Retrospective evaluation of malignant melanoma patients: A single-center experience

Introduction: Melanoma is a cancer arising from the malignant transformation of melanocytes. It is mostly seen in the skin, eyes, mucosal membranes, and meninges. Melanoma is one of the fastest rising of all cancers in the world.Methods: We retrospectively examined the medical records of adult patients who were diagnosed with melanoma between January 2005 and December 2013 according to the Hospital-Based Cancer Registry (HBCR) of Hacettepe University Oncology Hospital.Results: A total of 338 patients [193 (57.1%) men and 145 (42.9%) women] were included in the study. The male to female ratio was 1.3/1. The mean age of patients was 55.2±15.2 years (minimum-maximum: 16-87 years). The rate of male patients was higher in patients with cutaneous and uveal melanoma (respectively, 56.8% and 58.6%), whereas the rate of female patients was higher in patients with mucosal melanoma (female: 55.6% and male: 44.4%; respectively, p=0.746 and p=0.518). The median follow-up time was estimated to be 27.7 months (1-103 months). During follow-up period, 127 (37.6%) patients died, and 16 (4.7%) patients were lost to follow-up. The median overall survival time was 76.3 months. The 5-year survival rate was 53%. When all patients were evaluated according to melanoma subtypes, patients with melanoma of unknown primary origin had the lowest median survival time (6.4 months).Conclusions: It is necessary to increase the awareness of people about melanoma and to make physicians more sensitive about skin examination in order to detect cutaneous melanomas in the early stages

Crizotinib efficacy and safety in patients with advanced NSCLC harboring MET alterations: A real-life data of Turkish Oncology Group

Crizotinib is a multikinase inhibitor, effective in non-small cell lung cancer (NSCLC) harboring mesenchymal-epidermal transition (MET) alterations. Although small prospective studies showed efficacy and safety of crizotinib in NSCLC with MET alterations, there is limited real-life data. Aim of this study is to investigate real-life efficacy and safety of crizotinib in patients with advanced NSCLC harboring MET alterations. This was a retrospective, multicenter (17 centers) study of Turkish Oncology Group. Patients' demographic, histological data, treatment, response rates, survival outcomes, and toxicity data were collected. Outcomes were presented for the study population and compared between MET alteration types. Total of 62 patients were included with a median age of 58.5 (range, 26-78). Major histological type was adenocarcinoma, and 3 patients (4.8%) had sarcomatoid component. The most common MET analyzing method was next generation sequencing (90.3%). MET amplification and mutation frequencies were 53.2% (n = 33) and 46.8% (n = 29), respectively. Overall response rate and disease control rate were 56.5% and 74.2% in whole study population, respectively. Median progression free survival (PFS) was 7.2 months (95% confidence interval [CI]: 3.8-10.5), and median overall survival (OS) was 18.7 months (95% CI: 13.7-23.7), regardless of treatment line. Median PFS was 6.1 months (95% CI: 5.6-6.4) for patients with MET amplification, whereas 14.3 months (95% CI: 6.7-21.7) for patients with MET mutation (P = .217). Median PFS was significantly longer in patients who have never smoked (P = .040), have good performance score (P < .001), and responded to the treatment (P < .001). OS was significantly longer in patients with MET mutation (25.6 months, 95% CI: 15.9-35.3) compared to the patients with MET amplification (11.0 months; 95% CI: 5.2-16.8) (P = .049). In never-smokers, median OS was longer than smoker patients (25.6 months [95% CI: 11.8-39.3] vs 16.5 months [95% CI: 9.3-23.6]; P = .049). The most common adverse effects were fatigue (50%), peripheral edema (21%), nausea (29%) and diarrhea (19.4%). Grade 3 or 4 adverse effects were observed in 6.5% of the patients. This real-life data confirms efficacy and safety of crizotinib in the treatment of advanced NSCLC harboring MET alteration

Retrospective evaluation of malignant melanoma patients: A single-center experience

Introduction: Melanoma is a cancer arising from the malignant transformation of melanocytes. It is mostly seen in the skin, eyes, mucosal membranes, and meninges. Melanoma is one of the fastest rising of all cancers in the world.Methods: We retrospectively examined the medical records of adult patients who were diagnosed with melanoma between January 2005 and December 2013 according to the Hospital-Based Cancer Registry (HBCR) of Hacettepe University Oncology Hospital.Results: A total of 338 patients [193 (57.1%) men and 145 (42.9%) women] were included in the study. The male to female ratio was 1.3/1. The mean age of patients was 55.2±15.2 years (minimum-maximum: 16-87 years). The rate of male patients was higher in patients with cutaneous and uveal melanoma (respectively, 56.8% and 58.6%), whereas the rate of female patients was higher in patients with mucosal melanoma (female: 55.6% and male: 44.4%; respectively, p=0.746 and p=0.518). The median follow-up time was estimated to be 27.7 months (1-103 months). During follow-up period, 127 (37.6%) patients died, and 16 (4.7%) patients were lost to follow-up. The median overall survival time was 76.3 months. The 5-year survival rate was 53%. When all patients were evaluated according to melanoma subtypes, patients with melanoma of unknown primary origin had the lowest median survival time (6.4 months).Conclusions: It is necessary to increase the awareness of people about melanoma and to make physicians more sensitive about skin examination in order to detect cutaneous melanomas in the early stages

