Mean Platelet Volume (MPV) For Predicting Prognosis of Rectum Cancer After Neoadjuvant Treatment

Aim:Rectum cancer is a subtype of colorectal cancer. Its etiology and etiopathogenesis is similar to colon cancer. However, it is differentiated from colon tumors because of its anatomic location and treatment approach. In the literature, Mean Platelet Volume (MPV) has been shown to correlate with inflammation in gastrointestinal cancer patients. Based on this fact, we aimed to evaluate the MPV value for predicting prognosis of rectum cancer patients who are treated with neoadjuvant chemoradiotherapy.Materials and Methods:We retrospectively collected the data of 80 operated rectum adenocarcinoma patients who were treated neoadjuvant chemoradiotherapy between 2011 and 2018. MPV value was investigated as prognostic factors for disease free survival.Results:Fifty-five patients were male (69%). Median age was 56 (range 22 to 83 years). The most common histopathologic was adenocarcinoma (94%). The ideal cut-off value of pretreatment MPV that predicted disease-free survival was 7.65 in the ROC analysis [AUC:0.74 (0.63-0.85); p<0.002] with a sensitivity of 81%, and specificity of 69 %. Median DFS was 43 months in patients with MPV <7.65 (95%CI: 35.5-54.6). In multivariate analysis, MPV was found to be an independent prognostic factor for disease free survival (p = 0.02).Conclusion:According to our study, we suggest that high levels of MPV at the time of diagnosis can be used as a predictive biomarker for early relapse in rectum cancer patients

Immunogenicity and safety of the CoronaVac vaccine in patients undergoing treatment for breast and lung cancer

BACKGROUND: Patients with cancer receiving an active systemic therapy are at a high risk for coronavirus disease (COVID-19); however, the antibody response and long-term results of the inactivated whole-virion SARS-CoV-2 (CoronaVac) vaccine in these patients compared to the non-cancer population are unknown. OBJECTIVE: To compare seroconversion for SARS-CoV-2 receptor-binding domain (RBD) specific IgG positivity against two doses of the CoronaVac vaccine in breast and lung cancer patients receiving systemic therapy, to determine the factors affecting seropositivity, and to observe long-term results up to a secondary booster vaccine. RESULTS: The analysis included 201 cancer patients (99 breasts, 102 lungs; median age: 59 years (range: 28-92), 42.3 % men) and 97 controls (median age: 62 years (range: 24-87), 38.1 % men). The seropositivity rate for RBD IgG after 2 doses of vaccine in the cancer group was 81.6 % (n=164) and 93.8 % (n=91) in the control group (p=0.005). The median IgG titer of cancer patients was significantly lower than in the control group (338 (IQR, 95-933) AU/mL vs 676 (IQR, 389-1270) AU/mL; p= 60 patients than in <60 patients (75.9 % vs 89.4 %, p=0.014). DISCUSSION AND CONCLUSION: Cancer patients receiving an active systemic therapy with two doses of the CoronaVac vaccine had a lower antibody response than the non-cancer population, and deaths due to COVID-19 may occur in these patients despite the vaccine. Therefore, extensive protective measures should be taken to protect against COVID-19 in cancer patients aged 60 years and older, who have received two doses of the CoronaVac vaccine

Prognostic factors of perioperative FLOT regimen in operable gastric and gastroesophageal junction tumors: real-life data (Turkish Oncology Group)

Background/aim: Perioperative FLOT regimen is a standard of care in locally advanced operable gastric and GEJ adenocarcinoma. We aimed to determine the efficacy, prognostic factors of perioperative FLOT chemotherapy in real-life gastric and GEJ tumors. Materials and methods: The data of patients who were treated with perioperative FLOT chemotherapy were retrospectively analyzed from 34 different oncology centers in Turkey. Baseline clinical and demographic characteristics, pretreatment laboratory values, histological and molecular characteristics were recorded. Results: A total of 441 patients were included in the study. The median of age our study population was 60 years. The majority of patients with radiological staging were cT3-4N(+) (89.9%, n = 338). After median 13.5 months (IQR: 8.5–20.5) follow-up, the median overall survival was NR (95% CI, NR to NR), and median disease free survival was 22.9 (95% CI, 18.6 to 27.3) months. The estimated overall survival at 24 months was 62%. Complete pathological response (pCR) and near pCR was achieved in 23.8% of all patients. Patients with lower NLR or PLR have significantly longer median OS (p = 0.007 and p = 0.033, respectively), and patients with lower NLR have significantly longer median DFS (p = 0.039), but PLR level did not affect DFS (p = 0.062). The OS and DFS of patients with better ECOG performance scores and those who could receive FLOT as adjuvant chemotherapy instead of other regimens were found to be better. NLR was found to be independent prognostic factor for OS in the multivariant analysis. At least one adverse event reported in 57.6% of the patients and grade 3–4 toxicity was seen in 23.6% patients. Conclusion: Real-life perioperative FLOT regimen in operable gastric and GEJ tumors showed similar oncologic outcomes compared to clinical trials. Better performance status, receiving adjuvant chemotherapy as same regimen, low grade and low NLR and PLR improved outcomes in real-life. However, in multivariate analysis, only NLR affected OS. © TÜBİTAK

