Survival results according to Oncotype Dx recurrence score in patients with hormone receptor positive HER-2 negative early-stage breast cancer: first multicenter Oncotype Dx recurrence score survival data of Turkey

BackgroundThe Oncotype Dx recurrence score (ODx-RS) guides the adjuvant chemotherapy decision-making process for patients with early-stage hormone receptor-positive, HER-2 receptor-negative breast cancer. This study aimed to evaluate survival and its correlation with ODx-RS in pT1-2, N0-N1mic patients treated with adjuvant therapy based on tumor board decisions.Patients and methodsEstrogen-positive HER-2 negative early-stage breast cancer patients (pT1-2 N0, N1mic) with known ODx-RS, operated on between 2010 and 2014, were included in this study. The primary aim was to evaluate 5-year disease-free survival (DFS) rates according to ODX-RS.ResultsA total of 203 eligible patients were included in the study, with a median age of 48 (range 26-75) and median follow-up of 84 (range 23-138) months. ROC curve analysis for all patients revealed a recurrence cut-off age of 45 years, prompting evaluation by grouping patients as ≤45 years vs. >45 years. No significant difference in five-year DFS rates was observed between the endocrine-only (ET) and chemo-endocrine (CE) groups. However, among the ET group, DFS was higher in patients over 45 years compared to those aged ≤45 years. When stratifying by ODx-RS as 0-17 and ≥18, DFS was significantly higher in the former group within the ET group. However, such differences were not seen in the CE group. In the ET group, an ODx-RS ≥18 and menopausal status were identified as independent factors affecting survival, with only an ODx-RS ≥18 impacting DFS in patients aged ≤45 years. The ROC curve analysis for this subgroup found the ODx-RS cut-off to be 18.ConclusionThis first multicenter Oncotype Dx survival analysis in Turkey demonstrates the importance of Oncotype Dx recurrence score and age in determining treatment strategies for early-stage breast cancer patients. As a different aproach to the literature, our findings suggest that the addition of chemotherapy to endocrine therapy in young patients (≤45 years) with Oncotype Dx recurrence scores of ≥18 improves DFS

Smoking habits are an independent prognostic factor in patients with lung cancer

ObjectivesThe role of tobacco in the pathogenesis of lung cancer (LC) has been clearly established. Based on the epidemiological evidence that smoking may influence LC progression, we investigated the idea that smoking behavior could be associated with overall survival (OS) in this group of patients. MethodsA total of 351 patients with LC (311 men and 40 women) were reviewed. Smoking status was assessed as tobacco users or non-users. To calculate pack-years of smoking, the average of number of cigarettes smoked per day was divided by 20 to give packs per day, and then multiplied by the total number of years of smoking. OS was the main outcome measure. ResultsThe mean follow-up was 3.31.2 years. Kaplan-Meier plots of OS by use of tobacco revealed significant differences by smoking status (log-rank=5.44, P7 pack-years groups (log-rank=4.27, P<0.05). After adjusting for all potential confounders, tobacco smoking retained its independent prognostic significance for OS (hazard ratio=1.53, 95% confidence interval=1.19-2.17, P=0.02). ConclusionsOur data indicate that cigarette smoking is significantly associated with a poor prognosis among patients diagnosed with LC in a dose-dependent manner

True local recurrences after breast conserving surgery have poor prognosis in patients with early breast cancer.

İstanbul Bilim Üniversitesi, Tıp Fakültesi.İstanbul Bilim Üniversitesi, Sağlık Yüksekokulu.Background: This study was aimed at investigating clinical and histopathologic features of ipsilateral breast tumor recurrences (IBTR) and their effects on survival after breast conservation therapy. Methods: 1,400 patients who were treated between 1998 and 2007 and had breast-conserving surgery (BCS) for early breast cancer (cT1-2/N0-1/M0) were evaluated. Demographic and pathologic parameters, radiologic data, treatment, and follow-up related features of the patients were recorded

Stereotactic Vacuum-Assisted Core Biopsy Results for Non-Palpable Breast Lesions

İstanbul Bilim Üniversitesi, Tıp Fakültesi.Background: The increase in breast cancer awareness and widespread use of mammographic screening has led to an increased detection of (non-palpable) breast cancers that cannot be discovered through physical examination. One of the methods used in the diagnosis of these cancers is vacuum-assisted core biopsy, which prevents a considerable number of patients from undergoing surgical procedures. The aim of this study was to present the results of stereotactic vacuum-assisted core biopsy for suspicious breast lesions. Materials and Methods: Files were retrospectively scanned and data on demographic, radiological and pathological findings were recorded for patients who underwent stereotactic vacuum-assisted core biopsy due to suspicious mammographic findings at the Interventional Radiology Centre of the Florence Nightingale Hospital between January 2010, and April 2013. Statistical analysis was carried out using Pearson's Chi-square, continuity correction, and Fisher's exact tests. Results: The mean age of the patients was 47 years (range: 36-70). Biopsies were performed due to BIRADS 3 lesions in 8 patients, BIRADS 4 lesions in 77 patients, and BIRADS 5 lesions in 3 patients. Mammography elucidated clusters of microcalcifications in 73 patients (83%) and focal lesions (asymmetrical density, distortion) in 15 patients (17%). In terms of complications, 1 patient had a hematoma, and 2 patients had ecchymoses (3/88; 3.3%). The histopathologic results revealed benign lesions in 63 patients (71.6%) and malignant lesions in 25 patients (28.4%). The mean duration of the procedure was 37 minutes (range: 18-55). Although all of the BIRADS 3 lesions were benign, 22 (28.6%) of the BIRADS 4 lesions and all of the BIRADS 5 lesions were malignant. Among the malignant cases, 80% were in situ, and 20% were invasive carcinomas. These patients underwent surgery. Conclusions: In cases where non-palpable breast lesions are considered to be suspicious in mammography scans, the vacuum-assisted core biopsy method provides an accurate histopathologic diagnosis thus preventing a significant number of patients undergoing unnecessary surgical procedures

