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Item The Outcome of Patients with Triple Negative Breast Cancer: The Turkish Oncology Group Experience(AVES, 2014-01-01) Eralp, Yesim; Kilic, Leyla; Alco, Gul; Basaran, Gul; Dogan, Mutlu; Dincol, Dilek; Demirci, Senem; Icli, Fikri; Onur, Handan; Saip, Pinar; Haydaroglu, AyferObjective:Triple negative breast cancer (TNBC) is generally considered as a poorer prognostic subgroup, with propensity for earlier relapse and visceral involvement. The aim of this study is to evaluate the outcome of non-metastatic TNBC patients from different centers in Turkey and identify clinical and pathologic variables that may effect survival. Materials and Methods:Between 1993-2007, from five different centers in Turkey, 316 nonmetastatic triple negative breast cancer patients were identified with follow-up of at least 12 months. The data was collected retrospectively from patient charts. The prognostic impact of several clinical variables were evaluated by the Kaplan-Meier and Cox multivariate anayses. Results:Mean age at diagnosis was 49 years (range:24-82). The majority of the patient group had invasive ductal carcinoma (n:260, 82.3\%) and stage II disease (n:164Item Comparison of stage III mucinous and serous ovarian cancer: a case-control study(BMC, 2018-01-01) Cuylan, Zeliha Firat; Karabuk, Emine; Oz, Murat; Turan, Ahmet Taner; Meydanli, Mehmet M.; Taskin, Salih; Sari, Mustafa Erkan; Sahin, Hanifi; Ulukent, Suat C.; Akbayir, Ozgur; Gungorduk, Kemal; Gungor, Tayfun; Kose, Mehmet F.; Ayhan, AliBackground: The purpose of this case-control study was to compare the prognoses of women with stage III mucinous ovarian carcinoma (MOC) who received maximal or optimal cytoreduction followed by paclitaxel plus carboplatin chemotherapy to those of women with stage III serous epithelial ovarian cancer (EOC) treated in the similar manner. Methods: We performed a multicenter, retrospective review to identify patients with stage III MOC at seven gynecologic oncology departments in Turkey. Eighty-one women with MOC were included. Each case was matched to two women with stage III serous EOC in terms of age, tumor grade, substage of disease, and extent of residual disease. Survival estimates were measured using Kaplan-Meier plots. Variables predictive of outcome were analyzed using Cox regression models. Results: With a median follow-up of 54months, the median progression-free survival (PFS) for women with stage III MOC was 18.0months (95\% CIItem Staging with PET-CT in Patients with Locally Advanced Non Small Cell Lung Cancer is Superior to Conventional Staging Methods in Terms of Survival(ASIAN PACIFIC ORGANIZATION CANCER PREVENTION, 2013-01-01) Mutlu, Hasan; Buyukcelik, Abdullah; Erden, Abdulsamet; Aslan, Tuncay; Akca, Zeki; Kaya, Eser; Kibar, Mustafa; Seyrek, Ertugrul; Yavuz, Sinan; Calikusu, ZuleyhaBackground: Of patients with non small cell lung cancer (NSCLC), around one third are locally advanced at the time of diagnosis. Because only a proprotion of stage III patients can be cured by surgery, in order to improve the outcomes, sequential or concurrent chemoradiation, or concurrent chemoradiation with induction or consolidation is offered to the patients with locally advanced NSCLC. Today, PET combined with computerized tomography (PET-CT) is accepted as the most sensitive technique for detecting mediastinal lymph node and extracranial metastases from NSCLC. We aimed to compare PET-CT and conventional staging procedures for decisions regarding curative treatment of locally advanced NSCLC. Materials and Methods: A total of 168 consecutive patients were included from Acibadem Kayseri Hospital, Acibadem Adana Hospital and Kayseri Research and Training Hospital in this study. Results: While the median PFS was 13.0 +/- 1.9 months in the PET-CT group, it was only 6.0 +/- 0.9 in the others (p<0.001). The median OS values were 20.5 +/- 15.6 and 11.5 +/- 1.5 months, respectively (p<0.001). Discussion: As a result, we found that staging with PET CT has better results in terms of survival staging. This superiority leads to survival advantage in patients with locally advanced NSCLC.Item Does Sunlight Exposure Improve Survival in Patients with Non-small Cell Lung Cancer?(ASIAN PACIFIC ORGANIZATION CANCER PREVENTION, 2013-01-01) Mutlu, Hasan; Buyukcelik, Abdullah; Aksahin, Arzu; Kibar, Mustafa; Cihan, Yasemin Benderli; Kaya, Eser; Seyrek, Ertugrul; Yavuz, Sinan; Erden, Abdulsamet; Calikusu, Zuleyha; Aslan, Tuncay; Akca, ZekiBackground: Some epidemiological studies reported that sunlight exposure and highvitamin D levels may decrease the morbidity and mortality related to cancer. We aimed to evaluate whether sunlight exposure has an impact on survival in patients with non small cell lung cancer. Materials and Methods: A total of 546 patients with NSCLC from two different regions (Kayseri and Adana) differing according to sunlight exposure were analysed retrospectively. Results: The median overall survival (OS) rates were 11. 