Artvin yöresi potansiyel erozyon sahaları ile ağaçlandırma ve erozyon kontrol çalışmalarına genel bir bakış

Artvin-Çoruh Vadisi boyunca toprak erozyonu ciddi şekilde devam etmektedir. Vadi boyunca içerilere doğru gidildikçe iklim karasala dönüşmekte ve giderek kuraklaşmaktadır. Arazi yapısının çok dik, engebeli ve eğimli olmasından dolayı büyük ölçüde erozyona maruz kalan bu alanlarda toprak ve bitki örtüsü arasındaki ekolojik dengenin devam ettirilmesi zorunludur. Bunun için potansiyel ağaçlandırma ve erozyon kontrol alanlarının tespiti yanlış arazi kullanımının önüne geçilmesinde ve erozyonun önlenmesinde önemli bir adım olacaktır. Çalışmamıza göre Artvin ilinde orman sınırları içinde kalan 153915 ha ve orman sınırları dışında kalan 55990 ha alanda ağaçlandırma ve erozyon kontrol çalışması yapılması gerekmektedir. 1992-2003 yılları arasında yılda ortalama 380.8 ha ağaçlandırma ve 1009.2 ha erozyon kontrol çalışması planlanmış, bunların sırasıyla % 35.4 ve % 104.5’i gerçekleştirilmiştirThe soil erosion has been going on seriously in the Çoruh River Valley. Climate changes to dry terrestrial climate from marine as one moves to inland through the valley. It is necessary to maintain ecological balance between soil and vegetation in this region where the terrain is very steep and rugged, and subject to significant soil erosion. Therefore, determination of the potential afforestation and erosion control areas would be the first step towards stopping inappropriate land use practices and erosion. According to our results 153915 ha area in forest boundary and 55990 ha area out of forest boundary are subject to afforestation and erosion control efforts in Artvin province. Between 1992 and 2003 380.8 ha afforestation and 1009.2 ha erosion control are planned per year, and 35.4 % and 104.5 % are realized, respectivel

Clinicopathological and survival characteristics of mismatch repair status and PD-1 expression in serous ovarian cancer

Objective: To evaluate the clinicopathological characteristics of mismatch repair (MMR) deficiency and its clinical outcomes by performing immunohistochemistry (IHC) for MMR genes in the serous ovarian cancer (SOC) tumour sections.Study Design: A retrospective case-control study. Place and Duration of the Study: Gynecology Department of Kanuni Sultan Suleyman Training and Research Hospital, and Department of Medical Oncology of Medipol University, between March 2001 and January 2020. Methodology: IHC was carried out for MLH1, MSH2, MSH6, and PMS2 on full-section slides from 127 SOCs to evaluate the MMR status. MMR-negative and MMR-low groups together were defined as MMR deficient and called microsatellite instability-high (MSI-H). The MSI status and expression of programmed cell death-1 (PD-1) were compared in SOCs with different MMR statuses. Results: A significantly higher frequency of MMR-deficient SOCs was diagnosed at early stages compared with the patients in the MSS group (38.6% and 20.6%, respectively, p=0.022). The frequency of cases with PD-1 expression was significantly higher in the MSI-H group (76.2%) than in the MSS counterparts (58.8%, p=0.028). Patients in the MSI-H group had significantly longer DFS (25.6 months) and OS (not reached) than those in the MSS group (16 months and 48.9 months, p=0.039 and p=0.026, respectively).Conclusion: MSI-H SOCs were diagnosed at an earlier stage as compared to MMR proficient cases. The presence of PD-1 expres-sion was significantly higher in cases presenting MMR deficiency compared with MMR-proficient cases. MSI status was significantly associated with DFS and OS

The prevalence of drug-drug interactions and reported therapy related side-effects in oncology out-patients

