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Civelek B.,Kirikkale University | Aksoy S.,Hacettepe University | Sendur M.A.N.,Ankara Numune Education and Research Hospital | Yazici O.,Ankara Numune Education and Research Hospital | And 5 more authors.
Journal of B.U.ON. | Year: 2014

Purpose: To evaluate the clinicopathological characteristics and the outcomes of adjuvant chemotherapy of patients with colorectal cancer aged ≥65 years. Methods: Between March 2003 and December 2010, the medical files of 562 colorectal cancer patients ≥65 years of age who were under follow-up in Ankara Numune Educational Hospital, Department of Medical Oncology, were retrospectively analyzed. Only 210 patients with non-metastatic disease at the time of diagnosis and those who had undergone surgical resection were included in the study. Results: The patient median age was 71 years (range 65-87). Of the patients, 115 (54.8%) were males and 95 (45.2%) females. The most common involvement site was the rectum (41.4%), followed by sigmoid colon (21.9%). According to the TNM staging, 12.4% patients had stage I, 48.6% stage 11, and 39% stage 111 disease. At the time of diagnosis 19 patients (9%) had ECOG PS 0, 112 (53.3%) ECOG PS 1, 61 (29%) ECOG PS 2, and 16 (7.7%) ECOG PS 3. Of the patients, 141 (66.5%) were administered adjuvant chemotherapy, whereas 69 patients (33%) were not. Thirty nine (18.6%) patients with adjuvant chemotherapy received fluorouracil/folinic acid (FUFA) weekly, 59 (28%) received FUFA infusion, and 43 (21%) received oxaliplatin, folinic acid and 5-fluorouracil (FOLFOX-4) regimen. The median follow-up was 27 months (range 1-116). Disease free survival (DFS) was not reached during the follow-up period. The estimated overall survival (OS) was 68.8 months (range 48.5-73.0). Sixty six (31%) patients died during follow-up. Conclusion: Elderly patients with high risk for recurrence of colorectal cancer must receive adjuvant chemotherapy after curative surgery. Infusional FUFA seems more effective than other regimens. Source

Odabas H.,Kartal Dr Lutfi Kirdar Education And Research Hospital | Ulas A.,Abdurrahman Yurtaslan Oncology Hospital | Aydin K.,Kartal Dr Lutfi Kirdar Education And Research Hospital | Inanc M.,Erciyes University | And 13 more authors.
Tumor Biology | Year: 2015

Patients with advanced non-small cell lung cancer (NSCLC) generally require second-line treatment although their prognosis is poor. In this multicenter study, we aimed to detect the characteristics related to patients and disease that can predict the response to second-line treatments in advanced NSCLC. Data of 904 patients who have progressed after receiving first-line platinum-based chemotherapy in 11 centers with the diagnosis of stage IIIB and IV NSCLC and who were evaluated for second-line treatment were retrospectively analyzed. The role of different factors in determining the benefit of second-line treatment was analyzed. Median age of patients was 57 years (range 19–86). Docetaxel was the most commonly used (20.9 %, n = 189) single agent, while gemcitabine–platinum was the most commonly used (6.7 %, n = 61) combination chemotherapy regimen in second-line setting. According to survival analysis, median progression-free survival after first-line treatment (PFS2) was 3.5 months (standard error (SE) 0.2; 95 % confidence interval (CI), 3.2–3.9), median overall survival (OS) was 6.7 months (SE 0.3; 95 % CI, 6.0–7.3). In multivariate analysis, independent factors affecting PFS2 were found to be hemoglobin (Hb) level over 12 g/dl and treatment-free interval (TFI) longer than 3 months (p = 0.006 and 0.003, respectively). Similarly, in OS analysis, Hb level over 12 g/dl and time elapsed after the first-line treatment that is longer than 3 months were found to be independent prognostic factors (p = 0.0001 and 0.045, respectively). In light of these findings, determining and using the parameters for which the treatment will be beneficial prior to second-line treatment can increase success rate. © 2015, International Society of Oncology and BioMarkers (ISOBM). Source

Yalcin S.,Hacettepe University | Gumus M.,Kartal Training and Research Hospital | Kilickap S.,Hacettepe University | Alkis N.,Abdurrahman Yurtaslan Oncology Hospital | And 7 more authors.
Journal of B.U.ON. | Year: 2014

