Comert E.,Ankara Oncology Education and Research Hospital |
Tuncel U.,Ankara Oncology Education and Research Hospital |
Dizman A.,Ankara Oncology Education and Research Hospital |
Yukselen Guney Y.,Ankara Oncology Education and Research Hospital
Otolaryngology - Head and Neck Surgery (United States) | Year: 2014
Objective. To evaluate the oncologic results of transoral endolaryngeal microscopic diode laser surgery (MDLS) and radiotherapy (RT) for T1 and T2 glottic carcinoma. Study Design. Case series with planned chart review. Setting. Ankara Oncology Education and Research Hospital. Subjects and Methods. The study was conducted on a series of 140 cases of early glottic carcinoma (T1, T2) treated with MDLS or RT. The tumors were defined according to T stage and the involvement of the anterior commissure (AC). Results. The 3-year locoregional control rate of MDLS and RT groups was 93.1% and 89.7%, respectively (P = .434). There was no difference in 3-year disease-free survival when comparing T1 and T2 tumors treated with MDLS and those treated with RT (P = .618 for T1, P = .084 for T2). There was no difference in disease-free survival when comparing AC- and AC+ tumors treated with MDLS and those treated with RT (P = .291 for AC- and P = .530 for AC+ tumors). Conclusions. Microscopic diode laser surgery in early glottic cancer seems to be an oncologically safe procedure that has similar oncological results with RT. In T2 glottic tumors and AC involvement, the results with either treatment are less satisfactory. © American Academy of Otolaryngology-Head and Neck Surgery Foundation 2014.
Turanli S.,Ankara Oncology Education and Research Hospital
Langenbeck's Archives of Surgery | Year: 2012
Background and aims: To investigate whether isolated bone metastases at the time of diagnosis is a different entity than bone metastases after breast cancer surgery. Patients and methods: One hundred thirty-nine patients were examined between June 2004 and January 2007. These patients were classified into synchronous (group I) and metachronous groups (group II) depending on time to development of bone metastases. Patients and tumor characteristics, treatment, clinical progression, and survival were compared for each group. Results: There were 44 patients in group I and 95 patients in group II. The median follow-up time was 36 months. The two groups showed similar results when patients, tumor characteristics, and clinical progression were compared. In the groups, the median time to progression was 14 vs 13 months (p∈=∈0.70), and median overall survival was 47 vs 46 months (p = 0.96), respectively. Conclusion: Development time of bone metastasis has no effect on clinical progression, time to progression, and overall survival in breast cancer. © 2009 Springer-Verlag.
Kuru B.,Ondokuz Mayis University |
Gulcelik N.E.,Hacettepe University |
Gulcelik M.A.,Urankent sitesi E 3 blok |
Gulcelik M.A.,Ankara Oncology Education and Research Hospital |
Dincer H.,Ankara Oncology Education and Research Hospital
Langenbeck's Archives of Surgery | Year: 2010
fine-needle aspiration cytology (FNAC) for diagnosing thyroid carcinoma in thyroid nodules < 4 cm versus ≥4 cm. Materials and methods Six hundred sixty-two patients with thyroid nodules who underwent FNAC and surgery at our institution were analyzed. The association of predictive factors with thyroid carcinoma was evaluated. The sensitivity, specificity, and the false-negative rate of FNAC were calculated. Results The incidence of thyroid carcinoma was significantly higher in nodules ≥4 cm (24%) compared with nodules <4 cm (12%). The false-negative rates of FNAC were 2% in all nodules and 1.3% and 4.3% in nodules <4 cm and ≥4 cm (p=0.9), respectively. Sensitivity and specificity of FNAC were 90% and 79%, respectively. Conclusions The false-negative rate of FNAC is low for thyroid nodules <4 cm and for nodules ≥4 cm. © Springer-Verlag 2009.
Kayaalti Z.,Ankara University |
Sahiner L.,Ankara Oncology Education and Research Hospital |
Durakoglugil M.E.,Ankara Oncology Education and Research Hospital |
Soylemezoglu T.,Ankara University
Archives of Gerontology and Geriatrics | Year: 2011
Aging is determined as the product of an interaction among genetic, environmental and lifestyle factors. As interleukin-6 (IL-6) and metallothioneins (MTs) are related to inflammation and oxidative stress response, their genes are appropriate candidate for aging, age related diseases and infections. The aim of this study was to investigate the association between the IL-6 -174 G/C promoter region and MT2A -5 A/G core promoter region single nucleotide polymorphisms (SNPs) with longevity in Turkish population. Blood samples were collected from 354 individuals between 18 and 95 years of age. Individuals were classified into four groups according to their ages as 20-40, 41-60, 61-80, >80. IL-6 and MT2A polymorphisms were genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Mean ages of individuals with IL-6 -74 C - carriers and C + carriers were 49.82±20.45 years and 59.82±16.82 years, respectively. For the MT2A polymorphism, mean ages were estimated as 56.18±19.50 years for G - carriers and 47.59±13.45 years for G + carriers. As a result, when the IL-6 and MT2A polymorphisms were compared with the mean ages and age groups, statistically significant associations were found (p<0.001 and p<0.05, respectively). In conclusion, these data support that the IL-6 -174 C + carriers and MT2A -5 G - carriers may be more advantageous for longevity. © 2011 Elsevier Ireland Ltd.
