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Öğe A logarithmic model for hormone receptor-positive and breast cancer patients treated with neoadjuvant chemotherapy(Assoc Medica Brasileira, 2023) Seber, Erdoğan Selçuk; İriağaç, Yakup; Çavdar, Eyyüp; Karaboyun, Kubilay; Avcı, Okan; Yolcu, Ahmet; Gürdal, Sibel Özkan; Öznur, MeltemOBJECTIVE: The aim of this study was to investigate the predictive importance of the previously validated log(ER)*log(PgR)/Ki-67 predictive model in a larger patient population.METHODS: Patients with hormone receptor positive/HER-2 negative and clinical node positive before chemotherapy were included. Log(ER)*log(PgR)/ Ki-67 values of the patients were determined, and the ideal cutoff value was calculated using a receiver operating characteristic curve analysis. It was analyzed with a logistic regression model along with other clinical and pathological characteristics.RESULTS: A total of 181 patients were included in the study. The ideal cutoff value for pathological response was 0.12 (area under the curve=0.585, p=0.032). In the univariate analysis, no statistical correlation was observed between luminal subtype (p=0.294), histological type (p=0.238), clinical t-stage (p=0.927), progesterone receptor level (p=0.261), Ki-67 cutoff value (p=0.425), and pathological complete response. There was a positive relationship between numerical increase in age and residual disease. As the grade of the patients increased, the probability of residual disease decreased. Patients with log(ER)*log(PgR)/Ki-67 above 0.12 had an approximately threefold increased risk of residual disease when compared to patients with 0.12 and below (odds ratio: 3.17, 95% confidence interval: 1.48-6.75, p=0.003). When age, grade, and logarithmic formula were assessed together, the logarithmic formula maintained its statistical significance (odds ratio: 2.47, 95% confidence interval: 1.07-5.69, p=0.034).CONCLUSION: In hormone receptor-positive breast cancer patients receiving neoadjuvant chemotherapy, the logarithmic model has been shown in a larger patient population to be an inexpensive, easy, and rapidly applicable predictive marker that can be used to predict response.Öğe CRP/ albumin ratio can be a predictor of response to neoadjuvant chemoradiotherapy (CRT) in rectal cancer(Oxford Univ Press, 2018) Yetişyiğit, Tarkan; Şeber, Erdoğan Selçuk; Yolcu, Ahmet[No Abstract Available]Öğe Efficacy of Neoadjuvant Chemotherapy in Lobular and Rare Subtypes of Breast Cancer(Coll Physicians & Surgeons Pakistan, 2024) Seber, Erdogan Selcuk; Iriagac, Yakup; Cavdar, Eyyup; Karaboyun, Kubilay; Avci, Okan; Yolcu, Ahmet; Gurdal, Sibel OzkanObjective: To determine the predictive factors for the pathological complete response (pCR) in patients with non-ductal invasive breast cancer (ND-BC) receiving neoadjuvant chemotherapy.Study Design: Observational study.Place and Duration of the Study: Departments of Medical Oncology, Tekirdag Namik Kemal University, Sirnak State Hospital, Aydin Adnan Menderes University, Marmara University, Bakirkoy Sadi Konuk Hospital, Basaksehir Cam and Sakura Hospital, Sakarya University, Balikesir Ataturk Hospital, Turkiye, from April 2016 to December 2022.Methodology: A total of 222 non-metastatic breast cancer patients who received neoadjuvant chemotherapy were included in this retrospective multicentric study. The clinicopathologic data were obtained from the hospitals' electronic-record-system. The logistic regression models were used to identify predictive factors for pCR.Results: One hundred and twenty-six patients (56.8%) had invasive lobular carcinoma and 28 patients (12.6%) had signet ring cell/mucinous carcinoma. A total of 45 patients (20.3%) achieved pCR. The pCR rate was 14.3% for