Objective: The use of multiple medications in cancer patients is unavoidable; thus, adverse drug-drug interactions are frequent. This study aims to assess the prevalence of potential drug interactions in oncology patients visiting the outpatient chemotherapy unit. Method: Demographic and health-related information of patients visiting an outpatient chemotherapy unit was recorded using a pre-prepared form. A comprehensive list of all concurrently used medications was compiled and checked for interactions with the Micromedex online drug interaction tool.Results: A total of 179 adult patients were included. We recorded an average of 9.3 drugs per patient with 79 patients using more than 10 drugs. A total of 1671 drugs including 303 chemotherapeutic agents were assessed for drug-drug interactions. A total of 374 interactions, of which 203 were significant, were recorded in 118 (65.9%) patients with an average of 3.2 interactions per patient. Only 46 major interactions were recorded for anticancer agents. Cyclophosphamide (n=13) and cisplatin (n=12) were involved in most interactions. The number of interactions correlated with the number of drugs used (p=.001) and the presence of comorbidities (p=.002). The presence of comorbidities increased the risk of interaction by 1.21 (p=.04). Recorded side effects were not correlated to drug interactions. Conclusion: Medication review in cancer patients is essential in establishing all medications used by patients. Routine assessment in terms of potential drug interactions and evaluation of these interactions by a qualified pharmacist may help in optimizing patient outcomes

Survival outcomes of patients with oligometastatic non-small cell lung cancer who were treated with radical therapy: A multicenter analysis

Background/aim: Oligometastatic disease for nonsmall cell lung cancer (NSCLC) patients is generally thought to represent a better prognosis with a quieter biology, limited number of disease sites and long-term disease control. In this study, we aimed to determine the efficacy of radical treatment options for patients with oligometastatic NSCLC. Materials and methods: This retrospective trial included totally 134 patients with oligometastatic NSCLC. The presence of oncodriver mutation, tumor stages and nodal status, the number of metastases and involved metastatic site, treatment of primary tumor and oligometastasis, response rate, overall survival (OS) and progression-free survival (PFS) were evaluated. Results: Of 134 patients 66.4% were defined as adenocarcinoma, 26.1% were squamous cell carcinoma and 7.5% of patients were in other histology. Based on the treatment of primary tumor, in 36 patients (26.9%) curative surgery has undergone, in addition, 19 (14.2%) patients were received chemotherapy, 73 (54.5%) were treated with chemoradiotherapy, while immunotherapy and targeted therapy were used in 1 (0.7%) and 2 (1.4%), respectively. The preferred treatment for oligometastatic lesions were SBRT in 72.4% of patients, surgery in 10.5%, and both SBRT and surgery in 17.1% of patients. At the median follow up of 31.3 months (range: 9.5–48.5), the median PFS and OS times were 17 and 24.4 months, respectively. Moreover, OS-2 after progression was also 7.2 months. Conclusion: Based on our real-life experience, we demonstrated a significant correlation between good response to first treatment and survival in oligometastatic disease, we also understand that local ablative treatment modalities prolong and also delay both OS and PFS in oligometastatic NSCLC patients OS-2

Metastatik küçük hücre dışı akciğer kanseri hastalarının ikinci veya ileri sıra tedavisinde immünoterapinin gerçek yaşam analizi

