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Papers by Fatih Teker

Hellenic journal of nuclear medicine, 2021

OBJECTIVE The prognostic potential of pretreatment maximum standardized uptake volume (SUVmax) on... more OBJECTIVE The prognostic potential of pretreatment maximum standardized uptake volume (SUVmax) on gallium-68-DOTATATE was evaluated with positron emission tomography/computed tomography (68Ga-DOTATATE PET/CT) in 37 patients with G1/G2 gastroenteropancreatic neuroendocrine tumors (NET) who received peptide receptor radionuclide therapy (PRRT) with lutetium-177-[DOTAo,Tyr3] octreotate (177Lu-DOTATATE) after the failure of somatostatin analogues. METHODS The mean and total SUVmax were used in 68Ga-DOTATATE PET/CT before 177Lu-DOTATATE treatment to assess the progression-free survival (PFS). RESULTS The responses of the patients were evaluated as partial response in 8 (32%) patients, stable disease in 12 (48%), and progressive disease in 5 (20%). The median PFS was 18 months; longer than this threshold in 14 patients (26.0 months) and shorter in 11 (8.4 months). The mean SUVmax of metastases in the liver (34.15±17.89 vs. 14.69±9.17, P=0.004) and mean SUVmax of all body metastatic lesion...

Gastrointestinal stromal tumors (GISTs) are uncommon tumors of the gastrointestinal (GI) tract. R... more Gastrointestinal stromal tumors (GISTs) are uncommon tumors of the gastrointestinal (GI) tract. Regorafenib is a new multikinase inhibitor and is approved for the treatment of GISTs in patients who develop resistance to imatinib and sunitinib. The most common drug-related adverse events with regorafenib are hypertension, hand-foot skin reactions, and diarrhea. Grade IV hypertensive side effect has never been reported after a single dose. In this report, we present a case of Grade IV hypertensive side effect (hypertensive crisis and seizure) after a single dose of regorafenib. A 54-year-old male normotensive GIST patient was admitted to the emergency department with seizure and encephalopathy after the first dosage of regorafenib. His blood pressure was 240/140 mmHg upon admission. After intensive treatment with nitrate and nitroprusside, his blood pressure returned to normal levels in five days. Regorafenib was discontinued, and he did not experience hypertension again. This paper r...

Annals of Nuclear Medicine

We compared the ability of 68Ga-FAPI PET//CT with 18FDG PET/CT imaging techniques to detect addit... more We compared the ability of 68Ga-FAPI PET//CT with 18FDG PET/CT imaging techniques to detect additional lesions in breast cancer patients that may affect further chemotherapy options. A total of 48 patients with breast cancer underwent concurrent 68Ga-FAPI-04 and 18FDG PET/CT regardless of whether they had received chemotherapy or not in the last month before imaging. Both modalities were compared according to various parameters: clinical/pathological features, number of lesions detected, activity uptake (SUVmax), and the effect on the evaluation of response to treatment in the post-chemotherapy group. This retrospective study included 48 patients with breast cancer (mean age 53.3 ± 11.7 years; IDC 89.6%; ILC 10.4%). In the comparison of both modalities, no statistical significance was obtained in terms of the pathological characteristics of the patients. More lesions were demonstrated in all categorized regions in 68Ga-FAPI PET/CT imaging with higher uptake values compared to 18FDG PET/CT in this study. In the treatment response evaluation of the post-chemotherapy group, 12 cases (12/24) who were evaluated as PMR, CMR, or SD according to 18FDG PET/CT results were later accepted as PD due to newly detected lesions in complementary 68Ga-FAPI PET/CT imaging and treatment of patients was managed accordingly by clinicians. It was determined that 68Ga-FAPI PET/CT was superior to 18FDG PET/CT in terms of accuracy and it was thought that 68Ga-FAPI PET/CT could be utilized as an additional complementary imaging to 18FDG PET/CT. Moreover, 68Ga-FAPI PET/CT, with its significant theranostic potential, could become a key element in predicting the pathological response of breast cancer patients in further researches.

Journal of Oncological Sciences

Basal cell carcinoma (BCC) is caused by keratinocytes located in the basal epidermis, which first... more Basal cell carcinoma (BCC) is caused by keratinocytes located in the basal epidermis, which firstly infiltrate the epidermis and then the dermis. Clinically, it usually occurs on the face and neck. 1,2 BCC has five main clinical variants: nodular-ulcerative, superficial, sclerosing-morphea, pigment-ulcerated and fibroepithelial. 3 The incidence rate of BCCs in the US reportedly spiked by 145% between 2000 and 2010 with the reasons for this significant increase including the aging of the patient population, increased awareness of the overall population, increased number of surgical cases, better record-keeping, and UV radiation. 4 BCCs are slow-growing cancers with low metastatic potential and can be cured with surgical resection. The underlying treatment principle is the complete removal of the tumor with an ample resection margin. Reconstructive surgery can be performed depending upon the type of tumor and the size of the defect. While healing by primary closure is the appropriate surgical option for small lesions, grafts, and flaps are preferred for larger lesions. Primary radiotherapy can be an important treatment alternative for locally advanced diseases where surgical excision can lead to a severe loss of function or cosmetic problems. In the case of advanced diseases, surgery and radiation therapy often do not provide a cure. The estimated risk of BCC-related metastasis is under 1%. 5 The prognosis for metastatic BCCs is very poor and the overall survival, once metastasis has occurred, is ten months. 6 The benefit of chemotherapy has been