Over Karsinomu Olan Bir Hastada Akut Myeloid Lösemi

The occurrence of myelodysplastic syndrome or acute myeloid leukemia has been reported after treatment with cytotoxic alkylating agent-based chemotherapy for solid tumors. We report a 50-year-old woman presented with abdominal distension, vomiting, and fatique. The abdominal tomography showed bilaterally ovarian masses and ascite. Surgery was performed and histopathology of the ovarian mass revealed moderately differentiated papillary adenocarcinoma of ovarian. The patient was treated with chemotherapy combination including paclitaxel and carboplatin for six cycles. At 4 years after chemotherapy, recurrence of the primary disease developed. She received carboplatin and paclitaxel. Two years later, complete blood count showed leukocyte count 15.700 /mm3 (15% myeloblasts), hemoglobin 8.7 g/dL, and platelet count 88.000 /mm3. Bone marrow examination and flow cytometry analysis were consistent with acute myeloid leukemia. Standard induction chemotherapy with idarubicin and cytosine arabinoside was administered with failure to achieve complete remission. At the follow-up, the patient died due to prolonged febrile neutropenia. In conclusion, patients who were treated with high dose or long term alkylating agents should particularly follow-up for secondary tumors.Solid tümörler için sitotoksik alkilleyici ajan içeren kemoterapi tedavisinden sonra miyelodisplastik sendrom veya akut miyeloid lösemi oluşumu bildirilmiştir. Biz karında şişlik, kusma ve yorgunluk şikayeti ile başvuran 50 yaşında kadın hasta rapor ediyoruz. Abdominal tomografide bilateral ovaryan kitle ve asit gösterildi. Cerrahi uygulandı ve ovaryan kitle histopatolojisi orta diferansiye ovaryan papiler adenokarsinom geldi. Hasta altı siklus paklitaksel ve karboplatin kombine kemoteropi tedavisi verildi. Kemoterapiden 4 yıl sonra primer hastalığı nüks etti. Hasta tekrar paklitaksel ve karboplatin tedavisi aldı. İki yıl sonra tam kan sayımında lökosit sayısı 15.700/mm3 (%15 myeloblast), hemoglobin 8,7 g/dL ve platelet sayısı 88.000/ mm3 olarak görüldü. Kemik iliği örneklemesi ve flowsitometri analizi akut myeloid lösemi ile uyumlu idi. İdarubisin ve sitozin arabinozid kombinasyonundan oluşan standart indüksiyon kemoterapi uygulaması ile tam remisyon elde edilemedi. Takibinde hasta derin febril nötropeni nedeniyle öldü. Sonuç olarak, yüksek doz veya uzun süreli alkilleyici ajanlar ile tedavi edilen hastalarda, özellikle sekonder tümörler için takip gereklidir

The Relationship of Agmatine Deficiency with the Lung Cancer

The polyamines are essential for rapidly growing cells. Polyamines is synthesized by two reactions which begin from arginine. The aim of this study is to examine the serum levels of the enzymes located in the putrescine synthesis pathway and their relationship with lung cancer. In addition, the study also aim determine the oxidant-antioxidant status and the oxidative stress index. This study was performed on 36 lung cancer patients and 36 healthy controls. The arginase activity and the ornithine level were determined spectrophotometrically while the arginine decarboxylase, ornithine decarboxylase and agmatinase levels were determined by using Enzyme Linked Immunosorbent Assay (Elisa kit). The total antioxidant (TAS) and total oxidant status (TOS) were determined using a commercial kit auto analyser, oxidative stress index (OSI) was subsequently estimated. We observed an increase in ornithine decarboxylase, agmatinase and arginase levels in cancer patients (p 0.05). In the patient group, the TAS values decreased (p< 0.05), while the TOS values increased (p< 0.05). In addition, the OSI values increased (p< 0.05). Reduced agmatine level can cause an increase in polyamine synthesis and cell proliferation. For this reason, lung cancer prognosis may have a relationship with the agmantine levels.WoSScopu

Lack of Relationships Between Fgf19 Staining Pattern, Lymph Node Metastasis and Locally Invasive Characteristics of the Tumor in Colorectal Cancers