Purpose: Registry of Gastric Cancer Treatment Evaluation (REGATE) study was an international, prospective study including over 10000 patients from 22 countries, designed to describe the pattern of care in gastric cancer globally. The aim of this study was to summarize the data of the Turkish arm and compare them with the global results. Methods: Ten centers from Turkey took part in the REGATE registry. Between 2004 and 2008, 395 patients (median age, 60 years; range, 18-91, 67.6% men) with newly diagnosed primary adenocarcinoma of the stomach were followed at initial visit and 8-10 months later, at the time of treatment completion. Data on patient demographics, medical history, histopathology, cancer stage, planned and realized treatments was prospectively collected. Data processing and analysis were conducted centrally. Results: In Turkey, the majority of patients were diagnosed at an advanced stage, while the rate of surgery was lesser compared with the rest of the world. Realized treatment included more palliative-only therapy than initially planned (63.3%), while no therapy was recommended in 21.8%. Surgery involved total gastrectomy (46.3%) or distal subtotal gastrectomy (51.9%), with 87% R0 resection, 51.0% D1 and 44.9% D2 lymph node dissection. Combination chemotherapy was administered in more than half of the patients receiving palliative therapy (57.9%). Chemoradiotherapy was used in 66.7% of the cases receiving adjuvant therapy. Radiotherapy was applied to 32% of the cases receiving palliative therapy. Conclusion: Advanced stage gastric cancer is highly prevalent in Turkey. Increasing public awareness and implementing screening programs in high risk groups may help identify gastric cancer at earlier stages. Source

Akinci M.B.,Ankara Numune Educational Hospital | Aigin E.,Gazi University | Inal A.,Dicle University | Odabas H.,Ankara Numune Educational Hospital | And 8 more authors.
Journal of B.U.ON. | Year: 2013

Purpose: Anthracydines and taxanes are the most active agents in the adjuvant treatment of breast cancer (BC). They can be used simultaneously or sequentially. The optimal schedule and duration for their administration is unknown. We analyzed the efficacy of sequential adjuvant anthracydine and docetaxel administration in node positive BC patients. Methods: Node positive BC patients (N=539) from 6 medical oncology centers in Turkey who received sequential adjuvant anthracycline-based regimens and taxane chemotherapy were included in this study between 2006-2010. One-hundred and thirty-eight (25%) patients received 3 cycles of anthracycline-based chemotherapy followed by 3 cycles of docetaxel (3+3) and 401 (75%) patients received 4 cycles of anthracydine -based chemotherapy followed by 4 cycles of docetaxel (4+4). Prognostic factors analyzed were estrogen receptor (ER), progesterone receptor (PR), HER2, tumor grade, and nodal status in relation to disease free survival (DFS) and HER2 status in relation to overall survival (OS). Results: The patient median age was 48 years (range 18-79). Most common grade 3-4 toxicities were neutropenia, mucositis and arthralgia. No treatment-related toxic deaths were seen. With a median follow up of 26 months (range 1-115) 61 (11.3%) recurrences and 11 (2%) deaths were registered. Three-year DFS was 81% and OS 96% for all patients. There was no statistically significant difference between 3+3 and 4+4 groups in terms of survival (3-year DFS 88% and 79% [p=0.28] and OS 97% and 95% [p=0.60], respectively). Conclusion: Sequential chemotherapy with 4+4 cycles of anthracydine and docetaxel every 3 weeks is an acceptable regimen for adjuvant treatment of node positive BC patients. Duration of chemotherapy should be planned depending on prognostic factors. In this study there was no difference between 3+3 and 4+4 groups in DFS and OS despite the presence of good prognostic factors in the 3+3 group. Source

Abali H.,Acibadem University | Celik I.,Hacettepe University | Karaca B.,Ege University | Turna H.,Istanbul University | And 21 more authors.
Journal of B.U.ON. | Year: 2015

Purpose: To develop a large Turkish National Melanoma registry in order to define demographic and clinicopathologic characteristics of patients with melanoma. Methods: The data was collected from 1635 patients with melanoma through a web-based registry system in 22 centers. Herein we present the results of 1157 patients with cutaneous melanoma. Results: The patient median age was 56.4 years and 646 (55.8%) were males. The commonest subtype was superficial spreading type (357, 30.9%). The commonest primary site was the lower extremities (N=353, 30.5%). The most common Breslow thickness was 1-2 mm (361 patients, 43.5%). Only 104 (12.5%) patients had a thickness Source

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