İleri Evre Gastrointestinal Kanserli Hastalarda Fibrin ile İlişkili Yeni Bir Biyobelirteç Olan Serum DR-70 Düzeyinin Prognostik ve Prediktif Değeri

Amaç: DR-70, kandaki fibrin yıkım ürünlerini tespit eden yeni geliştirilmiş bir testtir. Bu çalışmada ileri evre gastrointestinal (GI) kanserlerde DR- 70’in tedavi yanıtını izlemedeki etkinliğini değerlendirmeyi amaçladık. Gereç ve Yöntem: Çalışmaya farklı serilerdeki sistemik tedaviler ile tedavi edilen ileri evre GI kanserli hastalar dahil edildi. Görüntüleme çalışmaları, DR-70 ve geleneksel tümör belirteçleri [karsinoembriyonik antijen (CEA), karbonhidrat antijeni (CA) 19-9] başlangıçta ve tedavinin üçüncü ayında tekrarlandı. Bulgular: Çalışmaya kolorektal (%52,1), özofagogastrik (%32,4) ve pankreatikobiliyer kanser (%15,5) tanısı konan toplam 142 hasta alındı. Hastaların çoğu birinci basamak tedavi alıyordu (%56,3). Hastaların %57’sinde ikinci kan örneği alındı. Özofagogastrik kanseri olan hastalarda, DR-70 yanıtı tedavi yanıtı ile iyi korelasyon gösterdi (p=0,007) ve başlangıçta düşük serum DR-70 düzeyi, daha uzun genel sağkalım ile anlamlı şekilde ilişkiliydi (p=0,02). Kolorektal kanserli hastalarda tedavi öncesi DR-70 ile CEA düzeyleri arasında pozitif fakat zayıf bir korelasyon (p=0,03, r=0,244) varken, tedavi öncesi DR-70 ile CA 19-9 arasında özofagogastrik ve pankreatikobilier kanserlerde orta düzeyde pozitif bir korelasyon vardı (sırasıyla p=0,01, r=0,402 ve p=0,04, r=0,515). DR-70 konsantrasyonunda %25’ten fazla azalma, daha iyi genel ve progresyonsuz sağkalım ile ilişkiliydi. Sonuç: DR-70, özellikle özofagogastrik kanserde tedaviye yanıtı ve sağkalımı ön gören güçlü bir belirteçtir

Prognostic Factors in Operated Early Stage Lung Cancer Patients- Retrospective Single Center Data

Aim: Non-small cell lung cancer (NSCLC) accounts for 85% of all lung cancers. Although curative treatment is surgery in the early stages, disease relapse is common. In this study, we retrospectively evaluated the prognostic factors and outcomes of operated NSCLC cases.Materials and Methods: Retrospective analysis of data from 166 patients with early stage NSCLC who presented after surgery and treated and followed in our clinic between 2006-2018 was performed. Histopathologic features and clinical findings were investigated as prognostic factors.The findings were analyzed using SPSS.Results: At the time of diagnosis, median age was 61 (39-82) and 84% of the patients were male. Most common pathologic subtype was adenocarcinoma. Median disease free survival (DFS) and overall survival (OS) were 76 months (%95CI:32.1-110.0) and 87 months (95%CI:59.8-114.1). ). In multivariate analysis, presence of vascular invasion was found to be independent prognostic factors for both DFS and OS (HR:2.5 and 2.3, respectively). Adenocarcinoma solid pattern was only associated with worse disease-free survival (HR: 1.7).Conclusion: In our study, we showed that the presence of vascular invasion and solid-type adenocarcinoma is associated with poor survival

First-line treatment of patients with HER2-positive metastatic gastric and gastroesophageal junction cancer