Journal of Clinical Oncology

e14107 Background: Baseline lymphopenia has been proved to be a marker for poor prognosis, chemot... more e14107 Background: Baseline lymphopenia has been proved to be a marker for poor prognosis, chemotherapy-induced toxicity and increased risk of febrile neutropenia, trombocytopenia and anemia in advanced solid neoplasms. This study aims to evaluate the effect of pretreatment lymphopenia on prognosis and hematological toxicity in colorectal cancer patients who received first line systemic chemotherapy. Methods: Lymphocyte count was evaluated in 386 pretreated colorectal cancer patients who do not have a seconder malignancy, HIV infection, bone involvement and primary G-CSF prophylaxis. Overall survival, progression free survival and disease free survival were calculated from date of diagnosis to date of relapse, progression and death. Kaplan-Meier, chi-square and Student-t test were used. Results: Mean follow-up was 30 months (range 1-180 months). Mean age was 57.4±12.5 years. Of all patients, 160 (41 %) were women. Rectum ( 26.2 %) and transvers colon (4.7 %) were the most and the le...

Annals of Oncology

ABSTRACT Aim Only 4% of cranial metastasis occur with gastrointestinal cancer. The aim of this st... more ABSTRACT Aim Only 4% of cranial metastasis occur with gastrointestinal cancer. The aim of this study is to evaluate the characteristics of cranial metastasis derived from gastrointestinal system tumors. Material-method 1863 patients diagnosed with gastrointestinal cancers between 1997-2011 years were included. Among the patients; 51 esophageal cancer, 516 gastric cancer, 5 small intestine tumor, 878 colorectal cancer, 11 gallbladder cancer, 190 pancreas cancer, 119 hepatocellular cancer, 63 cholangiocarcinoma and 30 GIST were involved. SPSS 16 is used. Results 20 gastrointestinal cancer patients with cranial metastases (1.07%) were included. The average age was 54.6 ± 1.1 years and 70% (n = 14) of the patients were male. 20 patients cancers were as follows: 4 gastric cancer (20%), 15 colorectal cancer ( 75%) and 1 pancreas cancer (5%). 3 patients had no extracranial metastases (15%). Lung metastases was the most common extracranial metastatic site in general, but liver was the most solitary extracranial metastatic site. The median interval of diagnosis-recurrence/metastases was 20.6 months (range 0-89 months) and the median interval of diagnosis-cranial metastases was 30.1 months (range 0-138 months). Mean OS was 36.6 months in 3 patients without extracranial metastases and 31.6 months in 17 patients with extracranial metastases. Discussion The most common primary sites that intend to metastasize to brain are lung and breast. Gastrointestinal tumors rarely metastasize to cranium. Our results were similar with literature: 0.7% of cranial metastases in gastric cancer and 1.7% cranial metastases in colorectal cancer.The arguing site in our study were as follows: in the literature lung was the most common site of extracranial metastases; but in our study despite being general most common extracranial metastatic site, it was not the solitary site of metastases. In 10 metastatic patients at the diagnosis, 5 were solely had liver metastases without lung metastases. Conclusion Cranial metastases is a rare and late sign of gastrointestinal cancers. By new approaches in diagnosis and therapy of cancer, cranial metastases is more common. All symptomatic patients and asymptomatic patients with liver or lung metastases may be suggested to be screened for brain. Disclosure All authors have declared no conflicts of interest.

Journal of Clinical Oncology

e18218Background: Standard treatment for early stage breast cancer (ESBC) consists of optimal sur... more e18218Background: Standard treatment for early stage breast cancer (ESBC) consists of optimal surgery followed by adjuvant chemotherapy and/or hormonotherapy and/or radiotherapy. Doxorubicin and cy...