Onal I.K.,Ankara Oncology Education and Research Hospital
Scandinavian Journal of Gastroenterology | Year: 2014
There are several causes for folate deficiency in Crohn's disease: malnutrition, malabsorption, excess folate utilization and medications. A combination of these factors may be responsible for the deficiency of this vitamin in some cases. © Informa Healthcare.
Turanli S.,Ankara Oncology Education and Research Hospital |
Aslan S.,Ankara Oncology Education and Research Hospital |
Cetin A.,Ankara Oncology Education and Research Hospital
American Journal of Otolaryngology - Head and Neck Medicine and Surgery | Year: 2011
Purpose: Total or near-total thyroidectomy is advocated in reducing the recurrence rate and improving survival in differentiated thyroid carcinoma. However, this potential benefit could be seen in all patient groups or only in the patients who have multifocal disease. We analyzed the clinical significance of occult multifocal disease in patients with completion thyroidectomy. Patients and methods: Ninety-seven patients in whom the completion thyroidectomy was performed within 6 months were included. The patients were grouped according to whether they have malignancy in the remnant thyroid tissue. The groups were examined and compared according to patients and tumor characteristics. The effect of the presence of residual tumor in remnant thyroid tissue on clinical course, disease-free survival, and overall survival were evaluated as well. Results: After completion thyroidectomy, 20 (20.6%) of the 97 patients revealed additional cancer focus in the residual tissue. Median follow-up period was 104 months (range, 84-205 months). Only tumor multifocality in the resected lobe after first surgery was predictive of the presence of malignancy in the thyroid remnant (P =.002; relative risk, 4.9; 95% confidence interval, 1.7-14.5). Detection of malignancy in the remnant thyroid tissue did not affect the disease-free survival (P =.39). There were no deaths in patients who underwent reoperative thyroid surgery. Conclusions: Only tumor multifocality in the original thyroid lobe was predictive of finding additional cancer in the contralateral lobe. However, clinical significance of occult multifocal disease was not shown. © 2011 Elsevier Inc.
Turanli S.,Ankara Oncology Education and Research Hospital
Indian Journal of Surgery | Year: 2010
Purpose: Surgery for gastric cancer with synchronous liver metastasis is applied for palliation. The aim was to determine whether surgical removal of the primary tumor provides a better survival and disease progression Methods: Sixty-two patients are classified according to the primary tumor were removed or not. Patients and tumor characteristics, removal of the primary tumor are examined as the factors that were affecting overall survival and metastatic progression-free survival. Results: The mean follow-up time was 243±23 days. The mean survival of the resection and nonresection groups were 422±50 and 170±16 days (p = 0.0001), respectively. After adjustment for other covariates, resection was associated with a trend toward improvement in overall survival (p = 0.003; relative risk RR: 0.34; 95% confidence interval (CI): 0.17-0.66) and improvement in metastatic progression-free survival (p = 0.07, RR = 0.51; 95% CI: 0. 25-1.07). Conclusions: Excision of the primary tumor has an effect on metastatic progression-free survival and overall survival. © 2010 Association of Surgeons of India.
Tuncel U.,Ankara Oncology Education and Research Hospital |
Comert E.,Ankara Oncology Education and Research Hospital
Otolaryngology - Head and Neck Surgery (United States) | Year: 2013
Objective. To analyze the complications and preliminary oncologic results of microscopic diode laser surgery. Study Design. Prospective research. Setting. Ankara Oncology Education and Research Hospital. Subjects and Methods. This prospective study was conducted on a series of 64 patients with glottic carcinoma (Tis, T1, T2) treated with microscopic endolaryngeal diode laser surgery. Results. Four patients had local recurrence (6.2%). Local control and larynx preservation rates were 93.8% and 100%, respectively, for all groups of patients. Two-year disease-free survival after primary surgery was 100% for the Tis group, 96.4% for the T1 group, and 89.7% for the T2 group. When considering anterior commissure involvement, 2-year disease-free survival after primary surgery was 100% for the AC0 group, 85.7% for the AC1 group, and 85.7% for the AC2 group. Conclusion. Our study of microscopic diode laser resection of Tis, T1, and T2 glottic tumors showed similar oncologic results to previous reports about CO2 laser surgery. In anterior commissure tumors, both techniques had high complication and recurrence rates. © 2013 American Academy of Otolaryngology - Head and Neck Surgery Foundation.
