1
|
Gurdal N, Yildirim BA, Gursel OK, Ozkurt S, Ibis K, Gultekin M, Tepetam H, Gul SK, Guzeloz Z, Oksuz DC, Cetin IA, Yalcin B, Duzova M, Kanyilmaz G, Yavas G, Ozsaran Z. Oncological outcomes for encapsulated papillary carcinoma of the breast: Multicentric study of Turkish Society for Radiation Oncology breast cancer study group (TROD 06-014 study). Asia Pac J Clin Oncol 2023; 19:e273-e282. [PMID: 36464924 DOI: 10.1111/ajco.13893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/12/2022] [Accepted: 10/17/2022] [Indexed: 12/11/2022]
Abstract
BACKGROUND Encapsulated papillary carcinoma (EPC) is a rare malignant papillary breast cancer accounting for approximately .5%-2% of all breast tumors. The aim of this multicenter study was to evaluate clinicopathologic features of EPC in addition to oncological outcomes and radiotherapy (RT) details. METHODS From 10 different academic hospitals in Turkey, we obtained pathology reports of 80 patients with histologically confirmed EPC between 2005 and 2022. Demographic, diagnostic, and treatment data were collected from medical records, retrospectively. Local failure, distant progression, toxicity-adverse effects, overall survival (OS), and disease-free survival were evaluated, and survival analyzes were performed using the Kaplan-Meier method. RESULTS Eighty patients with the diagnosis of misspelled sorry (ECP) were retrospectively evaluated. The median age of the patients was 63 (range, 35-85). After a median follow-up of 48 (range; 6-206) months, local recurrence was observed in three patients (4%). Local recurrence was less common in the patients who received whole breast RT with a tumour bed boost (p = .025). There were not any distant metastasis or disease-related death. RT was applied to 61% of the cases, and no treatment-related grade 3 or higher toxicity was reported in any of the patients. Five year OS, cancer-specific survival (CSS), and were observed as 85%, 100%, and 96%, respectively. CONCLUSIONS ECP is a rare, slow-progressing breast carcinoma associated with good prognosis, it is a disease of elderly patient, and usually occurs in postmenopausal women. It responds extremely well to optimal local treatments and appropriate adjuvant treatments on a patient basis, and has excellent OS and CSS ratios.
Collapse
Affiliation(s)
- Necla Gurdal
- Department of Radiation Oncology, Prof Dr Cemil Tascioglu City Hospital, Istanbul, Turkey
| | - Berna Akkus Yildirim
- Department of Radiation Oncology, Prof Dr Cemil Tascioglu City Hospital, Istanbul, Turkey
| | - Ozge Kandemir Gursel
- Department of Radiation Oncology, Prof Dr Cemil Tascioglu City Hospital, Istanbul, Turkey
| | - Selnur Ozkurt
- Department of Radiation Oncology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Kamuran Ibis
- Department of Radiation Oncology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Melis Gultekin
- Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Huseyin Tepetam
- Department of Radiation Oncology, Dr. Lutfi Kirdar Kartal Education and Research Hospital, Istanbul, Turkey
| | - Sule Karabulut Gul
- Department of Radiation Oncology, Dr. Lutfi Kirdar Kartal Education and Research Hospital, Istanbul, Turkey
| | - Zeliha Guzeloz
- Department of Radiation Oncology, Tepecik Education and Research Hospital, Izmir, Turkey
| | - Didem Colpan Oksuz
- Department of Radiation Oncology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Ilknur Alsan Cetin
- Department of Radiation Oncology, Marmara University, Pendik Education and Research Hospital, Istanbul, Turkey
| | - Berrin Yalcin
- Department of Radiation Oncology, Istanbul Education and Research Hospital, Istanbul, Turkey
| | - Mursel Duzova
- Department of Radiation Oncology, Faculty of Medicine, Selcuk University, Konya, Turkey
| | - Gul Kanyilmaz
- Department of Radiation Oncology, Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Guler Yavas
- Department of Radiation Oncology, Baskent University Faculty of Medicine, Ankara, Turkey
| | - Zeynep Ozsaran
- Department of Radiation Oncology, Faculty of Medicine, Ege University, Izmir, Turkey
| |
Collapse
|
2
|
Gurdal N, Fayda M, Alishev N, Bakir B, Tastekin D, Aykan F, Gezer U, Balik E, Saglam EK, Oral EN, Gulluoglu M, Kizir A. Neoadjuvant volumetric modulated arc therapy in rectal cancer and the correlation of pathological response with diffusion-weighted MRI and apoptotic markers. Tumori 2018; 104:266-272. [PMID: 29218690 DOI: 10.5301/tj.5000702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE In this prospective observational study, we aimed to report the applicability and tolerability of neoadjuvant volumetric modulated arc therapy with simultaneous integrated boost (SIB-VMAT) and concurrent chemotherapy in patients with locally advanced rectal cancer (LARC), and to evaluate the correlation of pathological response with apparent diffusion