Experimental Oncology

Aim: Primary testicular lymphoma (PTL) is an uncommon and aggressive form of extranodal non-Hodgk... more Aim: Primary testicular lymphoma (PTL) is an uncommon and aggressive form of extranodal non-Hodgkin’s lymphoma (NHL). We aimed to analyse the clinicopathological characteristics and outcomes of our PTL cases. Materials and Methods: A review was made of the medical records of 339 NHL patients who were treated in the Medical Oncology Department between January 2005 and December 2013. Results: 8 PTL patients were identified from the 339 NHL patients. The average age of the patients was 67.7 ± 7.9 years (range 53–79 years). The mean follow-up time was 24.8 months (range 7–98 months). Inguinal orchiectomy was performed as a diagnostic and initial therapy and all the patients underwent 4–6 cycles of chemoimmunotherapy consisting of cyclophosphamide, doxorubicin, vincristine and prednisone plus rituximab. 4 of 8 patients received intrathecal prophylactic chemotherapy and 6 of 8 patients continued contralateral testis irradiation. Relapse occured in only 1 patient in central nervous system ...

Experimental Oncology

Background: Breast cancer (BC) is the most common cancer among women. A high body-mass index (BMI... more Background: Breast cancer (BC) is the most common cancer among women. A high body-mass index (BMI) is related to increased incidence of BC with poorer prognosis. Aim: The aim of the study was to evaluate the association in patients with BC between BMI at the time of diagnosis and biological characteristics, according to the menopausal status. Materials and Methods: This retrospective study comprised a total of 318 women with BC. Clinicopathological differences between normal, overweight and obese patients according to menopausal status were evaluated. Results: Premenopausal women had a significantly lower BMI than postmenopausal patients (28.7 vs. 31.5, respectively; p = 0.00001). No statistically significant association was determined between BMI and clinicopathological characteristics in either the premenopausal or the postmenopausal group (all p values are > 0.05). Conclusions: There are many conflicting results in literature on this relationship. The results of this study sho...

Journal of Gastrointestinal & Digestive System

Aim: To evaluate patient characteristics by reviewing colonoscopy procedures performed within an ... more Aim: To evaluate patient characteristics by reviewing colonoscopy procedures performed within an 8-year period in the endoscopy centre of a training and research hospital. Methods: Colonoscopy procedures that were performed for various indications between 2002 and 2009 in the endoscopy unit of our hospital were retrospectively evaluated. Of 3035 colonoscopy procedures, 2831 were included in the analysis. In addition to demographic characteristics of the patients, presence and localization of colorectal masses, presence of inflammatory bowel disease, frequency of presence of hemorrhoids, diverticula, polyps, and other diseases, as well as complications were recorded. Results: The mean age of the patients (male, 50.5%) was 54.36 ± 15.05 years (range, 16-93 years). While a pathological finding was determined in 1512 (53.4%) colonoscopy procedures, 1319 (46.6%) colonoscopy procedures were reported as normal. Concerning complications during examinations, perforation was encountered in two patients and major bleeding was not determined in any of the patients. The most common diagnoses were polyps (15.9%) and hemorrhoids (15.9%), followed by colorectal mass (12.9%), diverticula (6.8%), and inflammatory bowel disease (5.6%). Conclusion: The fact that colorectal masses ranked third among the colonoscopic diagnoses suggested that cancer screening programs should be handled nationally.

Journal of B.U.ON. : official journal of the Balkan Union of Oncology

To determine the predictive value of the mean platelet volume (MPV) and the MPV/platelet count ra... more To determine the predictive value of the mean platelet volume (MPV) and the MPV/platelet count ratio on the development of isolated bone metastasis in patients with breast cancer. A total of 121 previously untreated female patients with isolated bone metastases from breast cancer (group 1) were included in this retrospective cohort study. The patients enrolled in this study had similar age, biological subtypes, and duration of follow-up after diagnosis. Group 1 was compared with both 71 previously untreated women with breast cancer with no metastases at all (group 2) and 39 healthy women (group 3). Demographic data, laboratory tests and histological features of all of the patients in groups 1 and 2 were recorded and the study variables from each of the three groups were compared. In group 1, the cut-off value (9.2 fL) for the MPV was determined and patients were stratified into 4 subgroups. The MPV was higher in group 1 than in either group 2 or group 3. Group 1 patients had a MPV o...

Journal of Cancer Research and Therapeutics, 2015

Advanced gastric cancer has a poor prognosis, and only chemotherapy improves survival. Further ch... more Advanced gastric cancer has a poor prognosis, and only chemotherapy improves survival. Further chemotherapy after progression is controversial. Eastern Cooperative Oncology Group performance status is an important indicator for new chemotherapy decision. Complete response (CR) after recurrent disease is very rare, but could occur in some cases with chemotherapy. The 68-year-old male received chemotherapy for metastatic gastric adenocarcinoma. He received epirubicin, cisplatin and fluorouracil in the first line, capecitabine in the second line and cisplatin-capecitabine in the third line. CR was observed after third-line chemotherapy with four courses. Mediastinal and abdominal metastases were completely resolved. We decided to report this patient because it is very unusual to achieve CR in a patient in whom the best supportive care might be reasonable.

