Burcu Yapar Taskoylu

MDR1 single nucleotide polymorphism C3435T in Turkish patients with non-small-cell lung cancer.

We assessed whether single nucleotide polymorphisms (SNPs) in MDR1 gene C3435T predicted the outcome of platinum-based chemotherapies and survival in our non small cell lung cancer (NSCLC) patients. A total of 79 non-small cell lung cancer patients were enrolled to study. We determined the MDR1 C3435T single nucleotide gene polymorphisms. Median age was 60years: 91.7% male, 8.9% female. We found that CC, CT, TT genotype and T, C allele frequencies in lung cancer patients as 24.1%, 62%, 13.9% and 44.3%, 55.7%, respectively. Patients with CT genotype had a higher response rate (11.4%) than the other genotypes. However, this difference is not statistically significant (p=0.743). Cox regression analysis for overall survival showed that ECOG PS status 0 (HR PS 1 vs. 0, 5.68 p=0.002; HR of PS 2 vs. 0 is 21.579, p=0.001; HR of PS 3 vs. 0 is 35.35, p=0.001), stage ≤II (HR of stage III vs. I+II is 17.77; p=0.016, HR of stage IV vs. I+II is 26.97, p=0.006), and albumin level ≥3g/dl (HR of albumin <3g/dl vs. ≥3g/dl is 2.46, p=0.044) were the most important prognostic factors (also, time to progression was related to these factors). There was no significant association between the genotypes and clinicopathologic parameters; however, good performance status, early stage and ≥3g/dl albumin level were found to be the most important prognostic factors for overall survival and progression-free survival.

Primary malignant melanoma of the penis: a case report.

We present the case of a patient with malignant melanoma of the glans penis and urethral meatus, which was found in a 60-year-old man with non-healing ulcerative penile lesion and bilateral clinically palpable inguinal lymphadenopathies at diagnosis. A diagnostic biopsy showed the characteristics of a malignant melanoma. Incisional biopsies from the cutaneous lesions on his glans penis and urethra were performed. Histopathological examination of both specimens showed generally ulceronecrotic surface and numerous atypical melanocytic cells. The diagnosis of giant cell melanoma was made. Two months later, bilateral inguinal lymph nodes dissection was performed. Histopathological examination of both specimens demonstrated malignant melanoma metastasis. Three months after the diagnosis, the patient underwent partial penectomy. High-dose interferon-alpha-2b treatment was started. Early diagnosis is of paramount importance, as the prognosis becomes very poor with an advanced tumor stage.

Impact of adjuvant treatment modalities on survival outcomes in curatively resected pancreatic and periampullary adenocarcinoma.

BACKGROUND We examined the impact of adjuvant modalities on resected pancreatic and periampullary adenocarcinoma (PAC). METHODS A total of 563 patients who were curatively resected for PAC were retrospectively analyzed between 2003 and 2013. RESULTS Of 563 patients, 472 received adjuvant chemotherapy (CT) alone, chemoradiotherapy (CRT) alone, and chemoradiotherapy plus chemotherapy (CRT-CT) were analyzed. Of the 472 patients, 231 were given CRT-CT, 26 were given CRT, and 215 were given CT. The median recurrence-free survival (RFS) and overall survival (OS) were 12 and 19 months, respectively. When CT and CRT-CT groups were compared, there was no significant difference with respect to both RFS and OS, and also there was no difference in RFS and OS among CRT-CT, CT and CRT groups. To further investigate the impact of radiation on subgroups, patients were stratified according to lymph node status and resection margins. In node-positive patients, both RFS and OS were significantly longer in CRT-CT than CT. In contrast, there was no significant difference between groups when patients with node-negative disease or patients with or without positive surgical margins were considered. CONCLUSIONS Addition of radiation to CT has a survival benefit in patients with node-positive disease following pancreatic resection.

Retrospective evaluation of patients diagnosed solid pseudopapillary neoplasms of the pancreas

PURPOSE Solid pseudopapillary neoplasm (SPN) is a rare, low-grade neoplasm with excellent prognosis. In this study, we evaluated clinicopathological characteristics of patients diagnosed with SPN retrospectively. METHODS This is a retrospective study intended to characterize patients with the diagnosis of SPN between 2005 and 2015. Clinicopathological features, recurrence rate, and overall survival of 28 patients were recorded. Malignant SPN criteria were defined as the presence of distant metastasis (developed at diagnosis or during follow up) or lymph node involvement. RESULTS The mean age at diagnosis was 42 (range: 17-41). Among patients, 82% (n = 23) were female and 17.9% (n = 5) were male. The mean size of tumor was 5.81 cm (range: 2-15). The mean follow up period was 55.6 months, 1-year survival was 96.5% and 5-year survival rate was 88%. A total of 25 patients were alive at the end of follow-up period and 3 of the patients became exitus due to disease. Two patients had a metastatic presentation in livers at the diagnosis and metastasis developed in 3 patients during follow-up (liver of 1 patient, peritoneum in 1 patient and liver and peritoneum in 1 patient). The reason of admission was headache in 68% patients. The type of operation was frequently subtotal pancreatectomy (n = 11, 39.3%) and distal pancreatectomy (n = 10, 35.7%). Tumors were located frequently in body and tail regions (n = 18, 64.3%) and the number of patients with malignant criteria was 6 (21.4%). Although the mean age of malignant patients was significantly higher than benign patients (P = 0.046), there was no significant difference between 2 groups in terms of gender, tumor size, capsule invasion, perineural invasion, vascular invasion, and margin status. CONCLUSION SPN is a rarely seen tumor with low malignity potential. Surgical resection provides long-term survival rate even in local invasion or metastasis conditions.