Background: Immunotherapy agents such as atezolizumab and nivolumab are appropriate option for non-small cell lung cancer (NSCLC) accounts in the absence of driver mutation, regardless of PDL-1 expression in second and later line setting. Herein we aimed to evaluate the efficacy and safety of immunotherapy for the second and later line settings in metastatic NSCLC patients as a single center experience. Methods: Totally, 37 patients with metastatic NSCLC who received atezolizumab or nivolumab in the second or later lines were included. Clinicopathological features of patients and survival outcomes were analyzed. The safety profile and the factors that may predict survival were also evaluated. Results: Twenty-nine (78.4%) of patients were men and 8 of patients (21.6%) were woman with median age of 61 years (range:42-80). Atezolizumab was preferred in 22 (59.5%) of these patients and nivolumab in 15 (40.5%) of them. Objective response rate was 35.1%. At a median follow up of 22.5 months, median progression-free survival (PFS) was 4.7 months, median overall survival (OS) was 24.1 months. Univariate analysis for PFS revealed that gender (p=0.03), age (p=0.005), the presence of brain metastasis (p=0.02), PDL-1 status >1% (p=0.035), ECOG PS (p=0.04) and the good response to frontline treatment (p=0.015) were found to be significant prognostic indicators. It also showed that the presence of brain metastasis (p=0.03), PDL-1 status >1% (p=0.027), good response to frontline treatment (p=0.022) and atezolizumab preference (p=0.018) were prognostic factors for OS. Conclusion: Our real-life analysis indicated that atezolizumab and nivolumab improved survivals with good safety profile in second and later lines treatment of metastatic NSCLC patients.Atezolizumab ve nivolumab, driver mutasyon yokluğunda, küçük hücre dışı akciğer kanserinin (KHDAK) ikinci ve sonraki basamak tedavisinde PDL-1 durumundan bağımsız olarak kullanılabilen iyi bir seçenektir. Burada, metastatik KHDAK’li hastalarda ikinci ve sonraki sıra tedavide immünoterapinin etkinliğini ve güvenliğini değerlendirmeyi tek Merkez deneyimi olarak amaçladık. Gereç ve yöntem: Çalışmaya, ikinci veya sonraki sıralarda atezolizumab veya nivolumab alan toplam 37 metastatik KHDAK hastası dahil edildi. Hastaların klinikopatolojik özellikleri ve sağkalım sonuçları analiz edildi. Güvenlik profili ve sağkalımı öngörebilecek faktörler değerlendirildi. Bulgular: Hastaların 29'u (%78.4) erkek, 8'i (% 21.6) kadın, ortanca yaş 61 (aralık: 42-80) idi. Bu hastaların 22'sinde (%59.5) atezolizumab, 15'inde (% 40.5) nivolumab tercih edilmişdi. Objektif yanıt oranı %35.1 idi. Medyan 22.5 aylık takipte, medyan progresyonsuz sağkalım 4.7 (PSK) ay iken, medyan genel sağkalım (OS) 24.1 ay olarak bulundu. PFS için tek değişkenli analizde, cinsiyet (p=0.03), yaş (p=0.005), beyin metastazı varlığı (p=0.02), PDL-1 durumu >%1 (p=0.035), ECOG PS (p=0.04) ve ilk sıra tedaviye iyi yanıt varlığı (p=0.015) anlamlı prognostik göstergeler olarak bulundu. OS için ise, beyin metastazı varlığı (p=0.03), PDL-1 durumu >%1 (p=0.027), ilk sıra tedaviye iyi yanıt varlığı (p=0.022) ve atezolizumab tercihi (p=0.018) prognostik faktörler olarak bulundu. Sonuçlar: Gerçek hayat analizimiz, atezolizumab ve nivolumabın, metastatik KHDAK hastalarının ikinci ve sonraki basamak tedavilerinde iyi güvenlik profili ile sağkalımı iyileştirdiğini gösterdi

Tümör mikroçevresinde CD8’in yüksek ekspresyonu, yüksek dereceli seröz over kanserinde PD-1 ekspresyonu ve hasta sağkalımı ile ilişkilidir

