Hilmi Kocaoglu

Retroperitoneal soft tissue sarcoma: effect of hyperthermic total abdominal perfusion.

Aims and Background Soft tissue sarcomas (STS) of the retroperitoneum are rare tumors. Surgery remains the principal modality of therapy in the management of primary and recurrent retroperitoneal STS. However, little is known about the effect of regional chemotherapy using hyperthermic total abdominal perfusion (HTAP). We analyzed independent prognostic variables in 33 patients with STS in the retroperitoneum admitted from November 1990 through December 1996. Methods and Study Design Data regarding patients’ age, gender, tumor size, histological tumor type, tumor location, type of operation (primary or secondary surgery), extent of surgical management (marginal or extended), use of HTAP, tumor grade, and tumor stage according to the TNM classification were examined by univariate and multivariate analyses. Results All 33 patients underwent complete resections (marginal or extended). Eleven of them received locoregional chemotherapy by HTAP. The overall cumulative 5-year survival rates in patients with stage IIA and advanced disease were 82% and 22%, respectively (log-rank test, P <0.01). Using Coxs proportional hazard model, tumor stage, use of HTAP and type of operation were found to have significant influence on overall survival (P <0.05). Conclusions Our results showed that complete resection along with HTAP chemotherapy may improve survival in patients with retroperitoneal STS. These phase II data could be used to support the initiation of a phase III trial to test HTAP in patients submitted to complete resection of retroperitoneal STS.

Aqueous extract from taxus baccata inhibits adenosine deaminase activity significantly in cancerous and noncancerous human gastric and colon tissues

Objective: To investigate possible effects of aqueous taxus baccata extract on adenosine deaminase (ADA) activity in cancerous and noncancerous human tissues and to clarify mechanism(s) of its anticancer potential. Materials and Methods: Cancerous and noncancerous human gastric and colon tissues were used in the study. The extracts were prepared in distilled water. Before and after treatment with the extracts, ADA activities in the tissue homogenates were measured. Results: ADA activity was found to be higher in gastric tissue compared with colon tissue, but no differences were found between ADA activities of cancerous and noncancerous tissues for both as well. In the plant extract studies, it was found that taxus extract significantly inhibited ADA activity both in cancerous and noncancerous gastric and colon tissues. Conclusion: Our results suggest that aqueous extract from taxus baccata inhibits ADA activities in both gastric and colon tissues significantly. It is suggested that in addition to other proposed mechanisms, accumulated adenosine due to the inhibition of ADA enzyme might also play part in the anticancer properties of taxus species.

Long-term survival after regional chemotherapy for liver metastases from breast cancer. A case report.

The prognosis of patients with liver metastases from breast cancer has to be regarded as rather unfavorable. A 45-year-old woman with cancer of the left breast and multiple simultaneous liver metastases was initially treated with cyclophosphamide, methotrexate, and 5-fluorouracil. After two treatment cycles a sonogram of the left breast revealed reduction of the tumor size and she underwent a modified radical mastectomy and hepatic artery catheterization. There was no change in the multiple lesions of the liver on abdominal ultrasonography. One week later a regional chemotherapy regimen was given through a hepatic arterial catheter with subcutaneous implanted reservoir. After completion of the seventh course of chemotherapy, ultrasonography revealed that the multiple liver metastases had regressed completely. To date (July 2001) there has been no relapse during the seven-year follow-up period. In conclusion, we suggest that intra-arterial regional chemotherapy may have an important role to play in the management of breast cancer patients with isolated liver metastases.

Treatment of non-resectable pelvic malignancies by isolated pelvic perfusion. a preliminary study

Management of non-resectable pelvic tumours by intra-arterial local chemotherapy was shown to be beneficial but systemic toxicity limits its use. To overcome this problem isolated pelvic perfusion (IPP) was introduced as an alternative. This study summarizes our preliminary experience with IPP in the treatment of 18 non-resectable pelvic tumours [recurrent rectal adenocarcinoma (six), soft tissue sarcoma (STS) (five), bone tumour (three), epidermoid carcinoma (two), prostatic adenocarcinoma (one), malignant melanoma (one)]. Results of IPP were regarded as complete remission (CR), partial remission (PR), stable disease (SD) and disease progression (DP) according to the changes in three parameters including; scoring in pain, tumour marker and tumour size measurements. Complete and partial remission were established in five (27%) and seven (39%) patients respectively indicating a benefit ratio of 66%. Objective pain relief was encountered in 53% of the cases. All patients with STS had undergone further surgical treatment after IPP with successful curative resections in four. No residual tumour was found at the laparotomy of the fifth patient. Presenting symptom of the prostatic adenocarcinoma patient was symptomatic hypoglycaemia which resolved completely after IPP. To our knowledge, this represents the first case reported in the English literature in whom tumour related hypoglycaemia was successfully managed by IPP. In conclusion; management of non-resectable pelvic tumours by IPP seems to offer serious palliation and increase in the quality of life without any systemic toxicity. Our preliminary experience suggests even resectability may be achieved in a number of patients especially in those with STS.

