Utku Oflazoglu

Prognostic Value of the Pretreatment Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio for Patients with Neuroendocrine Tumors: An Izmir Oncology Group Study

Background: Several studies evaluating the prognostic factors of gastrointestinal and pancreatic neuroendocrine tumors (GEP-NETs) have been published. The neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) have been accepted as prognostic factors for cancer patients. Materials and Methods: This study included 132 patients diagnosed with GEP-NETs. Peripheral blood samples were collected before the pretreatment period. Results: NLR and PLR were increased as the grade increased in NETs. The embryonic origin analysis revealed higher NLR and PLR rates in NETs of foregut origin. NLR and PLR were also higher in pancreatic NET patients compared to the gastroenteric NET patients. Analysis of NETs by TNM indicated that an advanced stage was accompanied by significantly higher NLR and PLR. We found a strong negative correlation between progression-free survival and NLR and PLR. Conclusion: The study verified that NLR and PLR are simple laboratory findings that can be used to identify NETs with a worse outcome.

Is monitoring mean platelet volume necessary in breast cancer patients

Abstract Background Mean platelet volume (MPV) is a parameter that increases during thrombotic and cardiovascular events. Tamoxifen (Tmx) and aromatase inhibitors (AIs), which are adjuvant endocrine therapies, may cause serious side effects, such as vascular thrombosis. The present study investigated the changes in MPV values of breast cancer patients receiving long-term adjuvant hormone therapy and the relationship of MPV with adverse effects of hormonotherapy. Methods Data of 261 patients who had pathologically confirmed estrogen or progesterone receptor positive invasive breast cancer and had received hormonotherapy for at least a 5-year period were retrospectively analyzed. MPV levels were measured at baseline and at the first and fifth year of hormone therapy. Results All patients were females and their median age was 50 years (range, 27–78 years). The mean MPV value was significantly increased in all patients in the Tmx, AI, and switch groups over time (p<0.001). Conclusion This is the first study evaluating the relationship between the 5-year adjuvant endocrine therapy and changes in MPV values in breast cancer patients. Monitoring changes in MPV values may be predictive for severe side effects in breast cancer patients receiving hormone therapy.

The alterations of serum FGF-21 levels, metabolic and body composition in early breast cancer patients receiving adjuvant endocrine therapy

BACKGROUND In early breast cancer patients, the effects of hormonal therapy (tamoxifen and aromatase inhibitors) on plasma fibroblast growth factor 21 (FGF-21), lipid levels and body composition have not yet been investigated. Therefore, we aimed to analyze the relationship between FGF-21 and body composition as well as the effects of tamoxifen and aromatase inhibitors on plasma lipid levels, FGF-21, and body composition. METHODS A total of 72 patients were treated with either tamoxifen or aromatase inhibitors due to their menopausal status after adjuvant radiotherapy. Each patient was followed-up over a period of 1 year. Changes in body composition and serum lipid profile, glucose and FGF-21 levels were evaluated. We recorded the type of hormonal therapy, body mass index, waist-to-hip ratio, lipid profile, and FGF-21 levels both at the beginning and after 12 months. RESULTS There was a statistically significant decrease in serum FGF-21 levels after 12 months of adjuvant endocrine therapy (46 ± 19.21 pg/ml vs. 30.99 ± 13.81 pg/ml, p< 0.001). Total body water (p< 0.001), serum glucose (p= 0.036) and triglyceride levels (p< 0.001) also exhibited a significant decrease. The decreases in total cholesterol and low-density lipoprotein were not statistically significant. Likewise, high-density lipoprotein increased after adjuvant endocrine therapy, although it did not reach statistical significance. The changes in body composition, glucose, lipid profile and FGF-21 were similar in tamoxifen and aromatase inhibitor groups. A positive correlation was found between basal weight, fat mass, fat-free mass and serum FGF-21 levels; however, the correlation was maintained only for the fat-free mass at the 12th month. CONCLUSION As part of the present study, we suggest that both tamoxifen and aromatase inhibitors can reduce FGF-21 levels independently of body compositions, and these drugs can provide antihyperlipidemic, antidiabetic and cardio-protective effects. We also recommend that serum FGF-21 level can be utilized as a tumor biomarker in early-stage breast cancer and for monitoring purposes. FGF-21 levels may help physicians estimate prognosis, too. Further studies with larger populations may shed light on the role of FGF-21 in breast cancer.

Evaluating Depression, Anxiety, Sexuality and Quality of Life in Metastatic Lung Cancer Patients

Introduction: Lung cancer (LC) affects psychosexual outcome and quality of life (QoL) of the patients because of short survival period and aggressive treatment modalities. The aim of our study was to investigate anxiety, depression, QoL and sexual satisfaction levels of LC patients. Methods: The data for metastatic LC patients treated with first or second-line chemotherapy were collected by using four forms completed during face-to-face interviews. The forms consist of socio-demographic characteristics, the Beck Depression Inventory (BDI), Golombok-Rust Inventory of Sexual Satisfaction (GRISS) and European Organization for Research on Treatment of Cancer Questionnaires Quality of Life-C30 (EORTCQoL-C30). Results: Forty-four LC patients were participated in this study. The total Beck scores of patients for anxiety and depression were very high (15.60 ± 12.30 and 16.02 ± 11.39; respectively). When we evaluated GRISS scores of our metastatic LC patients with respect to their anxiety or depression levels, we could not find any statistical significance. In the metastatic LC patients whose anxiety and depression scores were high, physical, cognitive, emotional and social functioning of EORTC-QLQ-C30 was found statistically significantly low. Statistical significance in terms of role functioning was only found in the patients with high anxiety scores. Conclusion: Metastatic LC patients had high anxiety and depression levels, decreased sexual satisfaction and impaired QoL.