The Effect of Prognostic Nutritional Index on Prognosis in Small Cell Lung Cancer: Single Center Experience

Aim:The aim of this study is to investigate the effect of prognostic nutritional index parameter on overall survival in small cell lung cancer patients.Materials and Methods:Fifty-two small cell lung cancer patients who were diagnosed in our clinic were reviewed retrospectively. Prognostic nutritional index (PNI) was calculated using albumin and lymphocyte value at the time of diagnosis. The relationship between PNI and overall survival was examined.Results:Of the 52 patients in our study, 47 were male and 5 were female. The median age was 62.9 years.The median PNI value was 45. Median progression-free survival was 6.9 months, median overall survival was 8.7 months. In the multivariate analysis, limited stage disease and PNI≥45 were found to be an independent good prognostic factor for overall survival. There was no relationship between overall survival and gender, age, and LDH status.Conclusion:In our study, we found that the prognostic nutritional index and limited stage disease are good prognostic factors in terms of overall survival

A small cell carcinoma in the testis associated with testicular teratoma

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Predictive and Prognostic Factors in Ovarian and Uterine Carcinosarcomas

Background: Prognostic factors and the standard treatment approach for gynaecological carcinosarco-mas have not yet been clearly defined. Although car-cinosarcomas are more aggressive than pure epithelial tumours, they are treated similarly. Serous/clear cell and endometrioid components may be predictive fac-tors for the efficacy of adjuvant chemotherapy (CT) or radiotherapy (RT) or RT in patients with uterine and ovarian carcinosarcomas. Heterologous carcino-sarcomas may benefit more from adjuvant CT.Aims: We aimed to define the prognostic and predic-tive factors associated with treatment options in ovar-ian (OCS) and uterine carcinosarcoma (UCS).Study Design: Retrospective cross-sectional studyMethods: We retrospectively reviewed the medical re-cords of patients with ovarian and uterine carcinosar-coma from 2000 to 2013, and 127 women were includ-ed in this study (24 ovarian and 103 uterine). Patients admitted to seventeen oncology centres in Turkey be-tween 2000 and December 2013 with a histologically proven diagnosis of uterine carcinosarcoma with FIGO 2009 stage I-III and patients with sufficient data ob-tained from well-kept medical records were included in this study. Stage IV tumours were excluded. The pa-tient records were retrospectively reviewed. Data from 104 patients were evaluated for this study.Results: Age (>=70 years) was a poor prognostic factor for UCS (p=0.036). Pelvic±para aortic lymph node dis-section did not affect overall survival (OS) (p=0.35). Macroscopic residual disease was related with OS (p<0.01). The median OS was significantly longer in stage I-II patients than stage III patients (p=0.03). Adjuvant treatment improved OS (p=0.013). Adju-vant radiotherapy tended to increase the median O

An examination on the work named Çocuklara Mektup Numunelerim by Selanikli Edhem İsmail

Mektup, yazının icadı ile beraber insanoğlunun hayatına girmiş ve haberleşme aracı olarak kullanılmıştır. Ancak zamanla kullanılış amacında değişim göstermiştir. Böylece sadece haberleşme aracı olmaktan çıkmış, bir edebi tür olarak insan hayatındaki yerini sağlamlaştırmıştır. İnceleme konumuz olan Çocuklara Mektup Numunelerim adlı eser de mektup türüyle yazılan onlarca eserden bir tanesidir. Bu çalışma giriş ve üç bölümden oluşmaktadır. İlk olarak mektup türünün tarihi gelişimi, mektup üslûbuyla kaleme alınan eserler, çocuk edebiyatında mektup türünün önemi ve bu konuda yapılan araştırmaları sunmaktadır. Akabinde mevcut eserde bulunan mektuplardaki ahlâki ilkeleri incelemektedir. Bu sırada tarih boyunca birçok esere konu olan ahlâki ilkelerin değerler eğitimindeki önemine vurgu yapılmaktadır. Esere değer katan en önemli unsurların başında da içeriğinin geldiği muhakkaktır. Eserde yer alan mektuplar dil ve üslûp açısından ele alınmıştır. Birinci ve ikinci bölümün çalışmalarında özellikle çocukların ihtiyaç ve seviyeleri göz önüne alınmıştır. Son olarak tez konumuz olan Çocuklara Mektup Numunelerim eserinin latinize edilmiş hali ile aslından birkaç örnek mektup bulunmaktadır.The letter came into the life of humans with the invention of writing and it was used as a communication tool. However, its area of usage has changed in the course of time. Hereby, it is no longer just a communication tool, moreover it has secured its position as a literary genre in humans life. The work that we examine, named Çocuklara Mektup Numunelerim, is one of the dozens of letter that is knows as epistolary in which writers use letters and they tell their stories or deliver messages through a series of letters. This study consists of introduction and three other parts. First of all, it represents the historicol development of the epistolary, and the Works written in the form of epistolary, then the significance of the epistolary in children’s literatüre and then the surveys made about this topic. Subsequently, it the mentioned work. Meanwhite, the significance of morel values which has subjected to a lot of Works during the history in the valuer education is the most important element that enriches the work. The epistles in the work aare handled in terms of language and style. In the studies of first and second parts, especially the necessities and grades of children are taken into consideration. In conclusion, this study includes the transcriptional form of Çocuklara Mektup Numunelerim which is our thesis subject and some of the samples of epistle from the original work