6 (CI: 9.50-13.6) and 15.6 months (CI: 12.4-18.8) for Kayseri and Adana, respectively, in all patients (p=0.880). Conclusions: There were no differences between groups in terms of OS. While there is strong evidence regarding inverse relationship between cancer incidence and sunlight exposure, it is still controversial whether sunlight exposure is a good prognostic factor for survival in patients with lung cancer.Item Is Season a Prognostic Factor in Breast Cancer?(ASIAN PACIFIC ORGANIZATION CANCER PREVENTION, 2013-01-01) Mutlu, Hasan; Akca, Zeki; Cihan, Yasemin Benderli; Kurnaz, Fatih; Aslan, Tuncay; Erden, Abdulsamet; Ugur, Hediye; Aksahin, Arzu; Buyukcelik, AbdullahBackground: Some studies have indicated an inverse relationship between cancer risk and sunlight exposure. Others have reported that the prognosis of some cancers such as prostate, colon, ovarian and non melanoma skin cancer, were affected by the season in which the cancer was diagnosed. In our study, we evaluated whether season is prognostic in Turkish patients with breast cancer. Materials and Methods: A total of 517 patients from Kayseri Training and Research Hospital were analysed retrospectively. Patients were divided into 4 groups according to season of cancer diagnosis: winter, spring, summer and autumn. The prognostic factors for disease free survival and overall survival were investigated. Results: No significant differences were found among groups regarding prognostic factors overall. Only estrogen receptor status and lymphovascular invasion were independent prognostic factors (p=0.001 and p=0.001 respectively). We found significantly differences for mean disease free survival among groups (p=0.019). Winter group had better mean DFS while summer group had worse DFS. Mean overall survival was similar in the four groups (p=0.637). Conclusions: The season is not an independent predictive factor. However, due to interaction with other factors, we think that the season of cancer diagnosis is important for cancer prognosis.Item Secondline Chemotherapy Versus Best Supportive Care in Patient with Malignant Pleural Mesothelioma: A Retrospective Study(ASIAN PACIFIC ORGANIZATION CANCER PREVENTION, 2013-01-01) Mutlu, Hasan; Buyukcelik, Abdullah; Karaca, Halit; Aksahin, Arzu; Berk, Veli; Aslan, Tuncay; Erden, Abdulsamet; Akca, Zeki; Ozkan, MetinIntroduction: Mesothelioma is a rare neoplasm arising from mesothelial surfaces with the malignant pleural mesothelioma (MPM) as the most common form. Secondline chemotherapy in MPM is still controversial and in this study we evaluated whether it is superior to best supportive care. Materials and Methods: A total of 51 patients with MPM from Acibadem Kayseri Hospital, Kayseri Training and Research Hospital and Erciyes University were analyzed retrospectively. The patients treated with secondline chemotherapies (SLCT) were compared with those treated with best supportive care (BSC) for overall survival. Results: The median overall survival (OS) for firstline chemotherapy -> SLCT and firstline chemotherapy -> BSC groups were 20.3 and 14.7 months respectively (p=0.079). After firstline chemotherapy the median OS for SLCT and BSC were 5.9 and 4.7 months (p=0.355). Discussion: Although there was a trend for improvement in overall survival in patients treated with secondline chemotherapy, the difference was not statistically significant. Our results do not support the proposal that secondline chemotherapy could be effective in patients with MPM.Item Lack of Sunlight Exposure Influence on Primary Glioblastoma Survival(ASIAN PACIFIC ORGANIZATION CANCER PREVENTION, 2014-01-01) Mutlu, Hasan; Akca, Zeki; Erden, Abdulsamet; Aslan, Tuncay; Ucar, Kadir; Kaplan, Bunyamin; Buyukcelik, AbdullahBackground: The prognosis of primary glioblastoma (GBM) is poor. Approximately 2/3 of primary brain tumor diagnoses are GBM, of which 95\% are primary lesions. In this study, we aimed to evaluate whether more sunlight exposure has an effect on survival of patients with primary GBM. Materials and Methods: A total of 111 patients with primary GBM were enrolled from Kayseri in inner Anatolia which has a cold climate (n: 40) and Mersin in Mediterranean region with a warm climate and more sunlight exposure (n: 71). The patients with primary GBM were divided into two groups as Kayseri and Mersin and compared for progression free survival (PFS) and overall survival (OS). Results: The PFS values were 7.0 and 4.7 months for Kayseri and Mersin groups, respectively (p=0.10) and the repsective OS values were 13.3 and 9.4 months (p=0.13). We did not found any significant difference regarding age, sex, comorbidity, smoking, surgery, resurgery, adjuvant chemoradiotherapy and palliative chemotherapy between the groups. Conclusions: We found that more sunlight exposure had no impact on prognosis of patients with primary GBM, adding inconsistency to the literature about the relationship between sunlight