,1), grade 3-4 trombositopeni %13,6hastada görüldü. Grade 3-4 anemi %14,6 hastada görüldü.Hematolojik dışı yan etkilerden grade 1-2 ishal %68olmasına rağmen grade 3-4 ishal %4,5 oranında görüldü.Grade 1-2 periferik duysal nöropati %72,7 oranında görülürkengrade 3-4 duysal nöropati tespit edilmedi.Sonuç: Metastatik pankreas kanserinde FOLFİRİNOX rejimikullanılarak 12 ayın üzerine çıkan bir genel sağkalımaulaşılmıştır. Fakat grade 3-4 hematolojik yan etki oranı%49’lara kadar çıkmıştır.Öğe Prognostic factors of perioperative FLOT regimen in operable gastric and gastroesophageal junction tumors: real-life data (Turkish Oncology Group)(Tubitak Scientific & Technological Research Council Turkey, 2022) Erol, Cihan; Sakin, Abdullah; Basoglu, Tugba; Ozden, Ercan; Cabuk, Devrim; Dogan, Mutlu; Oksuzoglu, BernaBackground/aim: Perioperative FLOT regimen is a standard of care in locally advanced operable gastric and GEJ adenocarcinoma. We aimed to determine the efficacy, prognostic factors of perioperative FLOT chemotherapy in real-life gastric and GEJ tumors. Materials and methods: The data of patients who were treated with perioperative FLOT chemotherapy were retrospectively analyzed from 34 different oncology centers in Turkey. Baseline clinical and demographic characteristics, pretreatment laboratory values, histological and molecular characteristics were recorded. Results: A total of 441 patients were included in the study. The median of age our study population was 60 years. The majority of patients with radiological staging were cT3-4N(+) (89.9%, n = 338). After median 13.5 months (IQR: 8.5-20.5) follow-up, the median overall survival was NR (95% CI, NR to NR), and median disease free survival was 22.9 (95% CI, 18.6 to 27.3) months. The estimated overall survival at 24 months was 62%. Complete pathological response (pCR) and near pCR was achieved in 23.8% of all patients. Patients with lower NLR or PLR have significantly longer median OS (p = 0.007 and p = 0.033, respectively), and patients with lower NLR have significantly longer median DFS (p = 0.039), but PLR level did not affect DFS (p = 0.062). The OS and DFS of patients with better ECOG performance scores and those who could receive FLOT as adjuvant chemotherapy instead of other regimens were found to be better. NLR was found to be independent prognostic factor for OS in the multivariant analysis. At least one adverse event reported in 57.6% of the patients and grade 3-4 toxicity was seen in 23.6% patients. Conclusion: Real-life perioperative FLOT regimen in operable gastric and GEJ tumors showed similar oncologic outcomes compared to clinical trials. Better performance status, receiving adjuvant chemotherapy as same regimen, low grade and low NLR and PLR improved outcomes in real-life. However, in multivariate analysis, only NLR affected OS.Öğe The prognostic significance of the 18F-fluorodeoxyglucose positron emission tomography/computed tomography in early-stage nonsmall cell lung cancer(Wolters Kluwer Medknow Publications, 2020) Geredeli, Caglayan; Artac, Mehmet; Kocak, Ismail; Koral, Lokman; Sakin, Abdullah; Altinok, Tamer; Kaya, BugraContext: The prognostic criteria for early-stage nonsmall cell lung cancer (NSCLC) wait to be explored. Aim: In this study, our aim was to evaluate the prognostic significance of the positron emission tomography/computed tomography (PET/CT) maximum standardized uptake value (SUVmax) value of the primary tumor in patients with a diagnosis of early-stage NSCLC who received surgical treatment. Settings and Design: This was a multicenter retrospective design. Materials and Methods: Patients who had been diagnosed with early-stage NSCLC and who underwent surgery for the condition were included in this study. The preoperative fluorodeoxyglucose (18F-FDG) PET/CT results of the patients were retrospectively accessed from their medical files. The disease-free survival (DFS) rates of patients who had SUVmax values above and below the determined cutoff value were compared. Statistical Analysis Used: SPSS version 22 and Kaplan-Meier method were used for statistical analysis. Results: A total of 92 patients were included in the study. The median age of the patients was 60 years (range: 36-79). The determined cutoff SUVmax value of the primary tumor was 13.6. A comparison of the DFS rates of the patients with an SUVmax value above and below 13.6 revealed a significant difference in patients with Stage I (22.9 months vs. 50.3 months; P = 0.02) and Stage II (28 months vs. 40.4 months; P = 0.04), Stage I + II (43.5 months vs. 26.1 months; P = 0,02), and Stage IIIA (14.7 months vs. 13.6 months; P = 0.92) NSCLC. Conclusions: We found that in early-stage NSCLC patients, the SUVmax value of the primary mass in 18F FDG PET/CT was a prognostic indicator for the DFS rates.Öğe A rare cause of pleural effusion: adult onset Still's disease(2015) Demirbaş, Soner; Kutlu, Orkide; Kandemir, Bahar; Sakin, AbdullahAdult onset Stills disease is a rare systemic inflammatory disorder. At the onset of the disease sore throat, pharyngitis; which does not respond to antibiotics, one or two times peaking febrile episodes, marked salmoncolored rash on the trunk and extremities, arthralgia, arthritis, myalgia, fatigue, loss of appetite with nausea and weight loss; hepatosplenomegaly and lymphadenopathy can be seen. Among laboratory examinations levels of ferritin and other acute phase reactants distinctly rise, and neutrophilic leukocytosis; ANA and RF negativity are detected. Pleural and pericardial effusions, transient pulmonary infiltration, and rarely myocarditis can be seen during the course of the disease. Here we report a patient who was examined for fever of unknown origin and diagnosed with adult onset Stills disease which is a rare etiology of pleural effusion.