The Journal of international medical research, Jan 5, 2016

To investigate the effect of immunosuppressive anticancer therapy on titre levels of anti-hepatit... more To investigate the effect of immunosuppressive anticancer therapy on titre levels of anti-hepatitis B surface antibodies (anti-HBs) in hepatitis B surface antigen (HBsAg) negative and anti-HBs positive patients with haematological malignancies or solid tumours. This retrospective study reviewed the medical records of patients with haematological malignancies or solid tumours. Pretreatment HBsAg negative and anti-HBs positive patients were included in the analysis. Anti-hepatitis B core antibody status was used to evaluate vaccinated patients and those with resolved HBV infections. The medical records of 237 patients were reviewed retrospectively. The median anti-HBs titre decreased significantly after anticancer therapy compared with the pretreatment median anti-HBs titre in all patients (71 mIU/ml versus 57 mIU/ml). Anti-HBs titre decreased significantly in patients with haematological malignancies (70 mIU/m versus 37 mIU/ml) and in patients administered rituximab-based chemotherap...

Acta Oncologica Turcica, 2015

Journal of B.U.ON.: official journal of the Balkan Union of Oncology

Colorectal cancer (CRC) survivors are currently living longer due to better therapies but they al... more Colorectal cancer (CRC) survivors are currently living longer due to better therapies but they also need to maintain their quality of life (QoL). QoL is increasingly being used as primary outcome measure in clinical studies. This study was designed to gain knowledge about QoL during chemotherapy across different lines and different regimens. The study comprised 101 CRC out patients receiving chemotherapy who completed the EORTC QLQ-C30 questionnaire. The Shapiro-Wilk, Kruskal-Wallis, and Mann-Whitney U tests were used for statistical analyses. The demographics of the patients were evaluated for QoL. Prior surgery, prior radiotherapy, working status, stage, comorbidity and sex had no effect on global health status in CRC patients, although some other demographics such as education, monthly income, age and type of chemotherapy regimen did have an effect on global health status. Role functioning was worse in older than in younger ones (p<0.05). Adjuvant chemotherapy did not affect t...

Asian Pacific journal of cancer prevention : APJCP, 2014

Advanced gastric cancer (AGC) patients have a poor prognosis. The best benefit of chemotherapy is... more Advanced gastric cancer (AGC) patients have a poor prognosis. The best benefit of chemotherapy is usually achieved by first line setting. Very few studies have compared combination regimens. This study was designed to compare two combination regimens. Patients with advanced gastric cancer receiving first line chemotherapy were retrospectively collected, and divided into two groups, receiving DCF (docetaxel, cisplatin and fluorouracil) or ECF (epirubicin, cisplatin and fluorouracil) regimens. Data were collected for the retrospective analysis in a single center. Eighty-six patients were eligible for analysis. Median overall survival (OS) was 10.0 months in the ECF group and 11.0 months in the DCF group (p=0.31). Median progression free survival (PFS) for ECF and DCF was equal at 6.0 months. Second line chemotherapy were administered in more than one third of patients. Both regimens had similar toxicity. This is the first study investigating the outcomes of gastric cancer chemotherapy...

Experimental oncology, 2014

Gastrointestinal stromal tumors (GISTs) are uncommon tumors of the gastrointestinal (GI) tract. R... more Gastrointestinal stromal tumors (GISTs) are uncommon tumors of the gastrointestinal (GI) tract. Regorafenib is a new multikinase inhibitor and is approved for the treatment of GISTs in patients who develop resistance to imatinib and sunitinib. The most common drug-related adverse events with regorafenib are hypertension, hand-foot skin reactions, and diarrhea. Grade IV hypertensive side effect has never been reported after a single dose. In this report, we present a case of Grade IV hypertensive side effect (hypertensive crisis and seizure) after a single dose of regorafenib. A 54-year-old male normotensive GIST patient was admitted to the emergency department with seizure and encephalopathy after the first dosage of regorafenib. His blood pressure was 240/140 mmHg upon admission. After intensive treatment with nitrate and nitroprusside, his blood pressure returned to normal levels in five days. Regorafenib was discontinued, and he did not experience hypertension again. This paper r...

Asian Pacific journal of cancer prevention : APJCP, 2014

Lung cancer (LC) is still the primary cause of cancer deaths worldwide, and late diagnosis is a m... more Lung cancer (LC) is still the primary cause of cancer deaths worldwide, and late diagnosis is a major obstacle to improving lung cancer outcomes. Recently, elevated preoperative or pretreatment neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and mean platelet volume (MPV) detected in peripheral blood were identified as independent prognostic factors associated with poor survival with various cancers, including colon cancer, esophageal cancer, gastric cancer and breast cancer. The aim of this study was to examine whether MPV, NLR and PLR could be useful inflammatory markers to differentiate lung cancer patients from healthy controls. An investigation was also made of the relationship between these markers and other prognostic factors and histopathological subgroups. Retrospectively eighty-one lung cancer patients and 81 age-sexes matched healthy subjects included into the study. Patients with hypertension, hematological and renal disease, heart failure, chron...

