Browsing by Author "Tinay, Ilker"

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A New Era in Metastatic Prostate Cancer: ``The Combination of Chemotherapy and Hormonal Treatment as Initial Treatment''
(GALENOS YAYINCILIK, 2016-01-01) Tinay, Ilker; Turkeri, Levent
In recent years, studies have been reported about the combination of androgen deprivation therapy (ADT) and different chemotherapy modalities as the initial therapy in newly-diagnosed patients with hormone-sensitive metastatic prostate cancer and recently, possible effects of docataxel chemotherapy in combination with ADT was evaluated in the 2 multi-institutional randomized trials from North America (CHAARTED) and Europe (GETUG-AFU-15). We reviewed the data for the current use of chemo-hormonal therapy as the initial treatment modality in castration-sensitive metastatic prostate cancer. New findings of CHAARTED trial showed that combination of ADT with docetaxel chemotherapy conferred a significant median over-all survival benefit over ADT alone and patients with high-volume disease derived a 17-month gain in median over-all survival. However in GETUG trial, while no over-all survival benefit was observed between two groups however combination therapy was associated with an improvement in biochemical and clinical progression-free survivals. The combination of docetaxel-based chemotherapy with ADT as the initial treatment seems as a promising treatment alternative in patients with hormone-sensitive metastatic prostate cancer, especially in patients with ``high-volume{''} disease.
Gas6 expression and Tyrosine kinase Axl Sky receptors: Their relation with tumor stage and grade in patients with bladder cancer
(PAGEPRESS PUBL, 2021-01-01) Akgul, Murat; Baykan, Ozgur; Cagman, Zeynep; Ozyurek, Mustafa; Tinay, Ilker; Akbal, Cem; Uras, Fikriye; Turkeri, Levent
Objectives: It has been shown that the dys-regulation of tyrosine kinase Axl receptor and its ligand growth arrest-specific gene (Gas6) are associated with poor prognosis in various types of tumors but there is not enough study about their importance in bladder cancer (BC). We evaluated the relation of Gas6 gene expression and tyrosine-kinase Axl and Sky (Tyro 3) receptors with tumor stage and grade in patients with BC. Material and Methods: The study group consists of 55 patients whose transurethral resection of bladder (TUR-B) has been performed due to RC and the control group consists of 12 patients with normal bladder mucosa. In tissues mRNAs of Gas6, Axl, and Sky receptors were examined by quantitative (Real-Time) PCR (qPCR). Protein expression was measured by immunohistochemistry. Plasma Gas6 protein levels were compared with control group by ELISA method. Results: Patients with BC were grouped as Ta low (n=17), Ta high (n=5), T1 low (n=9), T1 high (n=8) and T2 (n=16) according to their TUR-B pathologies. The qPCR analysis showed that the expression of Gas6 gene and AxI receptor is higher in the tumor-positive group and the immune-histochemical showed that the bladder samples of the tumor-positive group stained significantly positive. When the patients are grouped according to the TUR-B pathologies, a statistical significant difference was observed among groups in the qPCR analysis ratios of Gas6 gene and Axl receptor by (p < 0.05) but no significance was found for Sky receptor (p > 0.05). When Gas6 protein levels in plasma samples were compared by ELISA method, a statistical significance was determined among groups (p = 0.001). Conclusions: Our findings indicate that mRNAs of Gas6 and Axl receptor are closely related to tumor stage and grade in patients with BC. Further studies are needed for understanding the role of Gas6 and its receptors on the neoplastic transformation in terms of novel biomarkers and potential therapeutic targets.
Management of Patients with Urological Cancers in Turkey during the COVID-19 Pandemic: Recommendations of Uro-oncology Association
(GALENOS YAYINCILIK, 2020-01-01) Celik, Serdar; Tinay, Ilker; Narter, Fehmi; Eskicorapci, Saadettin; Ataus, Suleyman; Turkeri, Levent; Baltaci, Sumer
Coronavirus disease-19 (COVID-19) has been declared as a pandemic by the World Health Organization. The number of cases has increased over time in correlation with the increasing number of testing worldwide. In order to use the available resources for COVID-19 treatment, urological practice has been limited only to emergency procedures and certain uro-oncological surgeries. In this report, we aim to share our recommendations for the daily uro-oncology practice in light of local circumstances in Turkey.