coefficient (ADC) measurements on diffusion-weighted magnetic resonance imaging (DW-MRI) and apoptotic markers. METHODS The study enrolled 30 patients with T3 to T4 and/or N+ rectal cancer who preoperatively received SIB-VMAT and concurrent chemotherapy. Before and after the neoadjuvant treatment, apoptotic markers including the nucleosomes and cell-free DNA fragments in the serum samples were examined; DNA integrity was assessed by amplifying the ACTB gene; and the ADC measurements on the DW-MRI were analyzed. RESULTS No patients had acute or chronic grade III-IV toxicity. Pathologic complete response (pCR) was achieved in 8 patients (27%), while in 10 patients (33%) near-complete pathological response was obtained. Posttreatment ADC was significantly higher in patients with pCR compared with the others (1.28 vs. 1.10, p = 0.017). ROC curve analysis showed that posttreatment ADC values had a sensitivity of 75% and a specificity of 77.3% for distinguishing the patients with pCR from other responders. On the other hand, posttreatment DNA integrity values were revealed lower than the pretreatment values (p = 0.36). Also, the results revealed an insignificant increase in the posttreatment serum level of nucleosomes (p = 0.72). CONCLUSIONS Neoadjuvant SIB-VMAT with concurrent chemotherapy was proved to be a feasible treatment regimen in LARC with tolerable side effects, and improved local control rate and pCR rate.
Collapse
Affiliation(s)
- Necla Gurdal
- 1 Department of Radiation Oncology, Institute of Oncology, Istanbul University, Istanbul - Turkey
| | - Merdan Fayda
- 2 Department of Radiation Oncology, Istinye University, Faculty of Medicine, Istanbul - Turkey
| | - Nijat Alishev
- 3 Department of Radiology, Istanbul University, Istanbul Faculty of Medicine, Istanbul - Turkey
| | - Baris Bakir
- 3 Department of Radiology, Istanbul University, Istanbul Faculty of Medicine, Istanbul - Turkey
| | - Didem Tastekin
- 4 Department of Medical Oncology, Institute of Oncology, Istanbul University, Istanbul - Turkey
| | - Faruk Aykan
- 4 Department of Medical Oncology, Institute of Oncology, Istanbul University, Istanbul - Turkey
| | - Ugur Gezer
- 5 Department of Basic Oncology, Institute of Oncology, Istanbul University, Istanbul - Turkey
| | - Emre Balik
- 6 Department of General Surgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul - Turkey
| | - Esra Kaytan Saglam
- 1 Department of Radiation Oncology, Institute of Oncology, Istanbul University, Istanbul - Turkey
| | - Ethem Nezih Oral
- 1 Department of Radiation Oncology, Institute of Oncology, Istanbul University, Istanbul - Turkey
| | - Mine Gulluoglu
- 7 Deparment of Pathology, Istanbul University, Istanbul Faculty of Medicine, Istanbul - Turkey
| | - Ahmet Kizir
- 1 Department of Radiation Oncology, Institute of Oncology, Istanbul University, Istanbul - Turkey
| |
Collapse
|
3
|
Guveli H, Guveli ME, Sen F, Oflaz S, Gurdal N, Tambas M, Kucucuk S, Aydıner A, Ozkan M. Effect of the childhood trauma on the adjustment to cancer in the patients with breast cancer. Breast Cancer 2016; 24:544-551. [PMID: 27812996 DOI: 10.1007/s12282-016-0737-9] [Citation(s) in RCA: 4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 10/19/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Early identification of patients coping poorly is important for compliance with treatment and control of distress. This study aims to investigate the effect of the childhood trauma experience on the type of reaction and adjustment that the person exhibits to the cancer among the patients with breast cancer. METHODS This cross-sectional study enrolled 310 patients with breast cancer. The effect of the childhood trauma and the psychological condition on the adjustment to cancer was investigated by assessing the adjustment to cancer, the experiences of childhood trauma and psychological status of the subjects using mental adjustment to cancer scale (MAC), childhood trauma questionnaire (CTQ28), Beck Depression Inventory (BDI) and Beck anxiety inventory (BAI). RESULTS Majority of the subjects (77.4%) showed positive adjustment to cancer. Fighting spirit (63.9%) was the most commonly seen mechanism of adjustment to cancer. Of the subjects, 54.5% suffered at least one of the childhood trauma types. Among the patients, 47.1% had depression and 58.4% had anxiety. In the multivariate logistic regression analysis, emotional neglect and depression, respectively, have an effect on both positive and negative adjustment to cancer. CONCLUSIONS Our study demonstrated that childhood trauma, especially emotional neglect, affects coping and adjustment among the patients with breast cancer. It is necessary to determine the childhood experiences to ensure the development of psychosocial interventions that will increase the adjustment and quality of life after the diagnosis of the cancer.