Clinicopathologic characteristics, treatment outcomes, and prognostic factors of primary thoracic soft tissue sarcoma: A multicenter study of the Anatolian Society of Medical Oncology (ASMO)

Soft tissue sarcomas (STSs) are rare malignant tumors of embryogenic mesoderm origin. Primary thoracic STSs account for a small percentage of all STSs and limited published information is available. This study aimed to identify the prognostic factors for thoracic STSs and evaluate the diseases clinical outcomes.

Adult Urological Soft Tissue Sarcomas: A Multicenter Study of the Anatolian Society of Medical Oncology (ASMO)

OBJECTIVE To analyze clinicopathological characteristics, prognostic factors and survival rates of the patients with urological soft tissue sarcomas treated and followed up in Turkey. MATERIALS AND METHODS For overall survival analyses the Kaplan-Meier method was used. From medical records, nine prognostic factors on overall survival were analysed. RESULTS For the 53 patients (34 males, 19 females) whose charts were reviewed, the median age was 53 (range 22 to 83) years. Most frequently renal location (n=30; 56.6%) was evident and leiomyosarcoma (n=20, 37.7%) was the most frequently encountered histological type. Median survival time of all patients was 40.3 (95% CI, 14.2-66.3) months. In univariate analysis, male gender, advanced age (≥50 years), metastatic stage, unresectability, grade 3, renal location were determined as worse prognostic factors. In multivariate analysis, metastatic stage, unresectability and grade 3 were determined as indicators of worse prognosis. CONCLUSIONS Urological soft tissue sarcomas are rarely seen tumours in adults. The most important factors in survival are surgical resection, stage of the tumour at onset, grade and location of the tumour, gender and age of the patients.

Recurrence risk and prognostic parameters in stage I rectal cancers

BACKGROUND The standard therapy for stage I rectum cancer is surgical resection. Currently, there is no strong evidence to suggest that any type of adjuvant therapy is beneficial. The risks of local relapse and distant metastasis are higher in rectal tumors. Therefore, while there is no clearly defined absolute indication for adjuvant therapy in lymph node negative colon cancers, rectum tumors that are T3N0 and higher require adjuvant treatment. Due to the more aggressive nature of rectal cancers, we explored the clinical and pathologic factors that could predict the risk of relapse in Stage I (T1-T2) disease and whether there was any progression-free survival benefit to adjuvant therapy. MATERIALS AND METHODS This multicenter study was carried out by the Anatolian Society of Medical Oncology. A total of 178 patients with rectal cancers who underwent curative surgery between January 1994 and August 2012 in 13 centers were included in the study. Patient demographics, including survival data and tumor characteristics were obtained from medical charts. RESULTS The median age was 58 years (range 26-85 years). Most tumors were well or moderately differentiated. For adjuvant treatment, 13 patients (7.3%) received radiotherapy alone, 12 patients (6.7%) received chemotherapy alone and 15 patients (8.4%) were given chemoradiotherapy. Median follow up was 29 months (3-225 months). Some 42 patients (23.6%) had relapse during follow up; 30 with local recurrence (71.4%) whereas 12 (28.6%) were distant metastases. Among the patients, 5-year DFS was 64% and OS was 82%. Mucinous histology and receiving adjuvant therapy were found to have statistically insignificant correlations with relapse and survival. CONCLUSIONS In our retrospective analysis, approximately one quarter of patients exhibited either local or systemic relapse. The rates of relapse were slightly higher in the patients who had no adjuvant therapy. There may thus be a role for adjuvant therapy in high-risk stage I rectal tumors.

Impact of adjuvant treatment modalities on survival outcomes in curatively resected pancreatic and periampullary adenocarcinoma

ABSTRACT Aim: We examined impact of adjuvant treatment modalities in patients with curatively resected pancreatric adenocarcinoma (PAC). Methods: A total of 563 consecutive patients who were resected for PAC in 26 oncology centers were retrospectively analyzed between January 2003 and December 2013. Results: Of 563 patients, 472 received adjuvant treatment with chemotherapy alone (CT), chemoradiotherapy alone (CRT), and chemoradiotherapy with maintenance chemotherapy (CRT-CT) were analyzed. Of 472 patients, 231 were given CRT-CT, 26 were given CRT, and 215 were given CT. The median recurrence free survival (RFS) and overall survival (OS) were 12 and 19 months, respectively. Survival rates at 1st, 3rd, and 5th years were 70%, 23% and 16%, respectively. When CT and CRT-CT groups were compared, there was no difference with respect to both RFS and OS, and also there was no difference in RFS and OS among CRT-CT, CT and CRT alone groups. To further investigate the impact of addition of radiation to chemotherapy on subgroups, patients were stratified according to lymph node status and resection margins, and then analyzed separately. When patients with positive lymph node disease were considered, both RFS (p = 0.004) and OS (p = 0.003) were significantly longer in CRT-CT group than CT group. In contrast, there was no difference between groups when patients with no metastatic lymph node disease or patients with or without positive surgical margins were considered. Conclusions: Although adjuvant chemotherapy is the standart treatment in curatively resected PAC, radiation should be a part of treatment at least in patients with positive lymph node disease. Disclosure: All authors have declared no conflicts of interest.

Neutropenic enterocolitis after adjuvant chemotherapy: a case report

Neutropenic enterocolitis is a rare clinical entity with high mortality rates seen in immunosuppressive patients. Neutropenic patients with abdominal pain should be considered.We report here case of 40 year breast carcinoma patient presented with abdominal pain after adjuvant chemotherapy. Pam Med J 2013;6(2):96-99