1
|
Ürun Y, Utkan G, Yalcin B, Akbulut H, Onur H, Oztuna DG, Şenler FC, Demirkazık A, İçli F. The role of cardiac biomarkers as predictors of trastuzumab cardiotoxicity in patients with breast cancer. Exp Oncol 2015; 37:53-57. [PMID: 25804233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
AIM Identification of patient with increased risk of cardiotoxicity would allow not only prevention and early diagnosis of chemotherapy related cardiotoxicity but also administration of optimal dose and duration of chemotherapy. MATERIALS AND METHODS Fifty-two women with HER2(+) breast cancer treated with trastuzumab were included in this study. Patients were prospectively followed with routine cardiac evaluation. Before and after administration of trastuzumab blood samples for NT-proBNP were also taken. RESULTS The median age was 48.5 year (range: 26-74). Hypertension and obesity were two most common co-morbidities. The median duration application of trastuzumab was 52 weeks. During median 14.5 (3-33) months follow-up cardiac adverse events occurred in 5 (9.6%) patients and 2 out of 5 was grade III-IV heart failure. Both patients had preserved left ventricular ejection fraction and no symptom of heart failure before trastuzumab but older than 65 years old and had diabetes mellitus and obesity. High level of NT-proBNP (> 300 ng/ml) was observed in both patients and heart failure recovery was not observed. There was statistically significant difference regarding body mass index (p = 0.004) and diabetes mellitus (p = 0.002) between patients with and without cardiotoxicity. CONCLUSION Although, cardiac biomarkers still cannot replace routine cardiac monitoring, natriuretic peptides may provide additional tool for detection of patients with high risk of cardiotoxicity and early detection of cardiotoxicity.
Collapse
Affiliation(s)
- Y Ürun
- Department of Medical Oncology,Gaziantep Dr. Ersin Arslan State Hospital, Gaziantep 27310, Turkey
| | - G Utkan
- Department of Medical Oncology, Ankara University School of Medicine, Ankara 06590, Turkey
| | - B Yalcin
- Department of Medical Oncology,Yildirim Beyazit University School of Medicine, Atatürk Education and Research Hospital, Ankara 06800, Turkey
| | - H Akbulut
- Department of Medical Oncology, Ankara University School of Medicine, Ankara 06590, Turkey
| | - H Onur
- Department of Medical Oncology, Ankara University School of Medicine, Ankara 06590, Turkey
| | - D G Oztuna
- Department of Biostatistics,Ankara University School of Medicine, Ankara 06100, Turkey
| | - F C Şenler
- Department of Medical Oncology, Ankara University School of Medicine, Ankara 06590, Turkey
| | - A Demirkazık
- Department of Medical Oncology, Ankara University School of Medicine, Ankara 06590, Turkey
| | - F İçli
- Department of Medical Oncology, Ankara University School of Medicine, Ankara 06590, Turkey
| |
Collapse
|
2
|
Eralp Y, Kılıç L, Alço G, Başaran G, Doğan M, Dinçol D, Demirci S, İçli F, Onur H, Saip P, Haydaroğlu A. The Outcome of Patients with Triple Negative Breast Cancer: The Turkish Oncology Group Experience. J Breast Health 2014; 10:209-215. [PMID: 28331673 DOI: 10.5152/tjbh.2014.1904] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Accepted: 06/24/2014] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Triple negative breast cancer (TNBC) is generally considered as a poorer prognostic subgroup, with propensity for earlier relapse and visceral involvement. The aim of this study is to evaluate the outcome of non-metastatic TNBC patients from different centers in Turkey and identify clinical and pathologic variables that may effect survival. MATERIALS AND METHODS Between 1993-2007, from five different centers in Turkey, 316 nonmetastatic triple negative breast cancer patients were identified with follow-up of at least 12 months. The data was collected retrospectively from patient charts. The prognostic impact of several clinical variables were evaluated by the Kaplan-Meier and Cox multivariate anayses. RESULTS Mean age at diagnosis was 49 years (range: 24-82). The majority of the patient group had invasive ductal carcinoma (n: 260, 82.3%) and stage II disease (n: 164; 51.9%). Majority of the patients (87.7%) received adjuvant chemotherapy. 