lobular carcinoma and 17.9% for signet ring cell/mucinous carcinoma. The univariate analysis showed that estrogen receptor-negative tumours (p = 0.017), high Ki-67 (p = 0.008), high histologic grade (p<0.001), HER2+ expression (p<0.001), and non-lobular histologic type (p = 0.012) were predictive factors for pCR. The multivariate model revealed that HER2 expression (p<0.001) and Ki-67 (p = 0.005) were independent predictors.Conclusion: Neoadjuvant chemotherapy demonstrated effectiveness in ND-BC patients, leading to favourable pCR rates and enabling breast-conserving surgery. Predictive markers for pCR varied depending on histologic types, with HER2 expression, ER status, Ki-67, and histologic grade showing significance in non-ductal subtypes, while HER2 status alone was predictive in lobular carcinoma.Öğe Investigation of Serum Folate-Receptor-1 in Patients with Non- Small Cell Lung Cancer(Duzce Univ, Fac Medicine, 2022) Çelikkol, Aliye; Seber, Erdoğan Selçuk; Güzel, Savaş; Yolcu, Ahmet; Yetişyiğit, Tarkan; Yılmaz, AhsenObjective: Histopathological overexpression of folate receptor-1(FOLR1) involved in folate transport in cell growth has been reported in various cancers. Increased serum FOLR1 (sFOLR1) has also been reported in epithelial ovarian cancer. The aim was to investigate sFOLR1 levels in non-small cell lung cancer(NSCLC) patients and the response prediction of the standard chemotherapy targeting folic acid metabolism. Methods: In this prospective study, sFOLR1 levels were investigated in 30 healthy individuals and 60 patients with stage4 malign metastatic NSCLC before and after standard chemotherapy. The commercial immunoassay(ELISA) kit was used for the analysis of sFOLR1. Serum carcinoembryonic antigen(CEA), vitamin B12, and folate levels were also investigated. Results: In NSCLC patients sFOLR1 levels were significantly higher(p<0.001) than the healthy individuals. After 3 months of standard treatment, sFOLR1 was significantly lower than pre-treatment values in NSCLC patients(p<0.001). Diagnostic accuracy was strong in the differentiation of NSCLC patients from healthy individuals(AUC= 0.966). with the cut-off point of 82.45 pg/ml, the sFOLR1 level was performed with 95% sensitivity and 99% specificity. Pretreatment sFOLR1 levels were significantly lower in patients with-response to standard chemotherapy(p<0.01). The best predictive value was determined as 393.80 pg/ml. At the end of the 401 days, a significant difference was found in patients with high sFOLR1 predictive value. The median overall survival(OS) duration was 288 days for all patients (95% GA 198.13-377.87). Median progression-free survival(PFS) was 321 days(95% GA 211.90-430.10). Conclusions: For monitoring standard chemotherapy with drugs targeting folic acid metabolism, sFOLR-1 levels be an biomarker.Öğe Investigation of the Effect of Low-positive HER-2 on Neoadjuvant Chemotherapy Response in Hormone-positive Breast Cancer Patients(Galenos Publ House, 2023) Karaboyun, Kubilay; Oznur, Meltem; Yolcu, Ahmet; Iriagac, Yakup; Seber, SelcukObjective: Recently, it has been suggested that low-positive human epidermal growth factor receptor-2 (HER-2) is a separate group of breast cancer. We examined the effect of low-positive HER-2 on neoadjuvant chemotherapy (NACT). Methods: This retrospective study included female patients aged >18 years who were diagnosed with histologically proven breast cancer between January 1, 2016, and January 1, 2020, and had breast surgery after NACT. Patients with triple-negative, estrogen receptor (<10%) weak positive, HER-2 immunohistochemical (IHC) scores 3+ or 2+/FISH-positive patients, and metastatic patients were excluded. Pathological complete response (pCR) was defined as the no invasive and