and GBM.Item Survival Analysis of Biliary Tract Cancer Cases in Turkey(ASIAN PACIFIC ORGANIZATION CANCER PREVENTION, 2014-01-01) Akca, Zeki; Mutlu, Hasan; Erden, Abdulsamet; Buyukcelik, Abdullah; Cihan, Yasemin Benderli; Goksu, Sema Sezgin; Aslan, Tuncay; Sezer, Emel Yaman; Inal, AliBackground: Because of the relative rarity of biliary tract cancers (BTCs), defining long term survival results is difficult. In the present study, we aimed to evaluate the survival of a series of cases in Turkey. Materials and Methods: A totally of 47 patients with billiary tract cancer from Mersin Goverment Hospital, Acibadem Kayseri Hospital and Kayseri Training and Research Hospital were analyzed retrospectively using hospital records between 2006-2012. Results: The median overall survival was 19.3 +/- 3.9 months for all patients. The median disease free and overall survivals were 24.3 +/- 5.3 and 44.1 +/- 12.9 months in patients in which radical surgery was performed, but in those with with inoperable disease they were only 5.3 +/- 1.5 and 10.7 +/- 3.2 months, respectively. Conclusions: BTCs have a poor prognosis. Surgery with a microscopic negative margin is still the only curative treatment.Item Midterm results of the cylindrical fully porous-coated uncemented femoral stem in revision patients with Paprosky I-IIIA femoral defects(SAGE PUBLICATIONS INC, 2018-01-01) Ahmet, Salduz; Ismet, Kilicoglu Onder; Mehmet, Ekinci; Eren, Yildiz; Remzi, Tozun; Onder, YaziciogluIntroduction: The aim of this study was to analyze the survival of the Echelon (R) femoral stems in revision hip surgeries in patients with Paprosky I-IIIA femoral defects. Patients and methods: Sixty-six patients (70 hips) who underwent revision hip surgery with at least 3 years of follow-up data were included in the study between 2000 and 2013. The mean patient age was 64.5 (32-83) years, and the mean follow-up period was 93 (45-206) months. The reasons for revision were aseptic loosening in 55 (78.6\%) patients, periprosthetic joint infection in 9 (12.9\%) patients, periprosthetic fracture in 4 (5.7\%) patients, and stem fracture in 2 (2.9\%) patients. The preoperative and postoperative follow-up X-rays and functional scores were evaluated. Results: Five patients died in an average of 70 (45-86) months after surgery due to non-related diseases. We encountered sciatic nerve palsy in two patients and early hip dislocation in two patients, whereas 54 patients were able to walk without any assistive device. The remaining 12 patients required an assistive device to walk. The mean Harris hip score significantly increased from 34 (7-63) preoperatively to 72 (43-96) postoperatively. Aseptic loosening was observed in one patient. The survival of the porous-coated anatomical uncemented femoral stem was 98.4\% over 10 years. Conclusion: This study showed that good clinical outcomes and survival can be obtained when using porous-coated anatomical uncemented femoral stems.Item Obesity might be a good prognosis factor for COPD patients using domiciliary noninvasive mechanical ventilation(DOVE MEDICAL PRESS LTD, 2016-01-01) Altinoz, Hilal; Adiguzel, Nalan; Salturk, Cuneyt; Gungor, Gokay; Mocin, Ozlem; Takir, Huriye Berk; Kargin, Feyza; Balci, Merih; Dikensoy, Oner; Karakurt, ZuhalCachexia is known to be a deteriorating factor for survival of patients with chronic obstructive pulmonary disease (COPD), but data related to obesity are limited. We observed that obese patients with COPD prescribed long-term noninvasive mechanical ventilation (NIMV) had better survival rate compared to nonobese patients. Therefore, we conducted a retrospective observational cohort study. Archives of Thoracic Diseases Training Hospital were sought between 2008 and 2013. All the subjects were prescribed domiciliary NIMV for chronic respiratory failure secondary to COPD. Subjects were grouped according to their body mass index (BMI). The first group consisted of subjects with BMI between 20 and 30 kg/m(2), and the second group consisted of subjects with BMI >30 kg/m(2). Data obtained at the first month's visit for the following parameters were recorded: age, sex, comorbid diseases, smoking history, pulmonary function test, 6-minute walk test (6-MWT), and arterial blood gas analysis. Hospital admissions were recorded before and after the domiciliary NIMV usage. Mortality rate was searched from the electronic database. Overall, 118 subjects were enrolled. Thirty-eight subjects had BMI between 20 and 30 kg/m(2), while 80 subjects had BMI >30 kg/m(2). The mean age was 65.8+/-9.4 years, and 81\% were male. The median follow-up time was 26 months and mortality rates were 32\% and 34\% for obese and nonobese subjects (P=0.67). Improvement in 6-MWT was protective against mortality. In conclusion, survival of obese patients with COPD using domiciliary NIMV was found to be better than those of nonobese patients, and the improvement in 6-MWT in such patients was found to be related to a better survival.