Öğe Real life experience of patients with locally advanced gastric and gastroesophageal junction adenocarcinoma treated with neoadjuvant chemotherapy: a Turkish oncology group study(Taylor & Francis Ltd, 2023) Basoglu, Tugba; Sakin, Abdullah; Erol, Cihan; Ozden, Ercan; cabuk, Devrim; Cilbir, Ebru; Tataroglu ozyukseler, DenizNeoadjuvant chemotherapy (NACT) in gastroesophageal junction (GEJ) and gastric cancer (GC) was shown to improve survival in recent studies. We aimed to share our real-life experience of patients who received NACT to compare the efficacy and toxicity profile of different chemotherapy regimens in our country. This retrospective multicentre study included locally advanced GC and GEJ cancer patients who received NACT between 2007 and 2021. Relation between CT regimens and pathological evaluation were analysed. A total of 794 patients from 45 oncology centers in Turkey were included. Median age at the time of diagnosis was 60 (range: 18-86). Most frequent NACT regimens used were FLOT (65.4%), DCF (17.4%) and ECF (8.1%), respectively. In the total study group, pathological complete remission (pCR) rate was 7.2%, R0 resection rate 86.4%, and D2 dissection rate was 66.8%. Rate of pCR and near-CR (24%), and R0 resection (84%) were numerically higher in FLOT arm (p > 0.05). Patients who received FLOT had also higher chemotherapy-related toxicity rate compared to patients who received other regimens (p > 0.05). Median follow-up time was 16 months (range: 1-154 months). Estimated median overall survival (OS) was 58.4months (95% CI: 35.2-85.7) and disease-free survival (DFS) was 50.7 months (95% CI: 25.4-75.9). The highest 3-year estimated OS rate was also shown in FLOT arm (68%). We still do not know which NACT regimen is the best choice for daily practice. Clinicians should tailor treatment regimens according to patients' multifactorial status and comorbidities for to obtain best outcomes. Longer follow-up period needs to validate our results.Öğe The Real-Life Data of BRAF Mutation on the Treatment of Colorectal Cancer: a TOG Study(Springer, 2021) Beypinar, Ismail; Demir, Hacer; Sakin, Abdullah; Taskoylu, Burcu Yapar; Sakalar, Teoman; Ergun, Yakup; Korkmaz, MustafaPurpose Colorectal cancer is the third leading diagnosis accounting for nearly 10% of all new cancers worldwide. The distinct features among BRAF mutant colorectal cancers make these tumor groups hard to treat for oncologists. The median overall survival (OS) of these types of cancers is reported to be 9 to 14 months. Methods The study was declared on the Turkish Oncology Study Group Conference and approved. The patients' data was received from the centers who confirmed to participate. The BRAF-mutated patients were included in the study. The demographic features (age, gender, etc.), type of mutation, tumor localizations, histology, microsatellite instability (MSI) status, metastasis patterns chemotherapeutic agents and progression, and death times were recorded. Results Thirty-nine patients were enrolled in the study. Sixteen patients had concurrent KRAS mutations, while 7 had NRAS mutations. Most of the patients received doublet chemotherapies in combination with anti-VEGF agents in the first and second line of the treatment. There was a significant difference in OS according to the stage which showed a decreased survival in stage IV patients at the time of diagnosis. Concurrent KRAS mutation resulted in increased OS. The median OS was 47 and 24 months favoring the KRAS mutant group. The patients whose primary tumor operated had better survival when compared with other patients. The median OS of the operated group was 47 months, while the non-operated group was 24 months. Liver metastasis was related to worse prognosis at the time of diagnosis in univariate analysis. Conclusion In our study we found a high concurrent RAS mutation ratio in a BRAF mutant patient group which was different from prior studies. The concurrent mutations resulted in a favorable outcome in terms of OS which is also different from the current knowledge. More prospective studies are needed especially BRAF-mutated patient population and especially with concurrent RAS mutations.Öğe Tracheobronchial Amiloidosis(Aves, 2015) Demirbas, Soner; Kutlu, Orkide; Sakin, AbdullahLocalized pulmonary amyloidosis without systemic involvement differentiates as nodular parenchymal opacities, diffuse parenchymal opacities, or tracheobronchial amyloidosis (TBA). TBA is a condition mostly seen in males aged up to 50-60 years, accounting for approximately 1% of benign lesions in the tracheobronchial tree. TBA is characterized by the accumulation of the amyloid material comprising immunoglobulin light chain (AL), which are observed as submucosal plaques and/or polypoid tumors; progressive form of tracheobronchial amyloidosis can lead to airway obstruction. Repeated excisional treatments, mainly laser treatment is preferable to open surgery. Here, we have presented the case of a patient diagnosed with the rarely occurring localized TBA.