Objective: The current study assesss programmed death-1 (PD-1) receptor expression and CD3, CD4, and CD8 tumor-infiltrating lymphocytes (TILs) in high-grade serous ovarian cancer (HGSOC) and to associate our results with neoadjuvant chemotherapy history and disease prognosis. Materials and Methods: We included cases diagnosed with primary HGSOC with biopsy or surgical resection materials in this study. The immunoreactivity of CD3, CD4, CD8, and PD1 was assessed immunohistochemically in tumor tissue. We analyzed TILs in two predetermined groups of high and low TIL. The relationships between clinical characteristics, PD-1, and TIL were assessed. by the χ(2) test or Fisher’s Exact test. We used Kaplan-Meier survival analysis and Cox proportional hazards regression model to the connection between survival and the amounts of TIL, and PD1. Results: Univariate analysis demonstrated that optimal debulking (p<0.001), early International Federation of Gynecology and Obstetrics stage (p=0.046), and higher scores of stromal CD8+ TIL expression (p=0.028) in tumor cells were all substantially correlated with longer disease-free survival (DFS), whereas the remaining variables analyzed, including PD-1 positivity, stromal CD3+, and CD4+ TILs, and intraepithelial CD3+, CD4+, and CD8+ TILs, were not correlated with DFS. Also, univariate analysis revealed that optimal debulking (p=0.010), and higher scores of stromal CD8+ TIL expression (p=0.021) in tumor cells were all substantially correlated with longer overall survival (OS). Conclusion: Higher scores of stromal CD8+ TILs are substantially correlated with DFS and OS in univariate analyses, whereas scores of stromal CD3+ and CD4+ TILs, and intraepithelial CD3+, CD4+, and CD8+ TILs are not correlated with DFS and OS in both univariate and multivariate analyses. Also, we found a significant association between PD-1 positivity and the scores of stromal CD3+ TILs and intraepithelial CD8+ TILs. However, no remarkable relationship was revealed between PD-1 positivity and the survival of HGSOC cases.Amaç: Çalışmamızın amacı, yüksek dereceli seröz over kanserinde (HGSOC) programlanmış ölüm-1 (PD-1) reseptör ekspresyonunu ve CD3, CD4 ve CD8 tümör infiltre edici lenfositleri (TIL) değerlendirmek ve bulgularımızın neoadjuvan kemoterapi öyküsü ve hastalık prognozu ile ilişkisini incelemektir. Gereç ve Yöntemler: Biyopsi veya cerrahi rezeksiyon materyalleri ile primer HGSOC tanısı alan olgular çalışmaya dahil edildi. CD3, CD4, CD8 ve PD1’in immünoreaktivitesi, tümör dokusunda immünohistokimyasal olarak değerlendirildi. TIL, önceden tanımlanmış iki grup olan düşük ve yüksek TIL grubunda analiz edildi. Klinik özellikler, PD-1 ve TIL arasındaki ilişkiler χ(2) testi veya Fisher’s Exact test ile değerlendirildi. TIL, PD1 ve hayatta kalma arasındaki ilişki için Kaplan-Meier hayatta kalma analizi ve Cox oransal hazard regresyon modeli kullanıldı. Bulgular: Tek değişkenli analiz, tümör hücrelerinde optimal debulking (p<0,001), erken Uluslararası Jinekoloji ve Obstetrik Federasyonu evresi (p=0,046) ve daha yüksek stromal CD8+ TIL ekspresyonu skorlarının (p=0,028) tümünün daha uzun hastalıksız sağkalım (DFS) ile önemli ölçüde ilişkili olduğunu gösterdi; oysa ki kalan değişkenler, PD-1 pozitifliği, stromal CD3+ ve CD4+ TIL’ler ve intraepitelyal CD3+, CD4+ ve CD8+ TIL’ler dahil olmak üzere, analiz edildiğinde DFS ile korele değildi. Ayrıca, tek değişkenli analiz, tümör hücrelerinde optimal debulking (p=0,010) ve daha yüksek stromal CD8+ TIL ekspresyonu skorlarının (p=0,021) tümünün daha uzun genel sağkalım (OS) ile önemli ölçüde ilişkili olduğunu ortaya koydu. Sonuç: Daha yüksek stromal CD8+ TIL skorları, tek değişkenli analizde DFS ve OS ile anlamlı şekilde ilişkiliyken, stromal CD3+ ve CD4+ TIL’lerin ve intraepitelyal CD3+, CD4+ ve CD8+ TIL’lerin skorları, hem tek değişkenli hem de çok değişkenli analizlerde DFS ve OS ile ilişkili değildi. Ayrıca, PD-1 pozitifliği ile stromal CD3+ TIL’lerin ve intraepitelyal CD8+ TIL’lerin skorları arasında anlamlı bir ilişki bulundu. Ancak, PD-1 pozitifliği ile HGSOC hastalarının sağkalımı arasında anlamlı bir ilişki gözlenmedi

Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio as prognostic markers in patients with extensive-stage small cell lung cancer treated with atezolizumab in combination with chemotherapy

Atezolizumab is now the standard treatment for extensive-stage small cell lung cancer (ES-SCLC). Herein, we investigated the prognostic role of inflammatory markers in patients treated with atezolizumab plus chemotherapy and evaluated the efficacy and safety of adding atezolizumab to chemotherapy for patients with ES-SCLC and prognostic and predictive factors as a real-life experience. This retrospective study included 55 patients who received front-line atezolizumab with etoposide plus platin regimen for ES-SCLC. We analyzed the survival outcomes and factors that may predict response and survival. The objective response rate (ORR) was 81.8%. At a median follow-up of 23.5 months, the median progression-free survival (PFS) time was 10.8 months, and the median overall survival (OS) time was 15.2 months. In univariate analysis for PFS, limited-stage disease at the time of diagnosis, the presence of prophylactic cranial irradiation (PCI), the presence of liver metastasis, neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) were found to be prognostic factors (P = .041, P = .034, P = .031, P = .004, and P = 135.7. Similarly, median PFS was 14.9 months in patients with NLR ≤ 3.43, while it was 9.6 months in patients with > 3.43. Univariate analysis for OS revealed that limited stage at the time of diagnosis, NLR and PLR were significant prognostic indicators (P = .01, P = .006, and P = .007, respectively). Median OS time for patients with both NLR ≤ 3.43 and PLR ≤ 135.7 was significantly better than that of patients with NLR > 3.43 and PLR > 135.7 (16.9 vs 11.3 and 16.9 vs 11.5 months, respectively). Logistic regression analysis demonstrated that PLR was an independent significant predictive factor for the response to atezolizumab plus chemotherapy (OR: 0.07, P = .028). The patients with PLR ≤ 135.7 were significantly good responders to atezolizumab plus chemotherapy treatment. Real-life data demonstrated a significant correlation between survival and NLR and, PLR in ES-SCLC patients treated with atezolizumab. In addition, PLR was a significant predictive indicator of response to atezolizumab plus chemotherapy

The comparison of local tumor control after microwave ablation, surgical resection and combined treatment for colorectal liver metastases

Aim. We aimed to compare the local therapeutic efficiency of microwave ablation (MWA), surgical resection, and combined treatment, assess the outcomes, and identify predictive factors for local treatment response in colorectal liver metastases (CLMs). Methods. From March 2013 to September 2019, a total of 54 patients with 302 CLMs were enrolled in this retrospective study. Eleven patients (20.4%) were treated with MWA, 9 patients (16.7%) with surgery, and 34 patients (63%) with the combined method. Univariate and multivariate analyses were performed to investigate overall survival (OS) and hepatic progression-free survival (HPFS) using the Cox proportional hazard regression model. The logistic regression analysis was used to identify the predictive factors for the local treatment response. Results. Total treatment response was achieved in 46.3% (n=25) of the patients. Local tumor progression was seen in 7.4% (n=4) of the patients, and the rate of intrahepatic distal recurrence was 46.3% (n=25). There were no significant differences in HPFS and OS between the three groups (p=0.56 and 0.90, respectively). Younger age

Metastatik safra yolu kanseri olan yaşlı hastalarda optimal tedavi yaklaşımları ve prognostik faktörler