Hellenic journal of nuclear medicine, 2021

OBJECTIVE The prognostic potential of pretreatment maximum standardized uptake volume (SUVmax) on... more OBJECTIVE The prognostic potential of pretreatment maximum standardized uptake volume (SUVmax) on gallium-68-DOTATATE was evaluated with positron emission tomography/computed tomography (68Ga-DOTATATE PET/CT) in 37 patients with G1/G2 gastroenteropancreatic neuroendocrine tumors (NET) who received peptide receptor radionuclide therapy (PRRT) with lutetium-177-[DOTAo,Tyr3] octreotate (177Lu-DOTATATE) after the failure of somatostatin analogues. METHODS The mean and total SUVmax were used in 68Ga-DOTATATE PET/CT before 177Lu-DOTATATE treatment to assess the progression-free survival (PFS). RESULTS The responses of the patients were evaluated as partial response in 8 (32%) patients, stable disease in 12 (48%), and progressive disease in 5 (20%). The median PFS was 18 months; longer than this threshold in 14 patients (26.0 months) and shorter in 11 (8.4 months). The mean SUVmax of metastases in the liver (34.15±17.89 vs. 14.69±9.17, P=0.004) and mean SUVmax of all body metastatic lesion...

Gastrointestinal stromal tumors (GISTs) are uncommon tumors of the gastrointestinal (GI) tract. R... more Gastrointestinal stromal tumors (GISTs) are uncommon tumors of the gastrointestinal (GI) tract. Regorafenib is a new multikinase inhibitor and is approved for the treatment of GISTs in patients who develop resistance to imatinib and sunitinib. The most common drug-related adverse events with regorafenib are hypertension, hand-foot skin reactions, and diarrhea. Grade IV hypertensive side effect has never been reported after a single dose. In this report, we present a case of Grade IV hypertensive side effect (hypertensive crisis and seizure) after a single dose of regorafenib. A 54-year-old male normotensive GIST patient was admitted to the emergency department with seizure and encephalopathy after the first dosage of regorafenib. His blood pressure was 240/140 mmHg upon admission. After intensive treatment with nitrate and nitroprusside, his blood pressure returned to normal levels in five days. Regorafenib was discontinued, and he did not experience hypertension again. This paper r...

Annals of Nuclear Medicine

We compared the ability of 68Ga-FAPI PET//CT with 18FDG PET/CT imaging techniques to detect addit... more We compared the ability of 68Ga-FAPI PET//CT with 18FDG PET/CT imaging techniques to detect additional lesions in breast cancer patients that may affect further chemotherapy options. A total of 48 patients with breast cancer underwent concurrent 68Ga-FAPI-04 and 18FDG PET/CT regardless of whether they had received chemotherapy or not in the last month before imaging. Both modalities were compared according to various parameters: clinical/pathological features, number of lesions detected, activity uptake (SUVmax), and the effect on the evaluation of response to treatment in the post-chemotherapy group. This retrospective study included 48 patients with breast cancer (mean age 53.3 ± 11.7 years; IDC 89.6%; ILC 10.4%). In the comparison of both modalities, no statistical significance was obtained in terms of the pathological characteristics of the patients. More lesions were demonstrated in all categorized regions in 68Ga-FAPI PET/CT imaging with higher uptake values compared to 18FDG PET/CT in this study. In the treatment response evaluation of the post-chemotherapy group, 12 cases (12/24) who were evaluated as PMR, CMR, or SD according to 18FDG PET/CT results were later accepted as PD due to newly detected lesions in complementary 68Ga-FAPI PET/CT imaging and treatment of patients was managed accordingly by clinicians. It was determined that 68Ga-FAPI PET/CT was superior to 18FDG PET/CT in terms of accuracy and it was thought that 68Ga-FAPI PET/CT could be utilized as an additional complementary imaging to 18FDG PET/CT. Moreover, 68Ga-FAPI PET/CT, with its significant theranostic potential, could become a key element in predicting the pathological response of breast cancer patients in further researches.

Journal of Oncological Sciences

Basal cell carcinoma (BCC) is caused by keratinocytes located in the basal epidermis, which first... more Basal cell carcinoma (BCC) is caused by keratinocytes located in the basal epidermis, which firstly infiltrate the epidermis and then the dermis. Clinically, it usually occurs on the face and neck. 1,2 BCC has five main clinical variants: nodular-ulcerative, superficial, sclerosing-morphea, pigment-ulcerated and fibroepithelial. 3 The incidence rate of BCCs in the US reportedly spiked by 145% between 2000 and 2010 with the reasons for this significant increase including the aging of the patient population, increased awareness of the overall population, increased number of surgical cases, better record-keeping, and UV radiation. 4 BCCs are slow-growing cancers with low metastatic potential and can be cured with surgical resection. The underlying treatment principle is the complete removal of the tumor with an ample resection margin. Reconstructive surgery can be performed depending upon the type of tumor and the size of the defect. While healing by primary closure is the appropriate surgical option for small lesions, grafts, and flaps are preferred for larger lesions. Primary radiotherapy can be an important treatment alternative for locally advanced diseases where surgical excision can lead to a severe loss of function or cosmetic problems. In the case of advanced diseases, surgery and radiation therapy often do not provide a cure. The estimated risk of BCC-related metastasis is under 1%. 5 The prognosis for metastatic BCCs is very poor and the overall survival, once metastasis has occurred, is ten months. 6 The benefit of chemotherapy has been

