Comparision of classical methods with fine needle aspiration results in distinguishing benign and malignant nodules

Tiroid nodülleri toplumda sık gözlenen bir problem olup, saptanan nodüllerde benign malign ayırımının yapılması önem taşımaktadır. Bu çalışmada, tiroid nodüllerinin benign malign ayrımında, muayene bulguları ve ultrasonografik özelliklerin ince iğne aspirasyon biyopsisi sonuçlarıyla karşılaştırılması amaçlandı.Çalışmaya tiroid nodülü bulunan 60 hasta alındı. Her hastaya detaylı fizik muayene, gri skala ultrasonografi (USG) ve renkli Doppler USG yapıldı. 60 hastada 10 mm ve üzerinde çapı olan toplam 77 nodüle USG eşliğinde ince iğne aspirasyon biyopsisi (İİAB) yapıldı. Muayene bulguları ve sonografik özellikler sitolojik sonuçlarla karşılaştırıldı.Fizik muayenede sert olarak palpe edilen nodüllerin malignite ile ilişkili olduğu saptanırken (p<0.001); hipoekojenite, düzensiz sınır ve mikrokalsifikasyon malignite ilişkili sonografik kriterler olarak bulundu (p<0.05). Lojistik regresyon analizlerinde kalsifikasyonun bağımsız risk faktörü olduğu ve mikrokalsifikasyonun malignite kuşkusunu 5.53 kat artırdığı saptandı (OR 5.53). Hem santral hem de periferal pulsatilite indeksi (PI) ve rezistivite indeksi (RI) değerlerinin malign nodüllerde anlamlı derecede yüksek olduğu (p<0.05) ve bu değerlerin artışına paralel olarak malignite olasılığının arttığı belirlendi.Bu sonuçlar; tiroid nodüllerinin benign malign ayrımının yapılmasında, muayene bulguları ve sonografik özelliklerin yardımcı olmakla beraber, kesin tanı için her nodülün İİAB ile değerlendirilmesi gerektiğini düşündürmektedir. Ancak çeşitli nedenlerle, her nodüle İİAB yapılması mümkün olmayan multinodüler guatrlı olgularda, doğru tanı konulabilmesi için; sonografik incelemede maligniteyi destekleyen bulgular ve özellikle yüksek RI-PI değerleri saptanan nodüllerin, İİAB için seçilmesi önem taşımaktadır.Because thyroid nodules are frequently observed in society it’s important to separate whether nodules are benign or malignant. In this study, we aimed to compare physical examination and ultrasound (US) findings with fine needle aspiration (FNA) results in distinguishing of benign and malignant nodules. 60 patients with thyroid nodules are taken to the study. Detailed physical examination, gray scale US and color Doppler US had been done to each patient. US guided FNA had been done to 77 nodules which are greater than 10 mm diameter in 60 patients. Physical examination and US finding are compared with cytological results. It has been determined that stiff nodules palpated in physical examination (p<0.001), hipoecogenity, irregular borders and microcalsification observed in US are related with malignancy (p<0.05). Calcification was determined as an independed risk factor and microcalcification was determined to increase the malignancy suspicion 5.53 times in logistic regression analysis (OR 5.53). Malignancy risk was found to be increased with both central and peripheral index of pulsatility (PI) and index of resistivity (RI) values in thyroid nodules (p<0.05). As a result, physical examination and US findings are important in distinguishing benign and malignant nodules but FNA is required for definitive diagnosis. US findings especially high RI-PI values are important in selecting nodule for FNA in multinodular cases

Prognostic factors for gemcitabine-refractory patients with advanced pancreatic cancer: a retrospective analysis of a multicentre study (Anatolian Society of Medical Oncology)

AIM OF THE STUDY: Systemic chemotherapy for patients with pancreatic cancer has limited impact on overall survival (OS). Patients eligible for chemotherapy should be selected carefully. The aim of the study was to search for prognostic factors for survival in patients with gemcitabine (Gem)-refractory or with gemcitabine and cisplatin (GemCis)-refractory advanced pancreatic cancer. MATERIAL AND METHODS: We retrospectively evaluated patients with Gem- or GemCis-refractory advanced pancreatic cancer. Sixteen potential prognostic variables were chosen for analysis in this study. Univariate and multivariate analyses were conducted to identify prognostic factors associated with survival. Univariate and multivariate statistical methods were used to determine prognostic factors. RESULTS: Multivariate analysis included the four prognostic significance factors in univariate analysis. Multivariate analysis showed that liver metastasis and second-line chemotherapy were considered independent prognostic factors for survival. CONCLUSIONS: Liver metastasis and second-line chemotherapy were identified as important prognostic factors in advanced pancreatic cancer patients refractory to treatment with Gem or GemCis. This prognostic factors may also facilitate pretreatment prediction of survival and can be used for selecting patients for treatment