Collapse
Affiliation(s)
- Hulya Guveli
- Department of Prevantive Oncology, Istanbul University Institute of Oncology, Istanbul, Turkey
| | - Murat Emin Guveli
- Department of Radiation Oncology, Istanbul University Institute of Oncology, Istanbul, Turkey
| | - Fatma Sen
- Department of Medical Oncology, Istanbul University Institute of Oncology, Capa, Istanbul, Turkey.
| | - Serap Oflaz
- Department of Psychiatry, Istanbul University Istanbul Medicine of Faculty, Istanbul, Turkey
| | - Necla Gurdal
- Department of Radiation Oncology, Istanbul University Institute of Oncology, Istanbul, Turkey
| | - Makbule Tambas
- Department of Radiation Oncology, Istanbul University Institute of Oncology, Istanbul, Turkey
| | - Seden Kucucuk
- Department of Radiation Oncology, Istanbul University Institute of Oncology, Istanbul, Turkey
| | - Adnan Aydıner
- Department of Medical Oncology, Istanbul University Institute of Oncology, Capa, Istanbul, Turkey
| | - Mine Ozkan
- Department of Psychiatry, Istanbul University Istanbul Medicine of Faculty, Istanbul, Turkey
| |
Collapse
|
4
|
Meral R, Gurdal N, Kemikler G, Okutan M, Sahin D, Ahmedova A, Altun M, Sencer A, Uzum A, Hatipoglu E. Radiation Dose to Hippocampus With Increasing Planning Target Volume in Patients With Pituitary Adenoma Treated With Hypofractionated Radiation Therapy. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
5
|
Tastekin D, Kargin S, Karabulut M, Yaldız N, Tambas M, Gurdal N, Tatli AM, Arslan D, Gok AFK, Aykan F. Synuclein-gamma predicts poor clinical outcome in esophageal cancer patients. Tumour Biol 2014; 35:11871-7. [PMID: 25142230 DOI: 10.1007/s13277-014-2429-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [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: 07/11/2014] [Accepted: 07/31/2014] [Indexed: 02/05/2023] Open
Abstract
The synuclein gamma (SNCG) protein, a member of neuronal protein family synuclein, has been considered as a promising potential biomarker as an indicator of cancer stage and survival in patients with cancer. The present study was conducted to evaluate the prognostic value of SNCG in patients with esophageal carcinoma (EC). SNCG levels were assessed immunohistochemically in cancer tissues from 73 EC patients. Median age was 57 (range, 29-78) years old. Forty-seven percent of the patients were male. Thirty-seven percent of the patients had upper or middle localized tumor whereas 59 % had epidermoid carcinoma. More than half of the patients (61 %) had undergone operation where 57 % received adjuvant treatment including chemotherapy or chemotherapy plus radiotherapy. Median overall survival was 11.3 ± 1.8 months (95% confidence interval (CI): 7.7-14.9 months). SNCG positivity was significantly associated with the histological type of EC and inoperability (for SNCG positive vs. negative group; epidermoid 80 vs. 53 %; p = 0.05 and inoperable 59 vs.32 %; p = 0.04, respectively). Lymph node metastasis, inoperability and receiving no adjuvant treatment had significantly adverse effect on survival in the univariate analysis (p = 0.01, p < 0.001, and p = 0.001, respectively). SNCG positivity had significantly adverse effect on survival in both univariate and multivariate analysis (p = 0.02 and p = 0.01, respectively). Our results are the first to suggest that SNCG is a new independent predictor for poor prognosis in EC patients in the literature.
Collapse
Affiliation(s)
- Didem Tastekin
- Department of Medical Oncology, Oncology Institute, Istanbul University, 34390, Istanbul, Turkey,
| | | | | | | | | | | | | | | | | | | |
Collapse
|