Journal of Clinical Oncology

e14107 Background: Baseline lymphopenia has been proved to be a marker for poor prognosis, chemot... more e14107 Background: Baseline lymphopenia has been proved to be a marker for poor prognosis, chemotherapy-induced toxicity and increased risk of febrile neutropenia, trombocytopenia and anemia in advanced solid neoplasms. This study aims to evaluate the effect of pretreatment lymphopenia on prognosis and hematological toxicity in colorectal cancer patients who received first line systemic chemotherapy. Methods: Lymphocyte count was evaluated in 386 pretreated colorectal cancer patients who do not have a seconder malignancy, HIV infection, bone involvement and primary G-CSF prophylaxis. Overall survival, progression free survival and disease free survival were calculated from date of diagnosis to date of relapse, progression and death. Kaplan-Meier, chi-square and Student-t test were used. Results: Mean follow-up was 30 months (range 1-180 months). Mean age was 57.4±12.5 years. Of all patients, 160 (41 %) were women. Rectum ( 26.2 %) and transvers colon (4.7 %) were the most and the le...

Annals of Oncology

ABSTRACT Aim Only 4% of cranial metastasis occur with gastrointestinal cancer. The aim of this st... more ABSTRACT Aim Only 4% of cranial metastasis occur with gastrointestinal cancer. The aim of this study is to evaluate the characteristics of cranial metastasis derived from gastrointestinal system tumors. Material-method 1863 patients diagnosed with gastrointestinal cancers between 1997-2011 years were included. Among the patients; 51 esophageal cancer, 516 gastric cancer, 5 small intestine tumor, 878 colorectal cancer, 11 gallbladder cancer, 190 pancreas cancer, 119 hepatocellular cancer, 63 cholangiocarcinoma and 30 GIST were involved. SPSS 16 is used. Results 20 gastrointestinal cancer patients with cranial metastases (1.07%) were included. The average age was 54.6 ± 1.1 years and 70% (n = 14) of the patients were male. 20 patients cancers were as follows: 4 gastric cancer (20%), 15 colorectal cancer ( 75%) and 1 pancreas cancer (5%). 3 patients had no extracranial metastases (15%). Lung metastases was the most common extracranial metastatic site in general, but liver was the most solitary extracranial metastatic site. The median interval of diagnosis-recurrence/metastases was 20.6 months (range 0-89 months) and the median interval of diagnosis-cranial metastases was 30.1 months (range 0-138 months). Mean OS was 36.6 months in 3 patients without extracranial metastases and 31.6 months in 17 patients with extracranial metastases. Discussion The most common primary sites that intend to metastasize to brain are lung and breast. Gastrointestinal tumors rarely metastasize to cranium. Our results were similar with literature: 0.7% of cranial metastases in gastric cancer and 1.7% cranial metastases in colorectal cancer.The arguing site in our study were as follows: in the literature lung was the most common site of extracranial metastases; but in our study despite being general most common extracranial metastatic site, it was not the solitary site of metastases. In 10 metastatic patients at the diagnosis, 5 were solely had liver metastases without lung metastases. Conclusion Cranial metastases is a rare and late sign of gastrointestinal cancers. By new approaches in diagnosis and therapy of cancer, cranial metastases is more common. All symptomatic patients and asymptomatic patients with liver or lung metastases may be suggested to be screened for brain. Disclosure All authors have declared no conflicts of interest.

Journal of Clinical Oncology

e18218Background: Standard treatment for early stage breast cancer (ESBC) consists of optimal sur... more e18218Background: Standard treatment for early stage breast cancer (ESBC) consists of optimal surgery followed by adjuvant chemotherapy and/or hormonotherapy and/or radiotherapy. Doxorubicin and cy...

Experimental Oncology

Aim: Primary testicular lymphoma (PTL) is an uncommon and aggressive form of extranodal non-Hodgk... more Aim: Primary testicular lymphoma (PTL) is an uncommon and aggressive form of extranodal non-Hodgkin’s lymphoma (NHL). We aimed to analyse the clinicopathological characteristics and outcomes of our PTL cases. Materials and Methods: A review was made of the medical records of 339 NHL patients who were treated in the Medical Oncology Department between January 2005 and December 2013. Results: 8 PTL patients were identified from the 339 NHL patients. The average age of the patients was 67.7 ± 7.9 years (range 53–79 years). The mean follow-up time was 24.8 months (range 7–98 months). Inguinal orchiectomy was performed as a diagnostic and initial therapy and all the patients underwent 4–6 cycles of chemoimmunotherapy consisting of cyclophosphamide, doxorubicin, vincristine and prednisone plus rituximab. 4 of 8 patients received intrathecal prophylactic chemotherapy and 6 of 8 patients continued contralateral testis irradiation. Relapse occured in only 1 patient in central nervous system ...