Risk Factors of Patients with Prostate Cancer Upgrading for International Society of Urological Pathology Grade Group 1 After Radical Prostatectomy
(GALENOS YAYINCILIK, 2022-01-01) Ozgur, Abdurrahman; Ozgur, Gunal; Sahin, Bahadir; Filinte, Deniz; Tinay, Ilker; cam, Haydar Kamil; Turkeri, Levent
Objective: This study aimed to determine the predictive factors for patients whose International Society of Urological Pathology (ISUP) score was upgraded in radical prostatectomy (RP) pathologies with a prostate biopsy pathology of ISUP grade group 1. Materials and Methods: Among patients who underwent RP in our clinic within 10 years, 158 patients with prostate biopsy pathology of ISUP grade group 1 were examined retrospectively. Age, serum prostate-specific antigen (PSA) level, prostate biopsy ISUP grade group, number of cores taken in the prostate biopsy, number of tumor-positive cores, RP pathology ISUP grade group, and pathological stage were evaluated. Results: The mean age (+/- standard) of the 158 patients whose prostate biopsy pathology was ISUP grade group 1 were 64.07 (+/- 6.6). ISUP group upgrading was detected in 47 patients (29.7\%). The mean PSA value of these patients was 10.6 ng/mL (+/- 6.9). The mean PSA value of the other 111 patients without ISUP group upgrading was 7.98 ng/mL (+/- 4.9). The serum PSA level was significantly higher in patients with upgraded ISUP in the RP pathology (p=0.02). The percentage of tumor-positive cores in the group with ISUP group upgrading (37\%) was significantly higher than that in the group without ISUP group upgrading (27\%) (p=0.01). The detection rates of surgical margin positivity (42.6\% vs. 18\%), capsule invasion (55.3\% vs. 19.8\%), and seminal vesicle invasion (23.6\% vs. 3.6\%) were also significantly higher in the upgraded ISUP group after RP (p<0.05). Conclusion: The results of this trial suggest that active surveillance may not be an appropriate option for patients with biopsy ISUP grade group 1 with PSA level >10 ng/mL. Moreover, the presence of a higher number and percentage of tumor-positive cores constituted risks of ISUP group upgrading with concomitant poor pathological outcomes such as surgical margin positivity, capsule invasion, and seminal vesicle invasion.
The Early Impact of COVID-19 Pandemic on Surgical Urologic Oncology Practice in Turkey: Multi-Institutional Experience From Different Geographic Areas
(ELSEVIER SCIENCE INC, 2020-01-01) Tinay, Ilker; Ozden, Ender; Suer, Evren; Bozkurt, Ozan; Izol, Volkan; Sahin, Bahadir; Turkeri, Levent
Turkey Prostate Cancer Map 2021: Turkish Urooncology Association Prostate Cancer Database Report
(GALENOS YAYINCILIK, 2022-01-01) Sahin, Bahadir; Celik, Serdar; Tinay, Ilker; Eskicorapci, Saadettin; Aslan, Guven; Sozen, Sinan; Ataus, Suleyman; Turkeri, Levent
Objective: This study aimed to present the data of patients with prostate cancer (PCa) whose detailed information was stored in the Urologic Cancer Database-Prostate, Urooncology Association, Turkey with the title of ``Turkey Prostate Cancer Map 2021.{''} Materials and Methods: Patient data between 1995 and 2020 were retrospectively scanned. The age of the patients, their distribution according to age groups, symptoms during diagnosis, examination findings {[}digital rectal examination (DRE)], prostate-specific antigen (PSA) values, biopsy methods in the diagnosis, metastatic disease rates, treatment methods, and progression rates at follow-up were examined. These results were compared with the results of the previous report, namely ``Prostate Cancer Incidence (Incidence) in Turkey,{''} by the Urooncology Association in Turkey in 2009. Results: This study analyzed the data of 5040 patients from 19 different centers. The mean patient age was 63.6 (37-97) years. The age distribution examination revealed that most patients (49.8\%) were aged 60-69 years. Of the patients, 51.8\% were symptomatic at the time of diagnosis. The presence of symptoms was determined in 88.6\% in 2009 data. The ORE of patients revealed that 25\% of patients had malignancy findings. The PSA distribution examination revealed a >10 ng/mL PSA value in 37.5\% of patients. With the increasing use of magnetic imaging resonance (MRI) in PCa diagnosis over the years, increased MR-fusion biopsy rates have been observed. Considering the biopsy data, 91\% of patients were diagnosed with a classical transrectal ultrasound-guided biopsy, whereas 9\% were diagnosed with MR-Fusion biopsy. Fusion biopsies revealed that 23\% of patients with Prostate Imaging-Reporting and Data System (PI-RADS) 4 lesion and 57\% with PI-RADS 5 lesion were diagnosed with cancer. Of the patients, 8.9\% of patients had metastases during the initial diagnosis. This rate was 17\% in 2009 data. The treatment methods examination after the diagnosis revealed that 73.9\% of patients had undergone radical prostatectomy. This rate was 51.8\% in 2009. Robotic and laparoscopic approaches, which are among the surgical modalities, have increased over the years. However, the most frequently applied modality in our country was open radical prostatectomy with 62.6\%. Considering the follow-up data after treatment, 8.9\% of patients had progression, of which 62.6\% was biochemical, 30.2\% was radiological, and 6.9\% was a clinical progression. Conclusion: Technological advancements for PCa diagnosis (MRI and MR-guided biopsies) are becoming a routine part of daily practice compared to the results of the ``Prostate Cancer Incidence in Turkey{''} project in 2009. The comparative study results revealed that the rate of symptomatic and metastatic disease decreases at the time of diagnosis, and laparoscopic and robotic surgery methods are used at increasing rates for localized disease.