5 year overall survival (OS) and disease-free survival (DFS) rates were 84.6% and 71.6%, respectively. Univariate analysis revealed locally advanced disease (p: 0.001), advanced pathological stage (p: 0.021), larger tumor size (T1&T2 vs T3&T4) (p<0.001), nodal positivity (p: 0.006), and extensive nodal involvement (p<0.001) as significant factors for DFS; whereas, advanced pathological stage (p: 0.017), extensive nodal involvement (p<0.001) and larger tumor size (p: 0,001) and presence of breast cancer-affected member in the family (p=0.05) were identified as prognostic factors with an impact on OS. Multivariate analysis revealed larger tumor size (T3&T4 vs T1&T2) and presence of lymph node metastases (node-positive vs node-negative) as significant independent prognostic factors for DFS (Hazard ratio (HR): 3.03, 95% CI: 1.71-5.35, p<0.001 and HR: 1.77, 95% CI: 1.05-3.0, p=0.03, respectively). Higher tumor stage was the only independent factor affecting overall survival (HR: 2.81; 95% CI, 1.27-6.22, p=0.01). CONCLUSION The outcome of patients with TNBC in this cohort is comparable to other studies including TNBC patients. Tumor size and presence of lymph node metastasis are the major independent factors that have effect on DFS, however higher tumor stage was the only negative prognostic factor for OS.
Collapse
Affiliation(s)
- Yeşim Eralp
- Department of Medical Oncology, İstanbul University Faculty of Medicine, İstanbul, Turkey
| | - Leyla Kılıç
- Department of Medical Oncology, Fırat University Hospital, Elazığ, Turkey
| | - Gül Alço
- Department of Radiation Oncology, Florence Nightingale Gayrettepe Hospital, İstanbul, Turkey
| | - Gül Başaran
- Department of Medical Oncology, Acibadem University Faculty of Medicine, İstanbul, Turkey
| | - Mutlu Doğan
- Department of Medical Oncology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Dilek Dinçol
- Department of Medical Oncology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Senem Demirci
- Department of Radiation Oncology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Fikri İçli
- Department of Medical Oncology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Handan Onur
- Department of Medical Oncology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Pınar Saip
- Department of Medical Oncology, İstanbul University Faculty of Medicine, İstanbul, Turkey
| | - Ayfer Haydaroğlu
- Department of Radiation Oncology, Ege University Faculty of Medicine, İzmir, Turkey
| |
Collapse
|
3
|
İçli F, Calışkan D, Gönüllü U, Sunguroğlu K, Akdur R, Akbulut H, Özkan A, Ölmez S, Gönüllü İ, İbiş E. Fighting against cigarette smoking among medical students: a success story. J Cancer Educ 2014; 29:458-462. [PMID: 24189831 DOI: 10.1007/s13187-013-0573-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
A survey in the year 2007 among medical students of Ankara University Medical School to assess the smoking rates showed that 25.1 % of them were smoking. Moreover, the smoking rate was 35 % at sixth grade students and 60 % of the smokers specified that they started smoking at medical school. This report provides a successful approach to decrease smoking among medical students by measures against starting smoking. An "Antismoking Group" composed of voluntary academic staff, nurses, students, psychologists, and a social worker of the medical school was established to engage in lowering the smoking rate and eliminating it eventually among our students. Several methods including regular monthly meetings, annual "Smoking or Health" symposiums, and lectures to first, second, and third grade students to increase their awareness related to harms of smoking and their role in the fight against smoking were carried out. Our surveys in the years 2009 (641 students) and 2012 (975 students) showed that total smoking rates dropped to 15.0 and 11.0 %, respectively (p < 0.0002). Moreover, the smoking rate for the sixth grade students dropped from 35.0 % in 2007 to 21.8 and 8.8 % in the years 2009 and 2012, respectively (p < 0.0002). In 2012, the smoking rates of first year and sixth year students were 7.8 and 9.0 %, respectively. These close rates of smoking at the first and last years of medical school training and the significant drop in smoking rates in 5 years confirm that our group pursued a realistic and successful strategy against smoking.