in situ residue in the breast and lymph nodes in surgery after NACT. Results: One hundred twenty seven patients were included in this study. HER-2 IHC-score 0 patients were 55 (43.3%), 1+ patients were 52 (40.9%), and 2+ patients were 20 (15.7%). Nine (7.1%) patients showed a complete response to NACT. In the univariate analysis with clinicopathological variables of the patients to predict the complete response to NACT; estrogen receptor [odds ratio (OR): 0.97, 95% confidence interval (CI): 0.96-0.99, p=0.012], Ki-67 (OR: 1.12, 95% CI: 1.06-1.18, p<0.001), tumor grade (OR: 0.036, 95% CI: 1.13-30.36, p=0.036), and lymphovascular invasion (OR: 0.11, 95% CI: 0.01-0.93, p=0.043) showed the predictive features. In the multivariate analysis, Ki-67 (OR: 1.10, 95% CI: 0.04-1.17, p=0.001) was found to be an independent predictor of pCR. Conclusion: We determined that the low-positive-HER2 group has no effect on the treatment response in patients treated with NACT. We found that Ki-67 was an independent predictive for pCR.Öğe Is the serum level of survivin, an antiapoptotic protein, a potential predictive and prognostic biomarker in metastatic pancreatic cancer?(Lippincott Williams & Wilkins, 2023) Demirci, Nebi Serkan; Cavdar, Eyyup; Erdem, Gokmen Umut; Hatipoglu, Engin; Celik, Emir; Sezer, Sevilay; Yolcu, AhmetIn the present study, we aimed to assess the association between the serum survivin level and overall survival and treatment response rates in metastatic pancreatic cancer (MPC). Serum samples were prospectively collected from 41 patients with newly diagnosed MPC patients and 41 healthy individuals (control group) to assess the survivin levels. The median survivin level was 136.2ng/mL in patients with MPC and 52ng/mL in healthy individuals (P = .028). Patients were divided into low- and high-survivin groups according to the baseline median survivin level. Patients with a high serum survivin level compared with a low serum survivin level had shorter median progression-free survival (2.39 vs 7.06 months; P = .008, respectively) and overall survival (3.74 vs 9.52 months; P = .026, respectively). Patients with higher serum survivin levels had significantly worse response rates (P = .007). The baseline high level of serum survivin in patients with MPC may be associated with treatment resistance and poor prognosis. A confirmation will be needed for these results in future large multicenter prospective studies.Öğe Metastatic Adenoid Cystic Carcinoma: Case Report(Galenos Publ House, 2024) Yolcu, Ahmet; Celik, Omer; Beyaz, Yuksel; Sen, LeylaAmong head and neck cancers, adenoid cystic carcinoma (ACC) has a separate place compared to other histological types. Our case report is about the follow-up of a patient with ACC originating from the left parotid gland, who applied to our clinic for about 10 years, after different treatments were applied in different centers.Öğe Mide Kanserinde Adjuvan Kemoradyoterapi: Tek Merkez Deneyimi(2020) Yolcu, Ahmet; Erkal, Haldun Şükrü; Serin, MeltemAmaç: ide kanseri için hastalarımızın postoperatif kemoradyoterapi sonuçlarını değerlendirmektir.Materyal ve Metot: Çalışma için mide adenokarsinoma tanısı konulmuş ve radyoterapi uygulanması amacı ile Eylül 2004 ile Mart 2009 tarihleri arasında İnönü Üniversitesi Tıp Fakültesi Radyasyon Onkolojisi Kliniği’ne başvuran, 165 hastanın tıbbi kayıtları retrospektif olarak değerlendirildi, Kemoradyoterapi için uygunluk kriterleri, İntergroup 0116 çalışması ile benzerdi.Bulgular: 117 küratif amaçlı cerrahi yapılmış hasta çalışmaya dahil edildi, 48 metastatik hasta çalışmadan çıkarıldı.Seksen üç hasta (%71) erkek, 34 hasta (%29) kadındı. Yaşları 31-78 arasında değişiyordu (ortanca, 58 yaş). Sekiz hastada (%7) cerrahi sonrası mikroskopik hastalık vardı. Medyan takip süresi 18 aydı (4 ila 89 ay arasında). Doksan beş hasta (%81) planlanan kemoterapi döngülerini, 112 hasta (%96) radyoterapiyi, 92 hasta (%79) kemoradyoterapiyi tamamladı. 