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Tanriverdi O.,Muǧla University | Kaytan-Saglam E.,Istanbul University | Ulger S.,Gazi University | Bayoglu I.V.,Izmir Kâtip Celebi University | And 28 more authors.
Medical Oncology | Year: 2014

Brain metastasis in colorectal cancer is highly rare. In the present study, we aimed to determine the frequency of brain metastasis in colorectal cancer patients and to establish prognostic characteristics of colorectal cancer patients with brain metastasis. In this cross-sectional study, the medical files of colorectal cancer patients with brain metastases who were definitely diagnosed by histopathologically were retrospectively reviewed. Brain metastasis was detected in 2.7 % (n = 133) of 4,864 colorectal cancer patients. The majority of cases were male (53 %), older than 65 years (59 %), with rectum cancer (56 %), a poorly differentiated tumor (70 %); had adenocarcinoma histology (97 %), and metachronous metastasis (86 %); received chemotherapy at least once for metastatic disease before brain metastasis developed (72 %), had progression with lung metastasis before (51 %), and 26 % (n = 31) of patients with extracranial disease at time the diagnosis of brain metastasis had both lung and bone metastases. The mean follow-up duration was 51 months (range 5–92), and the mean survival was 25.8 months (95 % CI 20.4–29.3). Overall survival rates were 81 % in the first year, 42.3 % in the third year, and 15.7 % in the fifth year. In multiple variable analysis, the most important independent risk factor for overall survival was determined as the presence of lung metastasis (HR 1.43, 95 % CI 1.27–4.14; P = 0.012). Brain metastasis develops late in the period of colorectal cancer and prognosis in these patients is poor. However, early screening of brain metastases in patients with lung metastasis may improve survival outcomes with new treatment modalities. © 2014, Springer Science+Business Media New York.


Sonmez O.,Dr Abdurrahman Yurtarslan Oncology Training And Research Hospital | Uyeturk U.,Abant Izzet Baysal University | Helvaci K.,Dr Abdurrahman Yurtarslan Oncology Training And Research Hospital | Turker I.,Trabzon Numune Training and Research Hospital | And 5 more authors.
Turkish Journal of Medical Sciences | Year: 2012

Aim: Primary anorectal malignant melanoma (MM) is a rare but highly lethal malignancy. The aim of this study was to present an overview of the clinical features and treatment strategies in patients with anorectal MM. Materials and methods: Nine patients who were diagnosed with anorectal MM between 1998 and 2010 were reviewed retrospectively. Results: The median age of the patients was 51 years (range: 28-75). The sex ratio of male to female was 1:2. The main presenting symptom was rectal bleeding. At the time of diagnosis, 1 patient was stage IV and 8 patients were stage III. All of the patients underwent an abdominoperineal resection. Only 1 patient received adjuvant immunotherapy and 8 patients received palliative immunotherapy or dacarbazine and/or platinum-based chemotherapy. The median progression-free survival was 31 weeks (range: 6-211). Sites of metastasis were the lung, liver, and brain in order of frequency. The median overall survival was 81 weeks (range: 54-229). Conclusion: Clear guidelines for the therapy of anorectal MM have not been established. In the treatment plan of primary anorectal MM, multimodal treatment options involving surgery, radiotherapy, and systemic treatment with chemotherapeutics or biological agents should be considered. © TÜBİTAK.


Uyeturk U.,Abant Izzet Baysal University | Tatli A.M.,Van Training and Research Hospital | Gucuk S.,Bolu Izzet Baysal Family Health Center | Oksuzoglu B.,Dr Abdurrahman Yurtarslan Oncology Training And Research Hospital | And 9 more authors.
Asian Pacific Journal of Cancer Prevention | Year: 2013