Erken evre meme kanserli hastalarda genç yaş (≤40 Yaş) ve moleküler alt tip cerrahi tedavi seçimini etkiler mi?

İstanbul Bilim Üniversitesi, Tıp Fakültesi.AMAÇ: Genç yaş ve üçlü negatif moleküler alt tip bir çok çalışmada lokal nüks açısından risk faktörü olarak gösterilmektedir. Bu çalışmanın amacı, genç (≤40 yaş) hastalarda uygulanan cerrahi girişim, moleküler alt tipler ve diğer faktörler ile hastalıksız sağ kalım ve genel sağ kalım ilişkilerini belirlemektir

Cetuximab tedavisine bağlı trikomegali: 4 olgu sunumu

İstanbul Bilim Üniversitesi, Tıp Fakültesi.Amaç: Cetuximab, kolorektal kanserler ve baş-boyun kanserlerinin tedavisinde kullanılan, epidermal büyüme faktörü reseptörüne (EGFR) karşı geliştirilmiş bir monoklonal antikordur. En önemli yan etkisi cilt toksisitesidir. Cetuximab ile ilişkili kıllanma değişiklikleri ise trikomegali (kaş ve kirpiklerde anormal uzama, kıvrılma, kalınlaşma) ve hipertrikozisdir. Çalışmamızda 4 kolorektal kanser olgusunda cetuximaba bağlı trikomegali yan etkisi sunulmuştur. Hastaların genel özellikleri Tablo 1' de gösterilmiştir

Hematolojik maligniteli ve solid organ tümörlü hastaların kültürlerinde üreyen gram negatif bakterilerin florokinolon direnci oranları

İstanbul Bilim Üniversitesi, Tıp Fakültesi.Florokinolonlar, maligniteli hastaların ayaktan tedavisinde ve nötropenik hastaların profilaksisinde Gram negatif bakteriler hedef alınarak en sık kullanılan antibiyotik grubudur. Bu sebeple lokal florokinolon direnci hakkındaki epidemiyolojik verileri bilmek önemlidir. Bu amaçla hastanemizde izlenen maligniteli hastaların çeşitli klinik materyallerinde üreyen Gram negatif bakterilerin florokinolon direnci araştırılmıştır

The prognostic impact of molecular subtypes and very young age on breast conserving surgery in early stage breast cancer

İstanbul Bilim Üniversitesi, Tıp Fakültesi.İstanbul Bilim Üniversitesi, Sağlık Yüksekokulu.Background: Premenopausal breast cancer with a triple-negative phenotype (TNBC) has been associated with inferior locoregional recurrence free survival (LRFS) and overall survival (OS) after breast conserving surgery (BCS). The aim of this study is to analyze the association between age, subtype, and surgical treatment on survival in young women (≤40 years) with early breast cancer in a population with a high rate of breast cancer in young women. Methods: Three hundred thirty-two patients ≤40 years old with stage I-II invasive breast cancer who underwent surgery at a single institution between 1998 and 2012 were identified retrospectively. Uni- and multivariate analysis evaluated predictors of LRFS, OS, and disease free survival (DFS)

Dramatic response to catumaxomab treatment for malign ascites related to renal cell carcinoma with sarcomotoid differentiation.

İstanbul Bilim Üniversitesi, Tıp Fakültesi.Refractory malignant ascites (MA) is a common complication in cancer patients. Renal cell carcinoma (RCC) is rarely present with peritoneal ascites, which is commonly associated with carcinomas of the gastrointestinal and female reproductive tracts; including especially ovarian high-grade serous carcinoma. Currently, chemotherapy and paracentesis represent the most widely used methods to relieve the symptoms. Recently, intraperitoneal therapy with catumaxomab—a trifunctional hybrid antibody—has been introduced for the treatment of MA. The benefit of this treatment has been demonstrated in patients with distinct abdominal malignancies. In this case report, we present the first case of successful catumaxomab treatment against MA in a patient with advanced RCC with sarcomatoid differentiation. After the second administration of catumaxomab, paracentesis became no longer necessary. Catumaxomab might represent a safe treatment option for MA in the course of metastatic RCC with sarcomatoid differentiation