Introduction: There is a lack of evidence of the outcomes in elderly patients advanced stage biliary tract cancer due to the patients aged over 65 years are less than 25% in many prospective trials. We designed a retrospective multicenter study to evaluate the factors affecting treatment and survival in elderly patients with advanced-stage biliary tract cancer. Materials and methods: A total of 116 patients with advanced stage biliary tract cancer aged ≥65 years were included, and the treatment responses, survival, and toxicity rates were evaluated with respect to age groups Results: There was no significant difference between age and response to treatment, survival, or toxicity. The median progression-free survival and overall survival were 5.3, and 11.8 months respectively. Multivariate analysis indicated that ECOG PS (p<0.001 CI95% 1.5-3.7) and PNI (p<0.001 CI 95% 0.14-0.41) were significant independent prognostic factors for PFS. The independent prognostic factors for OS were choice of frontline regimen, NLR and PNI (p=0.007 CI 95% 0.71 – 0.94, p=0.006 CI 95% 1.2 – 3.1, p=0.001 CI 95% 0.35 – 0.91, respectively). Discussion: This study confirms the general prognostic relevance of inflammatory parameters and the importance of frontline treatment in elderly patients with advanced-stage biliary tract tumors. Additionally, getting older does not indicate that treatment will be avoided or that they will have a worse prognosis and suffer from more toxicities.Giriş: 65 yaş üzeri hastaların klinik çalışmaların %25’inden daha azını oluşturması nedeniyle biliyer sistem kanseri olan ileri yaş hastaların yönetimi konusunda kanıt eksiği bulunmaktadır. Bu amaçla, metastatik safra yolu kanseri tanılı yaşlı hastalarda tedaviyi ve sağkalımı etkileyen faktörleri değerlendirmek için retrospektif çok merkezli bir çalışma tasarladık. Gereç ve yöntemler: Çalışmaya 65 yaş ve üzeri, ileri evre safra yolu kanseri tanısı almış, 116 hasta dahil edildi ve yaş gruplarına göre tedavi yanıtları, sağkalım ve toksisite oranları değerlendirildi. Bulgular: Median yaşa göre gruplandırılıdğında; yaş ile tedaviye yanıt, sağkalım, toksisite arasında anlamlı bir fark bulunmadı. Tüm populasyonda medyan progresyonsuz sağkalım (PSK) ve genel sağkalım (GSK) sırasıyla 5.3, 11.8 aydı. Multivariate analizde, PSK için bağımsız prognostik faktörler preformans durumu(ECOG PS) (p<0.001 CI95% 1.5-3.7) ve Prognostik nutrisyonel indek (PNI) (p<0.001 CI 95% 0.14-0.41) olarak bulundu. GSK için ise bağımsız prognostik faktörler, birinci sıra tedavi seçimi, Notrofil Lenfosit oranı (p=0,007 CI %95 0,71 – 0,94) ve PNI (p=0,001 CI %95 0,35 – 0,91) olarak bulundu. Tartışma: Metastatik safra yolu kanseri olan yaşlı hastalarda prognozu etkileyen temel faktöreler inflamatuar parametreler ve birinci basamakta seçilen kemoterapi rejimidir. İleri yaş ile sağkalım, toksiste profili ve tedavi toleransı farklılık göstermemektedir

Correlation of HER3 expression with prognostic markers and survival in patients with metastatic breast cancer

