Devrim Cabuk

Vascular endothelial growth factor, hypoxia-inducible factor 1 alpha and CD34 expressions in early-stage gastric tumors: relationship with pathological factors and prognostic impact on survival.

Background: Angiogenesis is one of the key steps in solid tumor growth and metastasis. We planned to investigate the prognostic significance of vascular endothelial growth factor (VEGF), hypoxia-inducible factor 1α (HIF-1α) and CD34 expressions as markers of angiogenesis in gastric cancer. Patients and Methods: We retrospectively reviewed the medical records of 51 gastric cancer patients who had total or subtotal gastrectomy at Marmara University Hospital from 1990 to 2004 and evaluated the expression of VEGF, HIF-1α and CD34 by immunohistochemistry in their archival tumor tissues. We recorded the clinical and pathological characteristics of these patients and analyzed their survival outcome. Results: Thirty out of 51 patients were males. The median age was 63 years (range 34–81). The median follow-up was 17 months. Thirty-six patients had node-positive disease. The majority of patients (n = 43) had T2 and T3 disease. Vascular and lymphatic invasions were present in 57 and 77% of tumors, respectively. VEGF and HIF-1α were positive in 65 and 71% of tumors. The median CD34 staining score was 19 (3–68). VEGF, HIF-1α and CD34 expressions were more frequent in tumors without serosal invasion (p = 0.01, p = 0.01 and p = 0.003, respectively). CD34 expression was significantly more frequent in tumors with VEGF and HIF-1α expression (p = 0.00, p = 0.00). HIF-1α expression was more frequent in tumors with VEGF expression (p = 0.00). The 5-year overall survival was 45%. VEGF, HIF-1α, CD34 expressions and other pathological characteristics were found to have no impact on survival. Conclusion: VEGF, HIF-1α and CD34 expressions were more common in tumors without serosal invasion. As a future perspective, biological agents targeting VEGF and HIF-1α might be more effective at earlier stages of gastric cancer.

Clinical Outcome of Turkish Metastatic Breast Cancer Patients with Currently Available Treatment Modalities - Single Center Experience

BACKGROUND Breast cancer is the most common malignancy and the second leading cause of cancer-related death among women in the developed countries. Despite advances in screening, improved local therapies and adjuvant systemic treatments, median survival of metastatic breast cancer patients (MBC) is in the range of 2-3 years at most. We aimed to investigate whether the prognostic factors and therapeutic responses of our Turkish patients are similar to those in the literature. MATERIALS AND METHODS We reviewed the medical records of MBC patients who had been treated in our institution between 1999-2009 and analyzed their clinicopathological features and survival outcomes retrospectively. RESULTS A hundred and sixty patients were included. Median age was 47 (23-82), median follow up was 24 (2-186) months. At the time of diagnosis 59% of patients were under the age of 50 and 46% were postmenopausal. The majority (37%) had multiple sites of metastases. Forty percent received endocrine therapy and 40% chemotherapy as first line metastatic treatment. Thirty (20%) patients were treated with molecular targeting agents like trastuzumab, lapatinib and sunitinib, frequently combined with a chemotherapy agent. Five-year overall survival (OS) was 32% and median OS was 38 months for the whole group. Five year progression free survival (PFS) was 10% and median PFS was 10 months. Menopausal status, hormone receptor expression and disease free status had a significant impact on overall survival in the multivariate analysis (p 0.018, p 0.018 and p:0.003, respectively). CONCLUSIONS All our patients were treated with the modern oncologic therapies recommended by the international guidelines. From our data, MBC patients live up to 3-4 years, indicating that further improvement beyond that requires development of new treatment modalities. The survival outcomes of our patients were consistent with the data reported in the literature.

