Havva Yeşil Çınkır

Biological Subtypes and Distant Relapse Pattern in Breast Cancer Patients After Curative Surgery (Study of Anatolian Society of Medical Oncology)

Purpose: The aim of the study was to investigate the association between the molecular subtypes and patterns of relapse in breast cancer patients who had undergone curative surgery. Methods: We retrospectively evaluated 1,350 breast cancer patients with relapses after curative surgery between 1998 and 2012 from referral centers in Turkey. Patients were divided into 4 biological subtypes according to immunohistochemistry and grade: triple negative, HER2 overexpressing, luminal A and luminal B. Results: The percentages of patients with luminal A, luminal B, HER2-overexpressing, and triple-negative breast cancer were 32.9% (n = 444), 34.9% (n = 471), 12.0% (n = 162), and 20.2% (n = 273), respectively. The distribution of metastases differed among the subgroups: bone (66.2% and 53.9% in luminal A and B vs. 38.9% in HER2-overexpressing and 45.1% in triple negative, p < 0.001), liver (40.1% in HER2-overexpressing vs. 24.5% in luminal A, 33.5% in luminal B, and 27.5% in triple negative, p < 0.001), lung (41.4% in triple negative and 35.2% in HER2-overexpressing vs. 30.2% and 30.6% in luminal A and B, p = 0.008) and brain (25.3% in HER2-overexpressing and 23.1% in triple negative vs. 10.1% and 15.1% in luminal A and B, p < 0.001). Conclusions: Organ-specific metastasis may depend on the molecular subtype of breast cancer. Tailored strategies against distant metastasis concerning the molecular subtypes in breast cancer should be considered.

Treatment and Prognostic Factors in Primary Peritoneal Carcinoma: A Multicenter Study of the Anatolian Society of Medical Oncology (ASMO)

Background: In this study, we aimed to evaluate the clinicopathological characteristics and prognosis of patients with primary peritoneal carcinoma (PPC), and the effectiveness and toxicity of first-line platinum/taxane combination therapy. Patients and Methods: We retrospectively evaluated 79 patients with PPC, who were treated and followed up between December 2001 and August 2012 at 10 medical oncology clinics. Results: All patients were female, with a median age of 63 years (range 34-79 years). Histopathological diagnoses included primary peritoneal serous carcinoma (PPSC) (n = 69) and mixed epithelial carcinoma of the peritoneum (MEC) (n = 10). Patients received first-line treatment with carboplatin/paclitaxel (n = 67) or cisplatin/paclitaxel (n = 12) combination therapy. Overall response rate, median progression-free survival, and median survival time in the paclitaxel/carboplatin group and the paclitaxel/cisplatin group were 74.6 vs. 75%, 15.6 vs. 37.8 months, and 41 vs. 70.3 months, respectively. In multivariate analysis, favorable prognostic factors were: ECOG performance status 0 (p < 0.001) and optimal cytoreduction (p = 0.03). Conclusion: PPC is a rare, heterogeneous disease. ECOG performance status and optimal cytoreduction are important prognostic factors regarding survival rates. Platinum/taxane combination therapy is an effective and tolerable regimen in this patient group.

Pathologic and Clinical Characteristics of Elderly Patients With Breast Cancer: A Retrospective Analysis of a Multicenter Study (Anatolian Society of Medical Oncology)

There is very little information about breast cancer characteristics, treatment choices, and survival among elderly patients. The purpose of this multicenter retrospective study was to examine the clinical, pathologic, and biologic characteristics of 620 breast cancer patients age 70 years or older. Between June 1991 and May 2012, 620 patients with breast cancer, recruited from 16 institutions, were enrolled in the retrospective study. Patients had smaller tumors at diagnosis; only 15% of patients had tumors larger than 5 cm. The number of patients who had no axillary lymph node involvement was 203 (32.7%). Ninety-three patients (15.0%) had metastatic disease at diagnosis. Patients were characterized by a higher fraction of pure lobular carcinomas (75.3%). The tumors of the elderly patients were also more frequently estrogen receptor (ER) positive (75.2%) and progesterone receptor (PR) positive (67.3%). The local and systemic therapies for breast cancer differed according to age. An association between age and overall survival has not been demonstrated in elderly patients with breast cancer. In conclusion, the biologic behavior of older patients with breast cancer differs from younger patients, and older patients receive different treatments.

