An old enemy not to be forgotten during PET CT scanning of cancer patients: tuberculosis

Aim of the study: Positron emission tomography-computed tomography (PET CT) scan is commonly used in current medical oncology practice as an imaging method. In this study we present data from cancer patients who were followed at our clinic and suspected of having tuberculosis during PET CT scanning. After the biopsy, they were diagnosed with concomitant tuberculosis. Material and methods: In this study, 14 patients who applied to our clinic and followed up due to cancer, and had PET CT scanning for the preliminary staging or further evaluation, were included. The patients were diagnosed with metastatic or recurrent disease, and their biopsy results revealed tuberculosis. Results: The mean age was 57.8 years with SD (standard deviation) 13.1 years and gender distribution of 78.6% (n = 11) females and 21.4% (n = 3) males. None of the patients had tuberculosis in their personal history (0%). Among the patients, 5 (35.7%) were diagnosed with tuberculosis during the preliminary staging, whereas 9 (64.3%) were diagnosed during the follow-up after the treatment. The median time to tuberculosis diagnosis was 11 months (min-max: 3-24 months) after the treatment. The most commonly involved lymph nodes during PET CT scanning were mediastinal in 8 (64.3%), axillary in 3 (21.4%) and para-aortic in 3 (21.4%) patients. The mean SUVmax (maximum standardised uptake value) of lymph node involved by PET CT scanning was defined as 8.5 (SD 2.6). Conclusions: Despite all improvements in modern medicine, tuberculosis is still a serious public health problem. It should always be considered in differential diagnosis while evaluating PET CT scanning results of cancer patients, because it may cause false positive results

Akciğer Kanserli Hastalarda Çevresel Faktörlerin, Uyku Kalitesinin, Fonksiyonel Bağımsızlığın ve Postür Anatomisinin Değerlendirmesi: Araştırma Makalesi

Introduction: Lung cancer is a common problem. Many reasons can make life difficult for these patients. Objective: The aim of our study was to evaluate environmental factors, sleep quality, independence level and posture anatomy in lung cancer. Method: In the study in which 40 patients diagnosed with lung cancer were included, demographic information and disease history were questioned, Medical Research Council Dyspnoea Scale, Pittsburgh Sleep Quality Index, Visual Analogue Scale, Barthel Activities of Daily Living Index and New York Posture Analysis were performed. Results: Among the clinical findings, 77% of the participants had cough, 72.5% had sputum, 42.5% had chest pain, 62.5% had dyspnoea, and 37.5% had hoarseness. In the evaluation of dyspnoea, 27.5% of the patients had a dyspnoea score of 4, 22.5% had a dyspnoea score of 3 and 12.5% had no complaint. Diabetes mellitus (22.5%) was found to be the most common systemic disease in the patient history. It was also determined that 75% of the individuals had poor sleep quality, 25% were severely dependent and 35% were moderately dependent according to the Barthel index. When cancer was evaluated in terms of genetic factors, 87.5% of the patients did not have a family history of cancer. 90% of the patients used stove as a means of heating at home. Conclusion: In the study, it was determined that the patients had symptoms such as pain, shortness of breath, cough and sleep quality was significantly affected. In this respect, it was concluded that the rehabilitation process is important in the treatment planning of patients.  The high number of individuals without a family history of cancer suggests that environmental factors are important in terms of public health evaluation.Giriş: Akciğer kanseri yaygın bir problemdir. Bu hastaları birçok nedenler yaşamını zorlaştırabilir. Amaç: Çalışma akciğer kanserinde çevresel faktörleri, uyku kalitesini, bağımsızlık düzeyini ve postür anatomisini değerlendirmek amacıyla planlanmıştır. Yöntem: Akciğer kanseri tanısı almış hastaların dahil edildiği çalışmada bireylerin demografik bilgileri sorgulanmıştır. Katılımcılara Medical Research Council Dispne Skalası, Pittsburgh Uyku Kalitesi İndeksi, Vizüel Analog Skalası, Barthel Günlük Yaşam Aktiviteleri İndeksi ve New York Postür Analizi uygulanmıştır. Bulgular: Katılımcıların klinik bulgulardan %77’sinde öksürük, %72.5’inde balgam, %42.5’inde göğüs ağrısı, %62.5’inde dispne, %37.5’inde ses kısıklığı varlığı tespit edildi. Katılımcıların %27.5’inin 4, %22.5’inin 3 değerinde dispneye sahip olduğu ve %12.5’inde dispne semptomunun olmadığı görüldü. Katılımcıların tıbbi özgeçmişlerinde en yaygın olan sistemik hastalığın Diabetes Mellitus (%22.5) olduğu belirlendi. Katılımcıların %75’inin kötü uyku kalitesine sahip olduğu, Barthel indeksine göre ise %25’inin ileri derecede, %35’inin ise orta derecede bağımlı olduğu belirlendi. Sonuç: Akciğer kanseri olan hastalarda öksürük, dispne ve ağrı yaygın görülen semptomlardır. Hastaların uyku kalitesi bu semptomlardan önemli ölçüde etkilenir. Bu veriler doğrultusunda hastaların tedavi planlamasında rehabilitasyon sürecinin önemli olduğu sonucuna varılmıştır.  Aile öyküsünde kanser tanısı olmayan bireylerin sayısının yüksek olması, çevresel faktörlerin halk sağlığı açısından değerlendirilmesinin önemli olduğunu düşündürmektedir