Collapse
Affiliation(s)
- Fikri İçli
- Section of Medical Oncology, Ankara University Medical School, Dikimevi, Ankara, 06590, Turkey,
| | | | | | | | | | | | | | | | | | | |
Collapse
|
4
|
İçli F, Altundağ K, Akbulut H, Paydaş S, Başaran G, Saip P, Doğu GG, Eralp Y, Uslu R, Sevinç A, Onur H, Mandel NM, Sezgin C, Altınbaş M, Güler N, Işıkdoğan A, Gökmen E, Uygun K, Üstüner Z, Yaren A, Demirkan B, Coşkun U, Ata A, Özkan M, Arican A. Nine weeks versus 1 year adjuvant trastuzumab in patients with early breast cancer: an observational study by the Turkish Oncology Group (TOG). Breast Cancer 2013; 22:480-5. [PMID: 24338610 DOI: 10.1007/s12282-013-0506-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Accepted: 11/06/2013] [Indexed: 11/25/2022]
Abstract
BACKGROUND Optimal duration of adjuvant trastuzumab in early breast cancer is an unresolved issue. In this observational study, we compared the outcome of 9 weeks and 1 year adjuvant trastuzumab in early breast cancer patients in Turkey. METHODS Records of 680 patients with HER2-positive early breast cancer who received adjuvant trastuzumab plus chemotherapy were obtained and patients were followed up to compare the disease-free survival (DFS) outcome of 9 weeks versus 1 year trastuzumab. RESULTS Nine weeks and 1 year trastuzumab was given to 202 (29.7 %) and 478 (70.3 %) patients, respectively. There was a significantly lower rate of patients with negative lymph nodes in the 9-week trastuzumab group. At median 3 years of follow-up from the date of starting trastuzumab, the DFS rates were 88.6 and 85.6 %, respectively (p = 0.670). When adjusted for all the prognostic factors that were significant on univariate analysis, again there was no significant difference in DFS between the groups (HR 0.675; 95 % CI 0.370-1.231; p = 0.200). Cardiac toxicity defined as a ≥15 % decrease in LVEF was significantly higher in the 1-year trastuzumab group (1.88 % versus none for 1-year and 9-week trastuzumab groups, respectively; p = 0.050). CONCLUSION The results of this observational study suggest that DFS outcome of 9 weeks of adjuvant trastuzumab may be comparable to 1 year adjuvant trastuzumab: this needs confirmation by randomized trials.
Collapse
Affiliation(s)
- Fikri İçli
- Ankara Üniversitesi Tıp Fakültesi; Tıbbi Onkoloji BD, Dikimevi, Ankara, 06590, Turkey,
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
5
|
Utkan G, Ürün Y, Cangir AK, Kılıç D, Özdemir NY, Oztuna DG, Bulut E, Arslan ÜY, Koçer M, Kavukçu Ş, İçli F. Clinicopathological features of patients with malignant mesothelioma in a multicenter, case-control study: no role for ABO-Rh blood groups. Asian Pac J Cancer Prev 2013; 14:249-253. [PMID: 23534732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND Malignant mesothelioma (MM) is an aggressive tumor of mesothelial surfaces. Previous studies have observed an association between ABO blood groups and risk of certain malignancies, including pancreatic and gastric cancer; however, no information on any association with MM risk is available. The aim of this study was to investigate possible associations amoong MM clinicopathological features and ABO blood groups and Rh factor. MATERIALS AND METHODS In 252 patients with MM, the ABO blood group and Rh factor were examined and compared with the control group of 3,022,883 healthy volunteer blood donors of Turkish Red Crescent between 2004 and 2011. The relationship of blood groups with various clinicopathological features were also evaluated in the patient group. RESULTS The median age was 55 (range: 27-86) and 61.5% of patients were male. While 82.8% of patients had a history of exposure to asbestos, 60.7% of patients had a smoking history. Epithelioid (65.1%) was the most common histology and 18.7% of patients had mixed histology. Overall, the ABO blood group distribution of the 252 patients with MM was comparable with the general population. The median overall survival (OS) was 14 months (95% confidence interval, 11.3-16.6 months). The median OS for A, B, AB, and O were 11, 15, 16, and 15 months respectively (p=0.396). First line chemotherapy was administered to 118 patients. The median OS of patients on pemetrexed or gemcitabine was longer than patient who was not administered chemotherapy [17 months (95%CI, 11.7-22.2) vs. 9 months (95%CI, 6.9-11.0); p<0.001]. CONCLUSIONS The results of this study suggest that patients with MM can benefit from treatment with pemetrexed or gemcitabine in combination with cisplatin. We did not observe a statistically significant association between ABO blood group and risk of MM.