Non-Urothelial Bladder Cancer: Comparison of Clinicopathological and Prognostic Characteristics in Pure Adenocarcinoma and Non-Bilharzial Squamous Cell Carcinoma of the Bladder

Objectives: The clinicopathological characteristics, treatment modalities, and effects on the prognosis of pure squamous cell carcinoma (SqCC) and adenocarcinoma (AC) were evaluated. Materials and Methods: 86 patients with pure SqCC and AC bladder cancer were evaluated retrospectively. Results: Of the 86 patients, 51 had SqCC and 35 had AC. No differences in clinicopathological characteristics were observed between patients with AC and SqCC, except for the prevalence of T4 disease (28.6% vs. 51.0%, respectively). In multivariate analysis, older age, stage IV disease, and Eastern Cooperative Oncology Group (ECOG) performance status (> 2) were predictive of a poor overall survival (OS). The median OS was significantly longer for stage I-III patients (82.9 months) treated with surgery ± chemotherapy (CT) ± radiotherapy (RT) than for those treated with transurethral resection ± CT ± RT (24.3 months) (P = 0.007). The median OS of patients with SqCC and AC who were given platinum-based CT for metastasis was 7.7 and 30.3 months, respectively. Conclusions: Advanced age, stage IV disease, and poor ECOG performance status were factors associated with a poor prognosis. Surgery ± CT ± RT resulted in significantly better OS, except in stage IV disease. Patients with metastatic AC had better response rates with platinum-based CT.

Title Page / Contents / Imprint / Guidelines

S. Al-Batran, Frankfurt/M. C. Berking, München C. Bokemeyer, Hamburg M. Borner, Bern T. Cerny, St. Gallen H. T. Eich, Münster A. Engert, Köln M. Fassnacht, München B. Groner, Frankfurt/M. V. Heinemann, München M. Hentrich, München R. D. Issels, München W. Janni, Ulm U. R. Kleeberg, Hamburg H. Lang, Mainz M. Moehler, Mainz M. Schuler, Essen R. Stupp, Zürich M. Theobald, Mainz R. Thomas, Köln U. Wedding, Jena J. A. Werner, Marburg O. Zivanovic, New York

Meme Kanseri Nüksünü Düşündüren Aksiller Lenfadenopati: Olgu Sunumu

Breast cancer is the most common cause of cancer related death in women. The most common cause of mortality is recurrent diseases. We report the case of a patient followed-up with breast cancer under remission presented with newly developed regional lymphadenopathy on the axillary region of the other breast side, which was suspected as the recurrence of the disease and diagnosed as granulomatosus lymphadenitis.

Kolon Kanseri Hastasında Bilateral Endobronşiyal Obstruktif Metastaz: Olgu Sunumu

Although lung metastasis is frequent, endobronchial metastasis (EBM) is rare. We are presenting a case of colon cancer related bilateral EBM since it is rare. A sixty-two year old male patient was admitted with complaints of cough, respiratory distress and haemoptysis continuing for 3 months. He had a history of smoking 40 packages in a year, an operation due to colon cancer 12 years previously and adjuvant chemotherapy. Right pulmonary aeration was not observed in the direct pulmonary graphy, homogeneous opacity was detected in the right hemithorax and deviation to right was observed in the trachea. Fiberoptic bronchoscopy (FOB) revealed an endobronchial tumoral lesion obstructing the right main bronchus and tumoral lesions in the left main bronchus and the bronchus of the inferior left lobe. It was observed in an immunohistochemical study of the biopsy material, obtained from the mass within the right main bronchus, that the tumor sites were stained with CK20 and CDX2, and not stained with CK7 or TTF1. Histopathological findings were evaluated and found to be compatible with colon adenocarcinoma metastasis. Paliative 3600 cGY radiotherapy (RT) was performed on the right lung and mediastinum. FOLFIRI-Setuximab therapy was started since the metastatic colon cancer was of the K-ras wild type.