Efficacy and toxicity of Trastuzumab and Paclitaxel plus Capecitabine in the first-line treatment of HER2-positive metastatic breast cancer

Combinations of trastuzumab with paclitaxel or capecitabine are effective therapies in human epidermal growth factor 2 (HER2)-positive metastatic breast cancer (MBC). This retrospective study evaluated the efficacy and toxicity of trastuzumab and paclitaxel plus capecitabine in the first-line therapy for patients with HER2-positive MBC

Clinicopathological Characteristics and Prognosis of Patients According To Recurrence Time After Radical Nephrectomy for Localized Renal Cell Carcinoma: A Multicenter Study of Anatolian Society of Medical Oncology (ASMO)

Aim: We investigated the clinicopathological features in patients with recurrent RCC within 5 years or more than 5 years after nephrectomy and determined predictors of survival and response treatment after recurrence. Materials and Methods: We retrospectively evaluated 144 patients with disease recurrence; 73 had recurrence more than 5 years after radical nephrectomy. We compared clinicopathological characteristics in patients with disease recurrence before vs. after 5 years. In addition, we investigated predictors of survival and response to treatment after recurrence. Results: Seventy-one patients (49%) were diagnosed with recurrence within 5 years after radical nephrectomy (early recurrence) and 73 patients (51%) were diagnosed with recurrence more than 5 years after radical nephrectomy (late recurrence). Fuhrman grade, tumor necrosis and lymphovascular invasion were statistically significantly different between the two groups (p<0.001, p=0.013, p=0.026, respectively). The late recurrence patients were significantly associated with the Memorial Sloan Kettering Cancer Center (MSKCC) favorable risk group compared to patients with early recurrence (p=0.001). From the time of disease recurrence, median Overall Survival (OS) was 36.0 (95% Confidence Interval (CI) 30.7-412) months in the late recurrence group, and 19 (95% CI 15.4-22.5) months in the early recurrence group (p=0.01). The median Progression Free Survival (PFS) was 6 (95% CI 3.87-8.12) months in the early recurrence group, and 18 (95% CI 15.4-20.5) months for the late recurrence group (p<0.001). Conclusion: Early recurrence was significantly associated with Fuhrman grade 3-4, tumor necrosis, lymphovascular invasion, MSKCC poor- risk group compared to patients with late recurrence. The study also demonstrated a potential prognostic value of late recurrence in terms of PFS and OS