Collapse
Affiliation(s)
- Güngör Utkan
- Department of Medical Oncology, Ankara University School of Medicine, Ankara, Turkey
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
6
|
Ürün Y, Can F, Bariş E, Akbulut H, Utkan G, İçli F. Primary extranodal non-Hodgkin's lymphoma presenting as painful gingival swelling. Exp Oncol 2012; 34:134-135. [PMID: 23013768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Primary extra-nodal non-Hodgkin's lymphomas (NHL) constitute 25-40% of NHL but less than 1% arises in oral cavity. Here in 53-year-old man with stage IE gingival diffuse large B cell lymphoma who was treated successfully with chemotherapy and radiotherapy was presented.
Collapse
Affiliation(s)
- Y Ürün
- Department of Medical Oncology, Cebeci Hospital, Ankara University School of Medicine, Ankara, Turkey.
| | | | | | | | | | | |
Collapse
|
7
|
Ürün Y, Utkan G, Yalcin Ş, Coşkun HŞ, Koçer M, Özdemir NY, Kaplan MA, Arslan ÜY, Özdemir F, Öztuna D, Akbulut H, İçli F. Lack of any relationship between ABO and Rh blood groups and clinicopathological features in patients with gastrointestinal stromal tumors: Turkish Oncology Group. Asian Pac J Cancer Prev 2012; 13:4129-4131. [PMID: 23098529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
BACKGROUND An association between the ABO blood group and the risk of certain malignancies, including pancreatic and gastric cancer, has been reported previously. However, it is unclear whether this association is valid for gastrointestinal stromal tumors (GIST). In this study, ABO blood groups and the Rh factor were investigated in a series of GIST cases. MATERIAL AND METHODS In 162 patients with GIST, blood group and Rh factor were examined and compared with a control group of 3,022,883 healthy volunteer blood donors of the Turkish Red Crescent between 2004 and 2011. The relationship of blood groups with tumor size, mitotic activity, and age were also evaluated. RESULTS Overall, the ABO blood group and Rh factor distributions of the 162 patients with GIST were similar to those of the general population. There were no significant differences between both ABO blood types and Rh factor in terms of tumor size, mitotic activity, and age. CONCLUSION This is the first study reported on this issue. In our study, we didn't find any relationship between GIST and ABO blood group and Rh factor. However further studies with larger number of patients are needed to establish the role of blood groups in this population.
Collapse
Affiliation(s)
- Yüksel Ürün
- Faculty of Medicine, Ankara University, Turkey
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Ürün Y, Doğan İ, Kiremitç S, Akbulut H, İçli F. Angiosarcoma related to immunosuppressive therapy 8 years after renal transplantation. Ann Transplant 2011. [DOI: 10.12659/aot.882233] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Yüksel Ürün
- Department of Medical Oncology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - İzzet Doğan
- Department of Internal Medicine, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Saba Kiremitç
- Department of Pathology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Hakan Akbulut
- Department of Medical Oncology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Fikri İçli
- Department of Medical Oncology, Ankara University Faculty of Medicine, Ankara, Turkey
| |
Collapse
|
9
|
Tek İ, Mızrak D, Utkan G, Koçak Toprak S, Tutkak H, Büyükçelik A, Yalçın B, Akbulut H, İçli F. IgA lambda oligoclonal gammopathy in multiple myeloma. Turk J Haematol 2010; 27:126-7. [PMID: 27263458 DOI: 10.5152/tjh.2010.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- İbrahim Tek
- Department of Medical Oncology, Medicana International Ankara Hospital Mobile: +90 533 638 47 88 E-mail:
| | | | | | | | | | | | | | | | | |
Collapse
|