117 hastanın 53'ü (%45) tekrarladı ve bunların 46'sı öldü. Relapsların çoğu (41 hasta, %35) sadece uzak bölgelerde meydana gelmiştir. Bölgesel nüks gelişen 14 hasta için sadece ikisinde izole bölgesel nüks vardı. Genel sağkalım 2 yılda%59 ve 5 yılda%34 iken, hastalıksız sağkalım 2 yılda%58 ve 5 yılda%35 idi.Hastalıksız sağkalıma etkili faktörler yaş grubu,performans skoru, seroza ve lenf nodu tutulumu, hastalık evresi, yerleşimi, metastatik lenf nodu oranı ve adjuvankemoterapi programını tamamlaması olarak bulundu.Sonuç: Bulgularımız küratif cerrahi rezeksiyon ile adjuvan kemoradyoterapinin mide kanserinin lokal tedavisinde ılımlı toksisite ile oldukça etkin olduğunu, sistemik hastalığın kontrol altına alınması için daha etkin sistemik tedaviler konusunda araştırmalara gereksinim olduğunu işaret etmektedir.Öğe nvestigation of Serum Folate-Receptor-1 in Patients with Non- Small Cell Lung Cancer(2022) Şeber, Erdoğan Selçuk; Yetişyiğit, Tarkan; Yolcu, Ahmet; Çelikkol, Aliye; Güzel, Savaş; Yılmaz, AhsenObjective: Histopathological overexpression of folate receptor-1(FOLR1) involved in folate transport in cell growth has been reported in various cancers. Increased serum FOLR1 (sFOLR1) has also been reported in epithelial ovarian cancer. The aim was to investigate sFOLR1 levels in non-small cell lung cancer(NSCLC) patients and the response prediction of the standard chemotherapy targeting folic acid metabolism. Methods: In this prospective study, sFOLR1 levels were investigated in 30 healthy individuals and 60 patients with stage4 malign metastatic NSCLC before and after standard chemotherapy. The commercial immunoassay(ELISA) kit was used for the analysis of sFOLR1. Serum carcinoembryonic antigen(CEA), vitamin B12, and folate levels were also investigated. Results: In NSCLC patients sFOLR1 levels were significantly higher(p<0.001) than the healthy individuals. After 3 months of standard treatment, sFOLR1 was significantly lower than pre-treatment values in NSCLC patients(p<0.001). Diagnostic accuracy was strong in the differentiation of NSCLC patients from healthy individuals(AUC= 0.966). with the cut-off point of 82.45 pg/ml, the sFOLR1 level was performed with 95% sensitivity and 99% specificity. Pretreatment sFOLR1 levels were significantly lower in patients with-response to standard chemotherapy(p<0.01). The best predictive value was determined as 393.80 pg/ml. At the end of the 401 days, a significant difference was found in patients with high sFOLR1 predictive value. The median overall survival(OS) duration was 288 days for all patients (95% GA 198.13-377.87). Median progression-free survival(PFS) was 321 days(95% GA 211.90-430.10). Conclusions: For monitoring standard chemotherapy with drugs targeting folic acid metabolism, sFOLR-1 levels may be an important biomarkÖğe Prognostic factors influencing regorafenib treatment outcomes in metastatic colorectal cancer(2023) Karaboyun, Kubilay; Yolcu, AhmetAim: We aimed to determine the efficacy and prognostic factors of Regorafenib in advanced colorectal cancer patients. Materials and Methods: This study was designed as single-center and retrospective. The study included 72 patients with metastatic colorectal cancer treated with Regorafenib. Univariate and multivariate analyses of factors affecting survival were generated by Cox Regression Models. Results: Twenty-three (31.9%) of the patients were female, the median age was 65 years. The median progression-free survival (PFS) and overall survival (OS) were 4.13 and 8.7 months, respectively. The carcinoembryonic antigen (CEA) level (p=0.001), and Eastern Cooperative Oncology Group (ECOG) score (p<0.001) were found to be prognostic in the multivariate model for PFS. ECOG (p<0.001), CEA level (p<0.001), dose reduction (p=0.003), and side of the primary tumor (p=0.037) were prognostic for OS. Conclusion: Our study revealed that ECOG, requiring dose reduction during the treatment, and lower baseline CEA levels were found to be prognostic.