Fluoropyrimidine+cisplatin/oxaliplatin+trastuzumab therapy is recommended for the first-line treatment of HER2-positive metastatic gastric adenocarcinoma. However, there is no comprehensive study on which platinum-based treatment should be preferred. This study aimed to compare the treatment response and survival characteristics of patients with HER2-positive metastatic gastric or gastroesophageal junction (GEJ) cancer who received fluorouracil, oxaliplatin, and leucovorin (mFOLFOX)+trastuzumab or cisplatin and fluorouracil (CF)+trastuzumab as first-line therapy. It was a multicenter, retrospective study of the Turkish Oncology Group, which included 243 patients from 21 oncology centers. There were 113 patients in the mFOLFOX+trastuzumab arm and 130 patients in the CF+trastuzumab arm. The median age was 62 years in the mFOLFOX+trastuzumab arm and 61 years in the CF+trastuzumab arm (P = 0.495). 81.4% of patients in the mFOLFOX+trastuzumab arm and 83.1% in the CF+trastuzumab arm had gastric tumor localization (P = 0.735). The median progression-free survival (PFS) was significantly higher in the mFOLFOX+trastuzumab arm (9.4 months vs. 7.3 months, P = 0.024). The median overall survival (OS) was similar in both groups (18.4 months vs. 15.1 months, P = 0.640). Maintenance trastuzumab was continued after chemotherapy in 101 patients. In this subgroup, the median OS was 23.3 months and the median PFS was 13.3 months. In conclusion, mFOLFOX+trastuzumab is similar to CF+trastuzumab in terms of the median OS, but it is more effective in terms of the median PFS in the first-line treatment of HER2-positive metastatic gastric and GEJ cancer. The choice of treatment should be made by considering the prominent toxicity findings of the chemotherapy regimens

Akciğerlerde Mikrotrombozla Seyreden P. falciparum Olgusu

Olgu: 43 yaşında erkek hasta, Afrika ülkelerine (Ghana, Togo) yardım amaçlı ziyarette bulunmuş. Seyahat sonrası ateş bulantı ve ishal şikayetleri ile hastanemize başvurmuş ve Giemsa boyalı kalın damla ve periferik yayma incelemeleri ile P. falciparum sıtması teşhisi konularak tedavisine başlanmıştır. Olgumuz sıtma seyrinde beklenen bulgulara ek olarak ortaya çıkan, seyrek görülen bir komplikasyon olan akciğerlerde mikrotromboz gelişmesi nedeniyle sunulmuştur

Morphological investigations on the hairs of the honamlı goat and the hair goat (Black Goat)

Yapılan bu çalışma ile Kıl keçisi’nin ve Honamlı keçisi’nin kıl yapısı, ırk özellikleri, korteks, medulla, bulbus ve scopus pili’nin makro anatomik, stereo mikroskopik, ışık mikroskopik, SEM ve germe test sonuçlarının, farklı ve benzer yanlarının ortaya konulması amaçlandı. Her iki keçi ırkında gözlenen bulbus tiplerine bakıldığında ırk ayrımı bakımından önem taşıyan bir özellik saptanamadı. Honamlı keçisi kıllarının bulbus pili ve scapus pili çaplarının, kıl keçisi kıllarının bulbus pili ve scapus pili çaplarından daha büyük olduğu tespit edildi. Elde edilen rakamlar, kortex ve medulla ölçümlerinde de belirgin şekilde Honamlı keçilerinde yüksektir. Germe testi uygulamasında maksimum uzama ve maksimum kuvvete dayanma konusunda en güçlü kıllar Honamlı keçisine aittir. Ortalama esneme değerine bakılınca Kıl keçilerinin kıllarının esnekliğinin daha fazla olduğu görülmüştür.In this study, it was aimed that to reveal different and similar aspects of hair structures and breed characteristics with cortex, medulla, bulbus and scopus pili of these two goat breeds by macro anatomic, stereo microscopic, light microscopic, SEM and tensile test results. When we look at the types of bulbus observed in both goat breeds, a characteristic that is important in terms of breed discrimination cannot be determined. The diameters of the bulbus pili and scapus pili of Honamlı Goat were found to be greater than Hair Goat’s. This difference was also found to be significantly higher of the cortex and medulla measurements in the Honamlı Goats. The strongest hairs on the maximum elongation and maximum strength on pull-test were Honamlı Goats. According to the average stretch value, Hair Goats have more flexibilit