Introduction: Colorectal cancers are in the top of the cancer-related causes of death in the world and lymph node metastasis is accepted as the primary prognostic factor. In this study, correlations of FGF19 staining pattern with local invasion and lymph node metastasis in a series of colorectal cancers were investigated. Methods: This studyincluded 81 colorectal cancer patients who underwent surgery in our hospital with no evidence of preoperative radiological distant metastasis. Routine pathological examination of the resection material was performed in order to identify vascular, perineural and serosal infiltration, regional lymph node metastasis and the degree of differentiation. Tumor tissue samples were stained with an immunohistochemistry method for FGF 19 evaluation and the staining pattern was statistically compared with the above mentioned characteristics of the tumors. Results: The patient population consisted of 47 females and 34 males with a median age of 70 years. In 40 patients regional lymph nodes were positive and 51%, 32% and 38% had serosal, perineural and vascular invasion. While 64 cases were moderately-differentiated, 11 cases were well-differentiated and 6 poorly-differentiated, there was no association with FGF 19 staining, including intensity. Conclusion: No evidence of significant statistically correlation was found between FGF 19 staining pattern and serosal, perineural, vascular invasion, lymph node involvement and degree of differentiation.WoSScopu

Peripheral Neuropathy In Sézary Syndrome: Coincidence Or A Part Of The Syndrome?

PubMe

Higher Ki67 Expression Is Associates With Unfavorable Prognostic Factors and Shorter Survival in Breast Cancer

Background: The prognostic value of the Ki67 expression level is yet unclear in breast cancer. The aim of this study was to investigate the association between Ki67 expression levels and prognostic factors such as grade, Her2 and hormone receptor expression status in breast cancers. Materials and Methods: Clinical and pathological features of the patients with breast cancer were retreived from the hospital records. Results: In this study, 163 patients with breast cancer were analyzed, with a mean age of 53.4 +/- 12.2 years. Median Ki67 positivity was 20% and Ki67-high tumors were significantly associated with high grade (p<0.001), lymphovascular invasion (p=0.001), estrogen receptor (ER) negativity (p=0.035), Her2 positivity (p=0.001), advanced stage (p<0.001) and lymph node positivity (p<0.003). Lower Ki67 levels were significantly associated with longer median relapse-free and overall survival compared to those of higher Ki67 levels. Conclusions: High Ki67 expression is associated with ER negativity, Her2 positivity, higher grade and axillary lymph node involvement in breast cancers. The level of Ki67 expression is a prognostic factor predicting relapse-free and overall survival in breast cancer patients.WoSScopu

End-of-study results of Turkish gastric cancer patients from the global REGATE study

İstanbul Bilim Üniversitesi, Tıp Fakültesi.Purpose: Registry of Gastric Cancer Treatment Evaluation (REGATE) study was an international, prospective study including over 10000 patients from 22 countries, designed to describe the pattern of care in gastric cancer globally. The aim of this study was to summarize the data of the Turkish arm and compare them with the global results. Methods: Ten centers from Turkey took part in the REGATE registry. Between 2004 and 2008, 395 patients (median age, 60 years; range, 18-91, 67.6% men) with newly diagnosed primary adenocarcinoma of the stomach were followed at initial visit and 8-10 months later, at the time of treatment completion. Data on patient demographics, medical history, histopathology, cancer stage, planned and realized treatments was prospectively collected. Data processing and analysis were conducted centrally. Results: In Turkey, the majority of patients were diagnosed at an advanced stage, while the rate of surgery was lesser compared with the rest of the world. Realized treatment included more palliative-only therapy than initially planned (63.3%), while no therapy was recommended in 21.8%. Surgery involved total gastrectomy (46.3%) or distal subtotal gastrectomy (51.9%), with 87% R0 resection, 51.0% D1 and 44.9% D2 lymph node dissection. Combination chemotherapy was administered in more than half of the patients receiving palliative therapy (57.9%). Chemoradiotherapy was used in 66.7% of the cases receiving adjuvant therapy. Radiotherapy was applied to 32% of the cases receiving palliative therapy. Conclusion: Advanced stage gastric cancer is highly prevalent in Turkey. Increasing public awareness and implementing screening programs in high risk groups may help identify gastric cancer at earlier stages

Smoking Habits of Relatives of Patients with Cancer: Cancer Diagnosis in the Family is an Important Teachable Moment for Smoking Cessation

Background: In this study we aimed to determine the rate and habitual patterns of smoking, intentions of cessation, dependence levels and sociodemographic characteristics of relatives of patients with a diagnosis of cancer. Materials and Methods: This study was designed by the Turkish Oncology Group, Epidemiology and Prevention Subgroup. The relatives of cancer patients were asked to fill a questionnaire and Fagerstrom test of nicotine dependence. Results: The median ages of those with lower and higher Fagerstrom scores were 40 years and 42 years, respectively. We found no evidence of variation between the two groups for the remaining sociodemographic variables, including the subject's medical status, gender, living in the same house with the patient, their educational status, their family income, closeness to their cancer patients or spending time with them or getting any help or wanting to get some help. Only 2% of the subjects started smoking after cancer was diagnosed in their loved ones and almost 20% of subjects had quit smoking during the previous year. Conclusions: The Fagerstrom score is helpful in determining who would be the most likely to benefit from a cigarette smoking cessation program. Identification of these people with proper screening methods might help us to pinpoint who would benefit most from these programs.WoSScopu