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Öğe A new predictive marker for predicting response after neoadjuvant chemotherapy in hormone receptor positive/HER2-negative patients: a logarithmic model(Zerbinis Publications, 2021) İriağaç, Yakup; Çavdar, Eyyüp; Karaboyun, Kubilay; Tacar, Seher Yıldız; Taskaynatan, H.; Avcı, Okan; Seber, Erdoğan Selcuk; Yolcu, A.; Gürdal, Sibel Özkan; Öznur, M.; Seber, E.S.Purpose: Estrogen receptor (ER) and progesterone receptor (PgR) levels as well as Ki-67 expression levels are independent predictive markers in patients with hormone receptor-positive breast cancer. In this study, we investigated the predictive significance of the formula of log (ER)*log (PgR)/Ki-67, which was created using 3 independent predictive markers, for the pathological complete response of the Hormone Receptor (HR)-positive/HER2-negative breast cancer patients receiving neoadjuvant chemotherapy (NACT). Methods: This retrospective study included 126 patients with HR-positive/HER2-negative breast cancer and axillary lymph node metastasis who received NACT. The log (ER)*log (PgR)/Ki-67 value was calculated from the pre-NACT pathological evaluation results in all patients. We determined the ideal predictive cut-off value, which separates patients into 2 groups according to pathological complete response (pCR) and pathological non-complete response (non-pCR), using Receiver Operating Characteristic (ROC) curve analysis. According to this cut-off point, patients were divided into 2 groups as cut-off ratio high and cut-off ratio low and were compared using logistic regression analysis along with clinicopathological features. Results: According to the predictive model, we estimated the ideal cut-off value that distinguishes patients as pCR and non-pCR to be 0.12 (p=0.015). According to this cut off value, %54.8 of the patients were categorized as cut-off value high and %46.2 were cut-off value low. The non-pCR rates of the groups were 91.3% and %71.9, respectively(p=0.004). A cutoff value of 0.12 provided the feature of being a predictive marker in the univariate analysis for distinguishing between pCR and non-pCR (OR=4.09 95% CI 1.48-11.33, p=0.007), and it preserved this feature in the multivariate analysis. (OR=3.27, 95% CI 1.12-9.56, p=0.030). Conclusion: The formula of log (ER)*log (PgR)/Ki-67 can be used as a simple and easy-to-use predictive marker for response to neoadjuvant therapy in patients with HR-positive/HER2-negative breast cancer receiving NACT. © 2021 Zerbinis Publications. All rights reserved.Öğe Breast cancer in young and very young women; Is age related to outcome?(Wolters Kluwer Medknow Publications, 2021) Avcı, Okan; Tacar, Seher Yıldız; Seber, Erdoğan Selcuk; Yetişyiğit, TarkanBackground: Breast cancer in young women is associated with aggressive biology. We analyzed histopathological and clinical properties of breast cancer patients diagnosed at <= 40 years of age. Methods: Breast cancer patients who were admitted between 2015 and 2019 were included. Baseline characteristics of the patients with treatment-related outcomes were assessed. The study group was divided into two subgroups; <35 years old as very young and >= 35 years old as young. Results: The data of 137 patients (60 patients <35 years) were reviewed. The mean age was 34.7 years. The mean follow-up duration was 44.45 +/- 26.39 months, and the mean disease-free survival was 36.17 +/- 21.97 months. 11.4% of the patients were diagnosed with Stage 4 disease. Pathologic subtype was invasive ductal carcinoma in 86% of patients. 16.8% of the patients were luminal A, 38.7% luminal B, 30.5% were human epidermal growth factor receptor-2-positive type, and 15.3% were triple-negative. Only 5 (3.3%) patients had given birth after chemotherapy. During the follow-up period of early-staged diagnosed patients, metastatic disease occurred in 24.6%. The rate of distant metastasis development was statistically higher in the very young group (31% vs. 11%; P = 0.004). Thirteen patients (10.7%) died due to disease progression. Thirty-seven percent of the patients had a positive family history for either breast or ovarian cancer. Conclusions: Very young breast cancer patients seem to have a more aggressive disease course. The low rate of childbearing in this young patient population is conspicuous. An interdisciplinary approach for the management of this special patient population should be taken into consideration.Öğe Mindfulness Among Medical Oncology Doctors and Its Relation With Burnout: Turkish Oncology Group (TOG) Study(Lippincott Williams & Wilkins, 2021) Avcı, Okan; İriağaç, Yakup; Çavdar, Eyyüp; Seber, Erdoğan SelcukPURPOSE: Medical oncology physicians have been identified as one of the main risk groups for the development of burnout. Mindfulness as being aware of the moment nonjudgmentally seems to be a protective factor against burnout. We aimed to reveal mindfulness levels among medical oncology doctors and the potential impact of mindfulness on burnout syndrome. METHODS: In this cross-sectional study, the data of 285 medical oncology doctors were analyzed. The Mindful Attention Awareness Scale was used for mindfulness evaluation, and the Maslach Burnout Inventory was used for burnout assessment. After defining mindfulness levels among medical oncology doctors, the relationship between mindfulness and burnout was analyzed by the Pearson correlation and bivariate logistic regression tests. RESULTS: The mean Mindful Attention Awareness Scale score of participants was 54.52 +/- 13.77. Mindfulness was associated with age (P < .001), having a hobby (P = .008), regular exercise (P = .001), professional title (P = .02), and professional experience (P = .02). As the level of mindfulness increased, emotional exhaustion and depersonalization decreased, whereas personal accomplishment increased significantly (all P < .001). In the regression analysis, mindfulness was significantly associated with all three subscales of burnout (all P < .01). CONCLUSION: We have demonstrated for the first time on such a large scale that higher levels of mindfulness were related with lower burnout among medical oncology physicians. These findings suggest the potential benefits of mindfulness-based interventions in reducing burnout levels in medical oncologists.Öğe Protective effects of onion (Allium cepa) extract against doxorubicin-induced hepatotoxicity in rats(Sage Publications Inc, 2016) Mete, Rafet; Oran, Mustafa; Topçu, Birol; Öznur, Meltem; Seber, Erdoğan Selcuk; Gedikbaşı, Asuman; Yetişyiğit, TarkanBackground/aim: Doxorubicin (DOX) is a widely used and potent chemotherapeutic agent. However, serious dose-limiting toxicity through generation of free oxygen radicals is a commonly encountered clinical problem. The aim of the current study was to assess the protective role of onion (Allium cepa) extract (ACE) against DOX-induced hepatotoxicity in rats. Method: A total of 24 rats were randomly divided into 3 equal experimental groups: (1) DOX; (2) ACE + DOX; and (3) control groups. ACE was given orally as 1 mL of fresh ACE juice for 14 consecutive days followed by DOX injection. DOX was injected intraperitoneally in a single dose of 30 mg/kg body weight to induce hepatotoxicity, and the rats were killed after 48 h from injection. Control group was given saline only. Results: In the ACE pretreated group (ACE + DOX), serum aspartate transaminase, alanine transaminase, and tissue malondialdehyde and glutathione levels were significantly lower, while superoxide dismutase and glutathione peroxidase were higher compared with the DOX group. The histopathological examination of liver specimens revealed parenchymal necrosis, proliferation of biliary duct in DOX group; while ACE pretreatment provided marked reduction in these changes. Conclusion: Our study indicates that pretreatment with ACE protects against DOX-induced hepatotoxicity due to the antioxidant properties of ACE. Further studies on efficacy of antioxidant treatment by ACE in DOX-mediated toxicity and underlying mechanisms would provide a better explanation.
