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Permanent URI for this collectionhttps://hdl.handle.net/11443/932

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    A Retrospective Multicenter Evaluation of Cutaneous Melanomas in Turkey
    (ASIAN PACIFIC ORGANIZATION CANCER PREVENTION, 2014-01-01) Gamsizkan, Mehmet; Yilmaz, Ismail; Buyukbabani, Nesimi; Demirkesen, Cuyan; Demiriz, Murat; Cetin, Emel Dikicioglu; Ince, Umit; Akalin, Taner; Demirkan, Nese Calli; Lebe, Banu; Erdem, Ozlem; Gokoz, Ozay; Sakiz, Damlanur; Demireli, Peyker Temiz; Astarci, Hesna Muzeyyen; Adim, Saduman Balaban; Zemheri, Itir Ebru; Acikalin, Arbil; Yaman, Banu; Aydin, Ovgu; Bassorgun, Cumhur Ibrahim
    Background: We defined melanoma distribution in a large series of Turkish patients and evaluated the prognostic parameters of melanomas. Materials and Methods: A total of 1574 patients' data was retrospectively collected at 18 centers in Turkey. Demographic characteristics were questioned and noted. Prognostic parametres were evaluated based on sentinel lymph node involvement. Results: Mean age was 56.7 (4-99) years. While 844 (53.6\%) cases were male, 730 (46.4\%) cases were female. One thousand four hundred forty-seven (92\%) cases were invasive melanoma and 127 (8\%) cases were in-situ melanoma. The most common histopathological form was the superficial spreading melanoma (SSM) which was found in 549 patients (37.9\%). It was followed by nodular melanoma in 379 (26.2\%), acral lentiginous melanoma (ALM) in 191 (13.2\%) and lentigo maligna melanoma in 132 (9.1\%), respectively. On univariate analysis, lymphovascular invasion (p<0.001), tumor thickness (p<0.001), histopathological subtype (p<0.001), Clark level (p=0.001), ulceration (p<0.001), >= 6/mm(2) mitosis (p=0.005), satellite formation (p=0.001) and gender (p=0.03) were found to be associated with sentinel lymph node positivity. Regression was associated with sentinel lymph node negativity (p=0.017). According to multivariate analysis, lymphovascular invasion and tumor thickness were significant independent predictive factors of SLN positivity. Patient age, tumor localization, precursor lesions, lymphocytic infiltration and neurotropism were not related with sentinel lymph node involvement. Conclusions: In this retrospective analysis, it was found that the prevalence of SSM is at a lower rate while the prevalence of ALM is at a higher rate when compared to western countries. According to Breslow index
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    Evaluation of response to stereotactic radiosurgery in patients with radioresistant brain metastases
    (KOREAN SOC THERAPEUTIC RADIOLOGY \& ONCOLOGY, 2019-01-01) Sayan, Mutlay; Mustafayev, Teuta Zoto; Sahin, Bilgehan; Kefelioglu, Erva Seyma Sare; Wang, Shang-Jui; Kurup, Varsha; Balmuk, Aykut; Gungor, Gorkem; Ohri, Nisha; Weiner, Joseph; Ozyar, Enis; Atalar, Banu
    Purpose: Renal cell carcinoma (RCC) and melanoma have been considered `radioresistant' due to the fact that they do not respond to conventionally fractionated radiation therapy. Stereotactic radiosurgery (SRS) provides high-dose radiation to a defined target volume and a limited number of studies have suggested the potential effectiveness of SRS in radioresistant histologies. We sought to determine the effectiveness of SRS for the treatment of patients with radioresistant brain metastases. Materials and Methods: We performed a retrospective review of our institutional database to identify patients with RCC or melanoma brain metastases treated with SRS. Treatment response were determined in accordance with the Response Evaluation Criteria in Solid Tumors. Results: We identified 53 radioresistant brain metastases (28\% RCC and 72\% melanoma) treated in 18 patients. The mean target volume and coverage was 6.2 +/- 9.5 mL and 95.5\% +/- 2.9\%, respectively. The mean prescription dose was 20 +/- 4.9 Gy. Forty lesions (75\%) demonstrated a complete/partial response and 13 lesions (24\%) with progressive/stable disease. Smaller target volume (p < 0.001), larger SRS dose (p < 0.001), and coverage (p = 0.008) were found to be positive predictors of complete response to SRS. Conclusion: SRS is an effective management option with up to 75\% response rate for radioresistant brain metastases. Tumor volume and radiation dose are predictors of response and can be used to guide the decision-making for patients with radioresistant brain metastases.