KRAS Mutation in Small Cell Lung Carcinoma and Extrapulmonary Small Cell Cancer

Background: Lung cancer is one of the most lethal cancers. It is mainly classified into 2 groups: non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). Extrapulmonary small cell carcinomas (EPSCC) are very rare. The Ras oncogene controls most of the cellular functions in the cell. Overall, 21.6% of human cancers contain a Kirsten Ras (KRAS) mutation. SCLC and EPSCC have several similar features but their clinical course is different. Aims: We investigated the KRAS mutation status in SCLC and EPSCC. Study design: Mutation research. Methods: Thirty-seven SCLC and 15 EPSCC patients were included in the study. The pathological diagnoses were confirmed by a second pathologist. KRAS analysis was performed in our medical genetic department. DNA isolation was performed with primary tumor tissue using the QIAamp DNA FFPE Tissue kit (Qiagen; Hilden, Germany) in all patients. The therascreen KRAS Pyro Kit 24 V1 (Qiagen; Hilden, Germany) was used for KRAS analyses. Results: Thirty-four (91.9%) of the SCLC patients were male, while 11 (73.3%) of the EPSCC l patients were female. SCLC was more common in males, and EPSCC in females (p=0.001). A KRAS mutation was found in 6 (16.2%) if SCLC patients. The most common mutation was Q61R (CAA>CGA). Among the 15 EPSCC patients, 2 had a KRAS mutation (13.3%). When KRAS mutant and wild type patients were compared in the SCLC group, no difference was found for overall survival (p=0.6). Conclusion: In previous studies, the incidence of KRAS mutation in SCLC was 1-3%; however, it was 16.2% in our study. Therefore, there may be ethnic and geographical differences in the KRAS mutations of SCLC. As a result, KRAS mutation should not be excluded in SCLC

Outcomes of surveillance versus adjuvant chemotherapy for patients with stage IA and IB nonseminomatous testicular germ cell tumors

WOS: 000404154000013PubMed ID: 27812752Background Currently, it is accepted that risk assessment of clinical stage I (CS I) nonseminomatous germ cell tumors (NSGCT) patient is mainly dependent on the presence of lymphovascular invasion (LVI). Initial active surveillance, adjuvant chemotherapy and retroperitoneal lymph node dissection (RPLND) are acceptable treatment options for these patients, but there is no uniform consensus. The purpose of this study was to compare outcomes of active surveillance with adjuvant chemotherapy. Methods A total of 201 patients with CS I NSGCT after orchiectomy were included. Outcomes of active surveillance and adjuvant chemotherapy were retrospectively analyzed. The prognostic significance of risk factors for survival and relapse was evaluated. Results Of the 201 patients, 110 (54.7%) received adjuvant chemotherapy, while the remaining 91 patients (45.3%) underwent surveillance. Relapses were significantly higher for patients underwent surveillance compared to adjuvant chemotherapy group (18.3 vs. 1.2%, p 50% (p = 0.013) and tumor diameter (p = 0.016) were found to be independent factors for predicting relapse. Conclusion Our results indicate that adjuvant chemotherapy is associated with improved RFS compared with surveillance for CS I NSGCT patients. Moreover, the treatment strategy is an important prognostic indicator for RFS and a predictive factor for relapse. Although adjuvant chemotherapy seems to be a suitable treatment for patients with risk factors for relapse, surveillance is still preferred management option

Treatment preferences in stage IA and IB testicular seminoma: Multicenter study of anatolian society of medical oncology