Experimental Oncology

Background: Breast cancer (BC) is the most common cancer among women. A high body-mass index (BMI... more Background: Breast cancer (BC) is the most common cancer among women. A high body-mass index (BMI) is related to increased incidence of BC with poorer prognosis. Aim: The aim of the study was to evaluate the association in patients with BC between BMI at the time of diagnosis and biological characteristics, according to the menopausal status. Materials and Methods: This retrospective study comprised a total of 318 women with BC. Clinicopathological differences between normal, overweight and obese patients according to menopausal status were evaluated. Results: Premenopausal women had a significantly lower BMI than postmenopausal patients (28.7 vs. 31.5, respectively; p = 0.00001). No statistically significant association was determined between BMI and clinicopathological characteristics in either the premenopausal or the postmenopausal group (all p values are > 0.05). Conclusions: There are many conflicting results in literature on this relationship. The results of this study sho...

Journal of Gastrointestinal & Digestive System

Aim: To evaluate patient characteristics by reviewing colonoscopy procedures performed within an ... more Aim: To evaluate patient characteristics by reviewing colonoscopy procedures performed within an 8-year period in the endoscopy centre of a training and research hospital. Methods: Colonoscopy procedures that were performed for various indications between 2002 and 2009 in the endoscopy unit of our hospital were retrospectively evaluated. Of 3035 colonoscopy procedures, 2831 were included in the analysis. In addition to demographic characteristics of the patients, presence and localization of colorectal masses, presence of inflammatory bowel disease, frequency of presence of hemorrhoids, diverticula, polyps, and other diseases, as well as complications were recorded. Results: The mean age of the patients (male, 50.5%) was 54.36 ± 15.05 years (range, 16-93 years). While a pathological finding was determined in 1512 (53.4%) colonoscopy procedures, 1319 (46.6%) colonoscopy procedures were reported as normal. Concerning complications during examinations, perforation was encountered in two patients and major bleeding was not determined in any of the patients. The most common diagnoses were polyps (15.9%) and hemorrhoids (15.9%), followed by colorectal mass (12.9%), diverticula (6.8%), and inflammatory bowel disease (5.6%). Conclusion: The fact that colorectal masses ranked third among the colonoscopic diagnoses suggested that cancer screening programs should be handled nationally.

Journal of B.U.ON. : official journal of the Balkan Union of Oncology

To determine the predictive value of the mean platelet volume (MPV) and the MPV/platelet count ra... more To determine the predictive value of the mean platelet volume (MPV) and the MPV/platelet count ratio on the development of isolated bone metastasis in patients with breast cancer. A total of 121 previously untreated female patients with isolated bone metastases from breast cancer (group 1) were included in this retrospective cohort study. The patients enrolled in this study had similar age, biological subtypes, and duration of follow-up after diagnosis. Group 1 was compared with both 71 previously untreated women with breast cancer with no metastases at all (group 2) and 39 healthy women (group 3). Demographic data, laboratory tests and histological features of all of the patients in groups 1 and 2 were recorded and the study variables from each of the three groups were compared. In group 1, the cut-off value (9.2 fL) for the MPV was determined and patients were stratified into 4 subgroups. The MPV was higher in group 1 than in either group 2 or group 3. Group 1 patients had a MPV o...

Journal of Cancer Research and Therapeutics, 2015

Advanced gastric cancer has a poor prognosis, and only chemotherapy improves survival. Further ch... more Advanced gastric cancer has a poor prognosis, and only chemotherapy improves survival. Further chemotherapy after progression is controversial. Eastern Cooperative Oncology Group performance status is an important indicator for new chemotherapy decision. Complete response (CR) after recurrent disease is very rare, but could occur in some cases with chemotherapy. The 68-year-old male received chemotherapy for metastatic gastric adenocarcinoma. He received epirubicin, cisplatin and fluorouracil in the first line, capecitabine in the second line and cisplatin-capecitabine in the third line. CR was observed after third-line chemotherapy with four courses. Mediastinal and abdominal metastases were completely resolved. We decided to report this patient because it is very unusual to achieve CR in a patient in whom the best supportive care might be reasonable.