Prognostic Factors for Recurrence-Free Survival in Patients with HER2-Positive Early-Stage Breast Cancer Treated with Adjuvant Trastuzumab

Background: The objective of this study was to identify prognostic factors affecting the recurrence-free survival (RFS) in patients who received a 52-week trastuzumab therapy for HER2-positive early stage breast cancer (EBC). Patients and Methods: The medical records of all patients with EBC from 10 centers were analyzed. Pathologic and clinical tumor characteristics were evaluated in 424 female patients who received 52 weeks of adjuvant trastuzumab for HER2-positive EBC. Survival was estimated using the Kaplan-Meier method. Univariate analyses of RFS were performed with the log-rank test. Independent prognostic and predictive factors affecting RFS were assessed by Cox regression analysis. Results: Median follow-up time was 33.1 months (range 9.2-75.9 months). 3-year RFS and overall survival were 87 and 97%, respectively. In multivariate analysis, patients aged 70 years or over (p = 0.017, relative risk (RR) 2.7, 95% confidence interval (CI) 1.19-6.13), patients with > 9 positive lymph nodes (p = 0.001, RR 2.52, 95% CI 1.42-4.46), and those with progesterone receptor-negative tumors (p = 0.006, RR 2.33, 95% CI 1.27-4.27) had worse RFS. Conclusion: In spite of a 52-week adjuvant trastuzumab treatment, classic poor prognostic factors for invasive EBC remained as such in patients with HER2-positive EBC

Nine-week trastuzumab treatment versus 52-week trastuzumab treatment for HER2-positive early-stage breast cancer

Purposes Trastuzumab is known to be effective for early and advanced stages of breast cancer but optimal duration for early-stage breast cancer (EBC) is not well known. We evaluated the efficacy and toxicity of 9- and 52-week trastuzumab therapy for EBC retrospectively

Efficiency and Side Effects of Sorafenib Therapy for Advanced Hepatocellular Carcinoma: A Retrospective Study by the Anatolian Society of Medical Oncology

Background: Inoperable and metastatic hepatocellular carcinoma (HCC) is associated with a poor prognosis and low chemotherapeutic efficiency. Sorafenib is an oral multi-kinase inhibitor exerting its effects via the RAF/MEK/ERK pathway, vascular endothelial growth factor receptor (VEGFR) and platelet derived growth factor receptor beta (PDGFR-beta) tyrosine kinases. Randomized studies have shown a significant contribution of sorafenib to life expectancy and quality of life of cancer patients. The aim of the present study is to evaluate the efficacy and side effects of sorafenib therapy in Turkey. Materials and Methods: Data for 103 patients (82 males, 21 females) receiving sorafenib therapy in 13 centers from February 2008 to December 2012 were evaluated. Median age was 61 years and median ECOG performance status was 1 (range: 0-2). 60 patients (58%) had hepatitis B, 15 patients (15%) had hepatitis C infection and 12 patients (12%) had a history of alcohol consumption. All of the patients had Child scores meeting the utilization permit of the drug in our country (Child A). Results: A total of 571 cycles of sorafenib therapy were administered with a median of four per patient. Among the evaluable cases, there was partial response in 15 (15%), stable disease in 52 (50%), and progressive disease in 36 (35%). Median progression-free survival was 18 weeks and median overall survival was 48 weeks. The dose was reduced only in 6 patients and discontinued in 2 patients due to grade 3-4 toxicity, 18 patients (17%) suffering hand-foot syndrome, 7 (7%) diarrhea, and 2 (2%) vomiting. Conclusions: This retrospective study demonstrated better efficacy of sorafenib therapy in patients with advanced HCC compared to the literature while progression-free survival and overall survival findings were comparable. The side effect rates indicate that the drug was tolerated well. In conclusion, among the available treatment options, sorafenib is an efficient and tolerable agent in patients with inoperable or metastatic HCC