Öğe Radiosurgery effects and adverse effects in symptomatic eloquent brain-located Cavernomas(Oxford Univ Press, 2022) Berber, Tanju; Çelik, Suat Erol; Aksaray, Ferdi; Yöney, Adnan; Harmancı, Kemal; Tambas, Makbule; Yıldırım, Berna Akkuş; Yolcu, AhmetIn this study, the dose schedule efficacy, safety and late adverse effects of stereotactic radiosurgery (SRS) were evaluated for patients with symptomatic cavernomas who were not eligible for surgery and treated with SRS. Between January 2013 and December 2018, 53 patients with cavernomas were treated using SRS with the CyberKnife (R) system. Patients' diseases were deeply located or were in subcortical functional brain regions. In addition to bleeding, 23 (43.4%) patients had epilepsy, 12 (22.6%) had neurologic symptoms and 16 patients (30.2%) had severe headaches. The median volume was 741 (range, 421-1351) mm(3), and the median dose was 15 (range, 14-16) Gy in one fraction. After treatment, six (50%) of 12 patients with neurologic deficits still had deficits. Rebleeding after treatment developed in only two (3.8%) patients. The drug was completely stopped in 14 (60.9%) out of 23 patients who received epilepsy treatment, and the dose of levetiracetam decreased from 2000 mg to 1000 mg in four (17.3%) of nine patients. Radiologically, complete response (CR) was observed in 13 (24.5%) patients, and partial responses (PR) were observed in 32 (60.2%) patients. Clinical response of CR was observed in 30 (56.6%) patients, PR was observed in 16 (30.2%), stable disease (SD) was observed in three (5.7%) and four (7.5%) patients progressed. In conclusion, SRS applied in the appropriate dose schedule may be an effective and reliable method in terms of symptom control and prevention of rebleeding, especially in patients with inoperable cavernomas.Öğe Yaygın Evre Küçük Hücreli Akciğer Kanserinde Lenfosit/Monosit Oranının Prognostik Önemi(2022) Çavdar, Eyyüp; Yolcu, Ahmet; İriağaç, YakupAmaç: Küçük Hücreli akciğer kanseri (KHAK)kemoterapiye duyarlı ancak kötü prognozu olan bir akciğer kanseri türüdür. Bu çalışmamızda lenfosit/monosit oranının ile birlikte diğer klinik ve laboratuvar parametrelerinin prognostik önemini araştırmayı amaçladık.Araçlar ve Yöntem: Bu çalışmamızda retrospektif olarak Ocak 2014 ile Aralık 2019 tarihleri arasında KHAK tanısı almış ve yaygın evrede olan 146 hastanın tıbbi kayıtları incelendi. Kemoterapi öncesi alınan kan tetkiklerinden lenfosit/monosit oranı (LMO) hesaplandı.Bulgular: Çalışmaya alınan hastalarda medyan genel sağ kalım süresi 8.78 (aralık 1.07-54.80) ay, progresyonsuz sağ kalım süresi (PSK) 5.6 (1.07–44.03) ay olarak bulundu. Tüm hastaların kohort analizinde, LMO düşük grupta medyan PSK 4.5 ay, genel sağ kalım süresi (GSK) 7.5 ay olup, LMO yüksek grupta medyan PSK 6.5 ay, GSK 10.1 ay olarak saptandı. Tek değişkenli analiz ile incelendiğinde LMO yüksek olan hastaların düşük olan hastalara göre genel sağ kalım süreleri de daha uzundu (HR 0.591 %95 CI 0.42-0.83 p=0.003). Çok değişkenli analiz ile incelendiğinde ise LMO yüksekliği sağ kalım için iyi prognostik göstergelerden biri olma özelliğini devam ettiriyordu (HR: 0.54 %95 CI 0.38-0.77. p=0.001)Sonuç: Yüksek LMO, yaygın evre küçük hücreli akciğer kanseri hastalarında uzunPSK ve GSK’yı gösteren bağımsız bir prognostik parametre olabileceği kanıtlandı.