The Journal of international medical research, Jan 5, 2016

To investigate the effect of immunosuppressive anticancer therapy on titre levels of anti-hepatit... more To investigate the effect of immunosuppressive anticancer therapy on titre levels of anti-hepatitis B surface antibodies (anti-HBs) in hepatitis B surface antigen (HBsAg) negative and anti-HBs positive patients with haematological malignancies or solid tumours. This retrospective study reviewed the medical records of patients with haematological malignancies or solid tumours. Pretreatment HBsAg negative and anti-HBs positive patients were included in the analysis. Anti-hepatitis B core antibody status was used to evaluate vaccinated patients and those with resolved HBV infections. The medical records of 237 patients were reviewed retrospectively. The median anti-HBs titre decreased significantly after anticancer therapy compared with the pretreatment median anti-HBs titre in all patients (71 mIU/ml versus 57 mIU/ml). Anti-HBs titre decreased significantly in patients with haematological malignancies (70 mIU/m versus 37 mIU/ml) and in patients administered rituximab-based chemotherap...

Acta Oncologica Turcica, 2015

Journal of B.U.ON.: official journal of the Balkan Union of Oncology

Colorectal cancer (CRC) survivors are currently living longer due to better therapies but they al... more Colorectal cancer (CRC) survivors are currently living longer due to better therapies but they also need to maintain their quality of life (QoL). QoL is increasingly being used as primary outcome measure in clinical studies. This study was designed to gain knowledge about QoL during chemotherapy across different lines and different regimens. The study comprised 101 CRC out patients receiving chemotherapy who completed the EORTC QLQ-C30 questionnaire. The Shapiro-Wilk, Kruskal-Wallis, and Mann-Whitney U tests were used for statistical analyses. The demographics of the patients were evaluated for QoL. Prior surgery, prior radiotherapy, working status, stage, comorbidity and sex had no effect on global health status in CRC patients, although some other demographics such as education, monthly income, age and type of chemotherapy regimen did have an effect on global health status. Role functioning was worse in older than in younger ones (p<0.05). Adjuvant chemotherapy did not affect t...

Asian Pacific journal of cancer prevention : APJCP, 2014

Advanced gastric cancer (AGC) patients have a poor prognosis. The best benefit of chemotherapy is... more Advanced gastric cancer (AGC) patients have a poor prognosis. The best benefit of chemotherapy is usually achieved by first line setting. Very few studies have compared combination regimens. This study was designed to compare two combination regimens. Patients with advanced gastric cancer receiving first line chemotherapy were retrospectively collected, and divided into two groups, receiving DCF (docetaxel, cisplatin and fluorouracil) or ECF (epirubicin, cisplatin and fluorouracil) regimens. Data were collected for the retrospective analysis in a single center. Eighty-six patients were eligible for analysis. Median overall survival (OS) was 10.0 months in the ECF group and 11.0 months in the DCF group (p=0.31). Median progression free survival (PFS) for ECF and DCF was equal at 6.0 months. Second line chemotherapy were administered in more than one third of patients. Both regimens had similar toxicity. This is the first study investigating the outcomes of gastric cancer chemotherapy...

Experimental oncology, 2014

Gastrointestinal stromal tumors (GISTs) are uncommon tumors of the gastrointestinal (GI) tract. R... more Gastrointestinal stromal tumors (GISTs) are uncommon tumors of the gastrointestinal (GI) tract. Regorafenib is a new multikinase inhibitor and is approved for the treatment of GISTs in patients who develop resistance to imatinib and sunitinib. The most common drug-related adverse events with regorafenib are hypertension, hand-foot skin reactions, and diarrhea. Grade IV hypertensive side effect has never been reported after a single dose. In this report, we present a case of Grade IV hypertensive side effect (hypertensive crisis and seizure) after a single dose of regorafenib. A 54-year-old male normotensive GIST patient was admitted to the emergency department with seizure and encephalopathy after the first dosage of regorafenib. His blood pressure was 240/140 mmHg upon admission. After intensive treatment with nitrate and nitroprusside, his blood pressure returned to normal levels in five days. Regorafenib was discontinued, and he did not experience hypertension again. This paper r...

Asian Pacific journal of cancer prevention : APJCP, 2014

Lung cancer (LC) is still the primary cause of cancer deaths worldwide, and late diagnosis is a m... more Lung cancer (LC) is still the primary cause of cancer deaths worldwide, and late diagnosis is a major obstacle to improving lung cancer outcomes. Recently, elevated preoperative or pretreatment neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and mean platelet volume (MPV) detected in peripheral blood were identified as independent prognostic factors associated with poor survival with various cancers, including colon cancer, esophageal cancer, gastric cancer and breast cancer. The aim of this study was to examine whether MPV, NLR and PLR could be useful inflammatory markers to differentiate lung cancer patients from healthy controls. An investigation was also made of the relationship between these markers and other prognostic factors and histopathological subgroups. Retrospectively eighty-one lung cancer patients and 81 age-sexes matched healthy subjects included into the study. Patients with hypertension, hematological and renal disease, heart failure, chron...