Bu çalışma ile Uludağ Üniversitesi Tıbbi Onkoloji Bilim Dalı'nda tanı almış metastatik meme kanserli hastalarda HER3 ekspresyonunun sıklığının; bu sıklığın klinik ve patolojik parametrelerle ilişkisinin ve sağkalıma olan etkilerinin ortaya konulması amaçlanmıştır.Çalışmaya 1996-2006 yılları arasında, Uludağ Üniversitesi Tıp Fakültesi Tıbbi Onkoloji bölümünde tedavi edilen 45 metastatik meme kanserli hasta dahil edildi. Hastaların dosyaları retrospektif olarak taranarak, klinik ve patolojik parametreler not edildi. 45 metastatik meme kanser hastasının formalin fikse edilmiş parafine gömülü bloklarından RTJ1 monoklonal antikoru kullanılarak c-erbB-3 protein ekspresyon analizi çalışıldı. Yapılan boyama rajkumar skorlaması ve sitoplazmik 4 puanlı skorlamayla değerlendirildi.Yapılan immünohistokimyasal boyamanın sonucunda hücrelerde daha fazla sitoplazmik boyama görülmekle birlikte membranöz ve nükleer boyanmada not edildi. Hastaların %51.2 (n=23) Rajkumar Skorlaması'na göre HER3 negatif kabul edilirken %48.8'inde (n=22) pozitif boyanma saptandı. Yapılan analizde c-erbB-3 ekspresyonu ile klinik ve patolojik parametreler arasında istatistiki anlamlılığa ulaşan sonuç saptanmadı. Değerlendirilmeye alınan metastatik meme kanserli hastaların ortalama genel sağ kalımı 22,178 ± 17,209 ay, progresyonsuz sağ kalımı 11,356 ± 10,447 ay ve hastalıksız sağkalımı 22,650 ± 15,892 ay olarak hesaplandı. Rajkumar Skorlama sistemi ile değerlendirlen hastalarda sağkalım ile HER3 ekspresyonu arasında ilişki saptanmazken, sitoplazmik 4 puanlı skorlama ile aynı vakalar değerlendirildiğinde HER3 ekspresyon yüzdesi yüksek olan vakalarda hastalıksız sağkalım anlamlı olarak düşük saptandı (Log-rank=22,596; p=0,000.1).Sonuç olarak, çalışmamızda HER3 ekspresyonu ile klinik ve patolojik parametreler arasında ilişki saptanmazken, sitoplazmik boyama dikkate alındığında hastalıksız sağ kalım ile HER3 ekspresyonu arasında negatif anlamlı ilişki saptandı. Bu belirteçin klinik pratikte kullanıma girebilmesi ve tedavi kararında etki yapabilmesi için büyük ölçekli çalışmalara ihtiyaç vardır.This study aims to reveal the incidence of C-erbB-3 expression, its correlation with clinical and pathological parameters and its effects on the survival in the patients with metastatic breast cancer who had been diagnosed at the Uludag University, Department of Medical Oncology.The study included a total of 45 patients with metastatic breast cancer who had been treated in Uludag University, Faculty of Medicine, Department of Oncology between 1996-2006. The patient files were retrospectively reviewed and the clinical and pathological parameters were noted. HER3 protein expression was analyzed on formaline-fixed paraffin-embedded blocks obtained from 45 patients with metastatic breast cancer using RTJ1 monoclonal antibody. Staining results were evaluated using Rajkumar scoring and cytoplasmic 4-point scoring systems.Although the immunohistochemical staining mostly resulted in cytoplasmic staining in the cells, membranous staining and nuclear staining were also noted. According the Rajkumar scoring system, 51.2% (n=23) of the patients were c-erbB-3 negative and 48.8% (n=22) showed positive staining. In the analysis performed, no statistically significant correlation was found between HER3 expression and clinical and pathological parameters. Of the patients with metastatic breast cancer who have been enrolled to the study, mean overall survival was 22,178 ± 17,209 months, mean progression-free survival was 11,356 ± 10,447 months and mean disease-free survival was 22,650 ± 15,892 months. While no correlation was detected between survival and HER3 expression in the patients evaluated using Rajkumar scoring system, the subjects with a higher percentage of HER3 expression were found to have a significantly lower disease-free survival when cytoplasmic 4-point scoring system was used (Log-rank=22,596; p=0,000<0,01).Consequently, while our study did not reveal a correlation between HER3 expression and clinical and pathological parameters, cytoplasmic staining resulted in a significant negative correlation between disease-free survival and HER3 expression. Large scale studies are warranted to establish this marker in the clinical practice and to involve it in the therapeutic decision making