Cetinkaya K.,Ankara Oncology Education and Research Hospital |
Atalay F.,Ankara Oncology Education and Research Hospital |
Bacinoglu A.,Ankara Oncology Education and Research Hospital
Asian Pacific Journal of Cancer Prevention | Year: 2014
Background: The purpose of this study was to investigate and evaluate risk factors for lymph node metastases (LNM) in cases of endometrial cancer (EC). Materials and Methods: A retrospective single institution analysis of patients surgically staged for EC at Ankara Oncology Education and Research Hospital from 1996 to 2010 was performed. Roles of prognostic factors, such as age, histological type, grade, depth of myometrial invasion, cervical involvement, peritoneal cytology, and tumor size, in the prediction of LNM were evaluated. Fisher's exact test and logistic regression analysis were used to assess the effects of various factors on LNM. Results: LNM was observed in 22 out of 247 patients (8.9%) and was significantly more common in the presence of tumors of higher grade, deep myometrial invasion (DMI), cervical involvement, size >2cm, and with positive peritoneal cytology. Logistic regression analysis revealed that DMI remained the only independent risk factor for LNM. NPV, PPV, sensitivity, and specificity for satisfying LNM risk were 98.0, 19.5, 86.3, and 65.3%, respectively for DMI. Conclusions: The incidence of LNM is influenced independently by DMI. If data support a conclusion of DMI, LND should be seriously considered.
Prognostic significance of FDG PET/CT on the follow-up of patients of differentiated thyroid carcinoma with negative 131I whole-body scan and elevated thyroglobulin levels: Correlation with clinical and histopathologic characteristics and long-term follow-up data
Vural G.U.,Ankara Oncology Education and Research Hospital |
Akkas B.E.,Ankara Oncology Education and Research Hospital |
Ercakmak N.,Ankara Oncology Education and Research Hospital |
Basu S.,Bhabha Atomic Research Center |
Alavi A.,University of Pennsylvania
Clinical Nuclear Medicine | Year: 2012
AIMS: This study aimed (a) to determine the clinical and histopathologic factors that are related to FDG avidity in the recurrence/metastases of patients with differentiated thyroid carcinoma (DTC) who present with elevated thyroglobulin (Tg) levels and negative I whole-body scans (WBSs), (b) to clarify Tg cutoff levels in this setting, and (c) to evaluate the impact of PET/CT on patient management strategies and hence to critically look into the importance of PET/CT in combination with Tg in clinical decision making. METHODS: A total of 105 patients with DTC with negative I WBS and neck ultrasound but elevated Tg, who underwent FDG PET/CT for the suspicion of recurrent/metastatic disease, were included in this analysis. All patients had previously undergone total thyroidectomy and radioiodine ablation/therapy. PET/CT results were correlated with Tg levels and clinical and histopathologic characteristics of the primary tumor compared with the follow-up data. RESULTS: PET/CT was true-positive in 69 patients (of which 23 had surgically amenable disease), true-negative in 20, false-positive in 6 patients and false-negative in 10 patients. Extrathyroidal spread was an independent risk factor related to FDG-avid recurrence. Tumor size was significantly higher in PET-positive patients than others, 2.25 (1.8) versus 1.5 (1.1) cm, P = 0.02. Significant correlation was observed between PET positivity and high Tg levels (P = 0.0001). Receiver operating characteristic curve analysis demonstrated a Tg cutoff of 1.9 ng/mL under thyroid-stimulating hormone suppression, 38.2 ng/mL with thyroid-stimulating hormone stimulation. Among PET-negative patients, no recurrence was detected in patients with undetectable/suppressible Tg in on-therapy state. CONCLUSIONS: PET positivity correlated with extrathyroidal spread, and elevated Tg in recurrent/metastatic DTC. FDG PET/CT in combination with Tg levels was crucial in defining management strategies in patients with DTC with negative I WBS. A negative FDG PET/CT scan predicts a favorable prognosis and lack of recurrence on follow-up in patients with "suppressible Tg" levels in the on-therapy state despite significant elevation of Tg in the off-therapy state. © 2012 by Lippincott Williams & Wilkins.