Background: Breast cancer (BC) is the one of the most common cancers in women. It is also a leading cause of death. Unfortunately, some patients initially present with distant metastases and are diagnosed with stage IV disease that is nearly always, by then, incurable. This retrospective analysis investigated the risk factors for stage IV BC that may underlie such late presentation. Materials and Methods: In all, 916 patients with BC who visited the medical oncology polyclinic of eight different centres in Turkeybetween December 2011 and January 2013 were analysed. Results: A total of 115 patients (12.6%) presented with stage IV disease. In univariate analysis; to comparing these with patients at other stages, no statistical difference was found for median diagnosis age or age at menarche (p=0.611 and p=0.820), whereas age at menopause and age at first live birth were significant (p=0.018 and p=0.003). No difference was detected in terms of accompanying diseases, use of oral contraceptives and hormone replacement therapy, smoking, alcohol consumption and the rate of family history of BC between the patients (p=0.655, p=0.389, p=0.762, p=0.813, p=0.229, p=0.737). However, screening methods were employed less often, the rate of illiteracy was higher, and the rate of other cancers was higher in patients with stage IV BC (p=0.022, p=0.022, p=0.018). No statistical difference was observed between the patients in terms of tumour histopathology, and status of oestrogen receptor, progesterone receptor, or human epidermal growth factor-2 receptor (p=0.389, p=0.326, p=0.949, p=0.326). Grade 3 tumours were more frequent in patients with stage IV disease (p<0.001). On multivariate analysis, risk factors for stage IV breast cancer at the time of presentation were found to be age at first live birth and educational level (p=0.003 and p=0.047). Conclusions: Efforts should be made to perform mammography scans, in particular, at regular intervals through national training programs for all women, particularly those with family histories of breast and other types of cancer, and to establish early diagnosis of BC long before it proceeds to stage IV. Additionally, women's education had better be upgraded. In order to make women aware of BC, national education-programmes must be organised.


Uyeturk U.,Abant Izzet Baysal University | Turker I.,Dr Abdurrahman Yurtarslan Oncology Training And Research Hospital | Bal O.,Dr Abdurrahman Yurtarslan Oncology Training And Research Hospital | Demirci A.,Dr Abdurrahman Yurtarslan Oncology Training And Research Hospital | And 5 more authors.
Journal of B.U.ON. | Year: 2014

Purpose: Aging is an important risk factor for cancer. Molecular changes and defective immunity associated with aging result in increased susceptibility to many carcinogens of the gastrointestinal system (GIS). Comorbidities and changes in drug metabolism in elderly patients make the treatment of GIS cancers difficult. Methods: Between January 2009 and December 2012, a total of 790 patients diagnosed with GIS cancers were retrospectively evaluated. Among them, 357 patients aged ≥ 65 years constituted the study population in which the patient characteristics, disease location, TNM stage, ECOG PS, co-morbidities, chemotherapy regimens and overall survival (OS) were assessed. Results: The patient median age was 71 years (range 65-94). Cancer localizations were colorectal cancer (CRC), gastric cancer, and the pancreaticobiliary system (PBS) cancer in 178 (49.9%), 124 (34.7%), and 55 (15.4%) patients, respectively. A total of 260 (69%) patients underwent chemotherapy: 167 (64.3%) patients received optimal chemotherapy, and 93 (35.7%) suboptimal chemotherapy. The median OS was 47, 14, and 11 months in CRC, gastric, and PBS cancers, respectively. OS was better in the optimally-treated group than in the suboptimally-treated group among patients with all types of cancer. OS was 67 vs 19 months (p<0.001), 17 vs 8 months (p=0.004), and 12 vs 10 months (p=0.46) in CRC, gastric, and PBS cancers in the optimal and suboptimal chemotherapy groups, respectively. Multivariate analysis showed that the disease stage in all cancer types and optimal chemotherapy in the CRC group were important predictors of survival (p<0.001 and p=0.021, respectively). Conclusion: Cancer is usually in advanced stage at the time of diagnosis in these elderly patients and screening programs might improve outcomes in this age group. Patients with GIS cancers (especially CRC and gastric cancer) should be encouraged to receive optimal chemotherapy regimens.


Uyeturk U.,Dr Abdurrahman Yurtarslan Oncology Training And Research Hospital | Budakoglu B.,Dr Abdurrahman Yurtarslan Oncology Training And Research Hospital | Helvaci K.,Dr Abdurrahman Yurtarslan Oncology Training And Research Hospital | Uysal Sonmez O.,Dr Abdurrahman Yurtarslan Oncology Training And Research Hospital | And 4 more authors.
Turkiye Klinikleri Journal of Medical Sciences | Year: 2012

Sorafenib is an oral tyrosine kinase inhibitor used in the treatment of metastatic hepatocellular carcinoma (HCC). Its common adverse reactions include diarrhea, hand-foot syndrome, rash, cardiac ischemia or infarction, hypertension, elevated serum lipase and hypophosphatemia. A 35-year-old male patient with unresectable HCC was treated with sorafenib for progressive disease after locoregional chemoembolization. In the second month of the sorafenib treatment, he was admitted to the emergency department with weakness and drowsiness. His serum potassium level was 8.3 mmol/ L (3.5-5.5 mmol/L) which was accompanied with mild elevations in liver enzymes. Sorafenib treatment was stopped and emergency hemodialysis was applied. His potassium level reduced to normal levels and was stabilized. © 2012 by Türkiye Klinikleri.

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