Comparing the efficacy of regorafenib and 5-fluorouracil-based rechallenge chemotherapy in the third-line treatment of metastatic colorectal cancer

Abstract Background The optimal treatment for metastatic colorectal cancer (mCRC) after the second line is still controversial. Regorafenib has been the standard of care in this setting as it improved overall survival (OS) compared to placebo. In real-world practice chemotherapy rechallenge is also a preferred option even though supporting evidence is not enough. We aim to compare the efficacy of regorafenib and 5-fluorouracil-based (5-FU) rechallenge treatment in the third line setting of mCRC. Methods In this retrospective multi-institutional trial, mCRC patients from 21 oncology centers who progressed after 2 lines of chemotherapy were analyzed. Patients who were treated with regorafenib or rechallenge therapy in the third-line setting were eligible. Rechallenge chemotherapy was identified as the re-use of the 5-FU based regimen which was administered in one of the previous treatment lines. OS, disease control rate (DCR), progression free survival (PFS) and toxicity were analyzed. Results Three hundred ninety-four mCRC patients were included in the study. 128 (32.5%) were in the rechallenge, and 266 (67.5%) were in the regorafenib group. Median PFS was 5.82 months in rechallenge and 4 months in regorafenib arms (hazard ratio:1.45,95% CI, p = 0.167). DCR was higher in the rechallenge group than regorafenib (77% vs 49.5%, respectively, p =  < 0.001). Median OS after the third-line treatment was 11.99 (95% CI, 9.49–14.49) and 8.08 months (95% CI, 6.88–9.29) for rechallenge and regorafenib groups, respectively (hazard ratio:1.51, 95% CI, p < 0.001). More adverse effects and discontinuation were seen with regorafenib treatment. Conclusion Our study revealed that higher disease control and OS rates were achieved with rechallenge treatment compared to regorafenib, especially in patients who achieved disease control in one of the first two lines of therapy

Impact of adjuvant treatment modalities on survival outcomes in curatively resected pancreatic and periampullary adenocarcinoma.

We examined the impact of adjuvant modalities on resected pancreatic and periampullary adenocarcinoma (PAC)

Real-world data on efficacy and safety of first-line alectinib treatment in advanced-stage, ALK-positive non-small-cell lung cancer patients: A Turkish Oncology Group study

Aims: In this multicenter study, the authors aimed to determine the real-life efficacy and safety of first-line alectinib. Materials & methods: This retrospective trial included advanced-stage, ALK-positive non-small-cell lung cancer patients who were treated with first-line alectinib in terms of ALK-tyrosine kinase inhibitors, regardless of previous chemotherapy. The co-primary end points were progression-free survival both for all patients and for the treatment-naive population. The secondary end points were overall response rate, overall survival, rate of CNS progression and safety. Results & conclusion: A total of 274 patients (n = 177 for treatment-naive patients) were enrolled in the study. The median progression-free survival was 26 and 28.8 months for all patients and the treatment-naive group, respectively. The overall response rate, CNS progression rate and 1-year overall survival ratio were 77.9, 12.4 and 77%. Alectinib is a highly effective therapy with a favorable safety profile

Major and minor salivary gland cancers: A multicenter retrospective study

Background: Most of the studies on salivary gland cancers are limited for various reasons such as being single-center, small number of patients, including only major or minor SGCs, or only including epidemiological data. Methods: A total of 37 medical oncology clinics from different regions of Turkey participated in this retrospective-multicenter study. The analyzed data included clinical and demographical features, primary treatment, metastasis localizations, and treatments and includes certain pathologic features. Results: The study included data from a total of 443 SGCs. 56.7% was in major salivary glands and 43.3% was in minor salivary glands. Distant metastasis in the major SGCs was statistically significantly more common than in the minor SGCs, locoregional recurrence was statistically significantly more common in the minor SGCs than in the major SGCs (p = 0.003). Conclusions: Epidemiological information, metastasis and recurrence patterns, treatment modalities, and survival analysis of the patients over 20 years of follow-up are presented