Netrin-1 in cancer: Potential biomarker and therapeutic target?:

Netrin-1, a laminin-related protein, is known to be involved in the nervous system development. Recently, Netrin-1’s involvement in other processes such as cell adhesion, motility, proliferation, and differentiation that are important for the development of epithelial tissues has been described. In addition, Netrin-1 and its receptors, deleted in colorectal cancer and uncoordinated-5 homolog, have been linked to apoptosis and angiogenesis. Since these properties are essential for tumor development, Netrin-1 and its receptors have been reported to promote tumorigenesis in many types of cancers. Here, we review the Netrin-1 mediated regulation of cancer, its potential use as a biomarker, and the targeting of the Netrin-1 pathway to treat cancers.

Clinical features and outcome of adjuvant chemoradiotherapy in Turkish rectal carcinoma patients: Single institution experience

15103 Background: Chemoradiotherapy (CRT) after or before resection of high-risk rectal cancer (RC) improves overall survival (OS) and pelvic control. Thus, CRT is the standard adjuvant treatment in resected stage II/III RC. There are limited studies, if any, analyzing the outcome of RC patients with stage II/III who received adjuvant CRT after curative resection in Turkey. Therefore, we aimed to analyze the treatment outcome, and the prognostic significance of various parameters in these patients. Methods: 144 patients with stage II/III RC treated with adjuvant CRT since 1997 until present were analyzed retrospectively. Patients received 5-fluorouracil (375–425mg/m2/day × 5days) and calcium leucovorin (20mg/m2/day × 5days), q4weeks, two courses before and two courses after radiotherapy (RT). The 5- fluorouracil dose was reduced either to 225mg/m2/day given continuously as protracted short-term infusion during RT, or to 375–400 mg/m2/day on the first and last 4 days of RT. 45–50.4 Gy RT was given to the p...

VEGF, HIF-1 alpha and CD34 expressions in gastric tumors (tms): Relationship with pathological factors and prognostic impact on survival

4040 Background: We planned to investigate the prognostic impact of VEGF, HIF-1alpha, CD34 in gastric cancer patients (pts). Methods: We reviewed the medical records of 51 gastric cancer pts who had total or subtotal gastrectomy at Marmara University Hospital between 1999–2004 retrospectively. We evaluated the expression of VEGF, HIF-1alpha, CD34 by immunhistochemistry in the archival tumor tissues. Cytoplasmic staining was considered as positive for VEGF. The intensity of expression is scored between 0–4+ for HIF 1 alpha. CD 34 which represents microvessel density, was scored numerically based on the intensity of staining in endothelial cells. We recorded the clinical and pathological characteristics of these patients and analyzed their survival outcome. Results: Thirty out of 51 pts were male. The median age was 63(34–81). The median follow-up was 17 months. Thirty-six pts had node positive disease. Five pts had T1, 24 pts had T2, 19 pts had T3 and 3 pts had T4 disease. Vascular and lymphatic invasion w...

Does the incidence of anal canal cancers differ in Moslem societies

G. Demir · M. Ozguroglu Division of Medical Oncology, Cerrahpasa Medical Faculty Hospital, Instanbul University, Istanbul, Turkey Dear Editor: In the Western world, cancers of the anal region account for 1–2% of all colon cancers and 3.9% of all anorectal carcinomas [1]. The majority of these patients (75–80%) have squamous cell carcinomas and the rest mainly adenocarcinomas. Many medical oncologists in Turkey state in their private communications that the anal cancers are rare in the Moslem world, owing to the different sanitary habits of these societies. There are no tumor registries established in the Moslem world to confirm this assertion. In order to study this, we reviewed local tumor registries in two university medical centers with respected oncology programs. The tumor registries from 1990 to 2003 of the Marmara and Cerrahpasa University Hospital Medical Oncology Divisions were studied. All patients were included in the tally regardless whether or not they had received any chemo-radiotherapy. There were 798 patients with large bowel carcinomas during that period and nine (1.12%) of these patients had squamous cell carcinomas of the anal canal. Even though sanitary behaviors are different in Moslem societies like our own, it appears that the ratio of anal to colorectal cancers is no different than the ratio reported in the Western literature.