WOS: 000361841900031PubMed ID: 25605506Approximately 75 % of patients with testicular seminoma present with stage I disease, and the probability of long-term survival approaches 100 %. However, the standard adjuvant treatment for stage I seminoma patients remains controversial, and there is no uniform consensus in the literature. The present study was performed to evaluate treatment preference and outcomes for men with stage I testicular seminoma. From 1997 to 2013, 282 patients with histologically confirmed stage IA and IB testicular seminoma who underwent orchiectomy were included. The outcomes of three management options and survivals were retrospectively analyzed. The prognostic significance of risk factors for relapse on survival was evaluated by univariate and multivariate analysis; in addition, the factors predicting relapse were also evaluated by logistic regression analysis. Of the 282 patients with stage I seminoma, 130 (46.1) received adjuvant radiotherapy (RT), 80 (28.4 %) were treated with adjuvant carboplatin, while the remaining 72 patients (25.5 %) underwent surveillance. At the time of analysis, the median follow-up period of 38.5 months; relapses were observed in 16 patients (22.3 %) on surveillance, in one patient (1.2 %) treated with adjuvant carboplatin and in ten patients (%7.7) who received adjuvant RT. The 5-year disease-free survival (DFS) rate for patients who underwent surveillance was worse than those of patients treated with adjuvant carboplatin and RT (64.2 vs. 97.7 vs. 91.9 %, respectively; p < 0.001). However, the 5-year overall survival (OS) rate for patients on surveillance was similar compared with the adjuvant treatment groups (100 vs. 92.3 vs. 97.4 %, respectively; p = 0.44). Univariate analysis showed that only the treatment approach (surveillance vs. adjuvant carboplatin vs. adjuvant RT) for DFS (p < 0.001), invasion of the rete testis (p = 0.041) and the presence of relapse (p < 0.001) for OS were important prognostic indicators. Multivariate analysis indicated that the treatment strategy for DFS (p < 0.001, HR 0.34) was an independent prognostic factor. Furthermore, a logistic regression analysis showed that adjuvant treatment was found to be an independent factor for predicting relapse (p = 0.004, odds ratio: 0.39). Our results indicate that adjuvant treatment with carboplatin or RT is associated with improved DFS compared with surveillance for men with stage I testicular seminoma after orchiectomy. Moreover, the treatment strategy is an important prognostic indicator for DFS and a predictive factor for relapse. Although adjuvant treatment, especially carboplatin, seems to be a suitable treatment for patients with risk factors for relapse, surveillance is still feasible and the preferred management option after radical orchiectomy in men with stage I seminoma. More reliable predictive factors are needed to make treatment decisions

The comparison of FOLFOX regimens with different doses of 5-FU for the adjuvant treatment of colorectal cancer: A multicenter study

Purpose We aim to compare the efficiency and toxicity of three different 5-fluorouracil (5-FU) administration types in 5-FU, leucovorin, and oxaliplatin (FOLFOX) combination treatment for adjuvant therapy in colorectal cancer (CRC). Methods Five hundred and seventy patients with stage III colorectal carcinoma who received different FOLFOX regimens after curative resection were included. Patients were divided into three groups as FOLFOX-4, modified FOLFOX-6 (mFOLFOX-6), and mFOLFOX-4 for comparison of toxicity and disease-free survival (DFS) and overall survival (OS) times. Results Three-year DFS rates for FOLFOX-4, mFOLFOX-6, and mFOLFOX-4 groups were 65%, 72%, and 72%, respectively. Five-year OS rates for FOLFOX-4, mFOLFOX-6, and mFOLFOX-4 groups were 69%, 75%, and 67%, respectively. There was no statistically significant difference between the three treatment groups in terms of DFS and OS (p = 0.079, and p = 0.147, respectively). Among grade 1-2 adverse events (AE), thrombocytopenia, neuropathy, and stomatitis were more common in the mFOLFOX-6-treated group. The frequency of grade 1-2 nausea and vomiting were similar in mFOLFOX-6 (36.3% and 24%, respectively) and mFOLFOX-4 (32.4% and 24.7%, respectively) groups but were higher than that in the FOLFOX-4 (19.5% and 11.3%, respectively) group. Among the most common grade 3-4 AE, neutropenia (53.4%, 9%, and 13.5%, respectively) and diarrhea (10.5%, 2.2%, and 2.4, respectively) were more common in FOLFOX-4. The rate of anemia and febrile neutropenia was similar in treatment groups (p = 0.063, and p = 0.210, respectively). Conclusion In the adjuvant treatment of stage III CRC patients, three different 5-FU administration types in FOLFOX combination treatment can be used with similar efficiency and manageable toxicity