Primer meme kanserinin lokal kontrolünde radyofrekans ablasyon bir seçenek olabilir mi

Meme kanseri tedavisi icin radyofrekans ablasyon gorece yeni bir tekniktir. Radyofrekans ablasyon uygulama- lari konusunda literaturde her gun artan yayinlara karsin meme kanserinde uygulamalardaki deneyim sinirli bu- lunmaktadir. Sinirli sayidaki klinik calismanin sonuclarina bakildiginda bu yontem, tumor boyutu kucuk olan (T1) lokalize olgularda tercih edilebilir minimal invaziv bir yontem gibi gorunmektedir. Doku harabiyeti nedeniy- le ablasyon sonrasi histopatolojik degerlendirmenin yapilamamasi ve hastalarin takibinde belirli bir standardi- zasyonun olmayisi bu islemin cozum bekleyen onemli sorunlaridir. Radyofrekans ablasyonun ameliyat edilebi- lir meme kanserinde bir tedavi secenegi olabilmesi icin, literaturdeki hasta sayisi dusuk olan az sayidaki hete- rojen calismalara eklenmis, uzun takip sureli ve genis serili klinik calismalara ihtiyac vardir.

Aqueous extracts of Rosmarinus officinalis, Urtica diocia, and soybean exert different effects on adenosine deaminase activity in cancerous and noncancerous human gastric and colon tissues

Objective: This study aimed to investigate effects of aqueous extracts of Rosmarinus officinalis, Urtica diocia, and soybean on adenosine deaminase (ADA) activity in cancerous and noncancerous gastric and colon tissues since it is key enzyme participating in DNA turn-over. Materials and Methods: In method, cancerous and noncancerous human gastric and colon tissues removed by surgical operations were studied. In the samples, ADA activities were measured with and without plant extract incubated for 1 h. Results: As a result, it has been observed that rosemary extract inhibits ADA enzyme in cancerous (P = 0.031) and noncancerous gastric tissues (P = 0.048), but not in colon tissues, and Urtica extract inhibits the enzyme only in the cancerous gastric tissue (P = 0.039). On contrast, soybean extract activates ADA enzyme in colon tissues significantly (P = 0.012). Conclusion: Inhibition of ADA enzyme might play a part in the proposed anti-cancer properties of rosemary and U. diocia. However, the finding of ADA activation in colon tissues by soybean extract is a new one which needs further verification.

Mide kanseri cerrahisinde fast-track ve geleneksel yöntemlerin karşılaştırılması

GIRIŞ Mide kanseri sik karsilasilan bir hastaliktir. Dunyada her yil yaklasik bir milyon yeni olgu teshis edilmektedir (1). Billroth tarafindan ilk basarili gastrektominin yapildigi 1881 yilindan bu yana cerrahi mide kanserinin kuratif tedavisinde hala tek umuttur. Geleneksel elektif gastrik rezeksiyon %10-45 komplikasyon orani ve 8-13 gunluk postoperatif hastanede yatis suresiyle uygulanmaktadir (2-5) . Mide kanser cerrahisinde fasttrack cerrahi (FTC) uygulamalarla ilgili, literaturde cok az veri bulunmaktadir. Tek prospektif randomize calisma Wang ve ark. (6) ait olup FTC’nin mide kanser cerrahisine guvenle uygulanabilecegi rapor edilmistir.

An alternative method for preventing extravasation complications in vascular access catheters with reservoirs for subcutaneous infusion: the double injection technique.

Long-term intravascular access catheters with reservoirs are a common requirement for cancer patients. Complications resulting from the use of these devices have been studied in several single-institution investigations, the consensus being that they are safe and have a low complication rate. However, extravasation may occur especially in obese patients due to accidental infusion of the subcutaneous tissue. To prevent this problem we describe an easy method that could be an alternative to the widely used ultrasonography-guided injection method.

Effects of Repeated Transcatheter Arterial Embolization in Patients with Hepatocellular Carcinoma

Fifteen patients with hepatocellular carcinoma were treted repeatedly by transcatheter arterial embolization (TAE) using ethiodized oil, cisplatin, and mitomycin C. The patients were not eligible for

Treatment of Acute Mesenteric Infarction by Resection of the Bowel and Reimplantation of the Superior Mesenteric Artery into the Aorta: A Case Report

In this report the authors present a case of acute mesenteric infarction resulting from the thrombotic occlusion of the superior mesenteric artery in which a reimplantation technique was used as a revascularization procedure with success.