Meltem Ekenel

Publications (18)36.13 Total impact

• Article: Serum M65 as a Biomarker for Metastatic Renal Cell Carcinoma.

  Ibrahim Yildiz, Fatma Sen, Leyla Kilic, Serkan Keskin, Derya Duranyildiz, Elif Bilgin, Rian Disci, Meltem Ekenel, Emin Darendeliler, Sevil Bavbek, Mert Basaran
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  ABSTRACT: INTRODUCTION/BACKGROUND: Effective cancer biomarkers for early detection, prognosis, or therapy response prediction are urgently need in metastatic RCC. M30 and M65 are released during apoptotic cell death and precisely reflect epithelial tumor cell death. The aim of this study was to determine the prognostic value of plasma M30 and M65 levels in predicting survival rates for patients with metastatic RCC. PATIENTS AND METHODS: Thirty-nine patients with metastatic RCC and 39 healthy control subjects were included in this study. Serum M30 and M65 levels were measured by ELISA. RESULTS: The median ages of the patients and control subjects were 60 and 58 years, respectively. No difference was detected in the median serum M30 level between the patients and control subjects (53.7 vs. 49.1 U/L; P = .31). The median serum M65 level was significantly higher in patients than in control subjects (334.0 vs. 179.1 U/L; P < .001). Receiver operating characteristic analysis revealed that the best cutoff value for serum M65 level for predicting progression-free survival (PFS) was 313.6 U/L. The median PFS of patients whose M65 levels were ≤ 313.6 U/L was better than that of patients whose M65 levels were > 313.6 U/L (P = .03). CONCLUSION: To the best of our knowledge, this is the first study to evaluate serum M30 and M65 levels in patients with RCC. Serum M65 levels were significantly elevated in patients with metastatic RCC compared with healthy individuals. In addition, the serum M65 level could be predictive of PFS in patients with RCC.
  Clinical Genitourinary Cancer 02/2013; · 2.61 Impact Factor
• Article: Predictive value of marker half-life in relapsed and nonrelapsed nonseminomatous germ cell testicular tumor patients undergoing chemotherapy.

  Serkan Keskin, Meltem Ekenel, Mert Başaran, Sevil Bavbek
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  ABSTRACT: The aim of this study was to investigate the influence of a marker half-life (MHL) on relapse in nonseminomatous germ cell testicular tumor patients. MHL was retrospectively analyzed in relapsed (n = 37) and nonrelapsed patients (n = 28) undergoing first-line chemotherapy (CT). Before CT and after the second cycle of CT, serum α-fetoprotein (AFP) and β-human chorionic gonadotropin levels were measured for MHL analysis. The International Germ Cell Cancer Collaborative Group risk classification system was used to assess the correlation between MHL and relapse. MHL was calculated according to a logarithmic formula. Median follow-up was 25 months (range, 6 to 96 mo). A statistically significant difference was not observed between initial AFP (P = 0.266) and β-human chorionic gonadotropin (P=0.092) in both patient groups. MHL was statistically different between the relapsed and nonrelapsed patients with a good, intermediate, and poor prognosis, except for the half-life of AFP in patients with a poor prognosis. MHL is an indicator that predicted recurrence. Patients with an MHL longer than expected should be investigated to improve the effectiveness of treatment and should be treated with a recovery regimen.
  American journal of clinical oncology 08/2012; 35(4):369-72. · 2.21 Impact Factor
• Article: What is the role of enlarged lymph node resection alone in patients with nonseminomatous germ cell tumor who had stage II or III disease?

  Meltem Ekenel, Serkan Keskin, Öner Sanli, Sevil Bavbek, Murat Tunç, Haluk Ander, Faruk Ozcan, Işin Kiliçaslan, Mert Başaran
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  ABSTRACT: Retroperitoneal lymph node dissection is an important treatment modality in nonseminomatous germ cell tumors of the testis. However, the role of more limited surgical approaches such as resection of enlarged lymph nodes only is still controversial. Between January 1991 and December 2010, charts of 94 patients who underwent resection of enlarged retroperitoneal lymph nodes alone were reviewed. Pathologic findings, local recurrence, and adverse effects were noted after this surgical approach. The median age was 25.5 years. Twenty-one (22.6%) patients had lung metastasis, and 5 (5.4%) patients had nonregional lymph node metastasis at the initial visit. Eighty-seven (91.6%) patients received chemotherapy after inguinal orchiectomy, and the other patients had mass resection only for enlarged lymph nodes without prior chemotherapy. In patients who had chemotherapy before surgery, the median retroperitoneal lymph node size before and after chemotherapy cycles was 55 mm and 32.5 mm, respectively. The pathologic assessment of retroperitoneal masses revealed mature teratoma in 51.6% (n = 47) of patients, viable carcinoma in 20.9% (n = 19) of patients, and necrosis or fibrosis in 27.5% (n = 25) of patients. The median follow-up time was 60.2 months (range, 2.7-334.8 months). During follow-up, 5 (5.4%) patients had radiologic relapse at the retroperitoneal area, and 3 patients developed systemic metastases. Six (6.4%) patients died of their disease, 2 (2.1%) patients were alive with disease, 86 (91.5%) patients were healthy at the last follow-up. Ejaculation status was recorded in 56 patients. Antegrade ejaculation had preserved in 53 (94.6%) of these patients. Resection of enlarged lymph node metastases alone is a reasonable treatment option for patients with nonseminomatous germ cell tumors.
  Clinical Genitourinary Cancer 06/2012; 10(3):185-9. · 2.61 Impact Factor
• Article: Clinicopathological characteristics and treatment outcomes of adult patients with paratesticular rhabdomyosarcoma (PRMS): A 10-year single-centre experience.

  Serkan Keskin, Meltem Ekenel, Mert Basaran, Isin Kilicaslan, Murat Tunc, Sevil Bavbek
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  ABSTRACT: We report our experience with 8 consecutive adults treated for paratesticular rhabdomyosarcoma (RMS) at a single institution between 2000 and 2010. After primary surgical excision, 7 patients were classified into group I according to the Intergroup Rhabdomyosarcoma Study Group (IRSG) Postsurgical Grouping Classification, and 1 patient into group IIB. Retroperitoneal node dissection was not a required staging procedure. Adjuvant chemotherapy was administered to 7 of the 8 patients. No additional radiotherapy was administered. The median age at diagnosis was 24 years (range: 18-60). Embryonal histology was the most common (75%) subtype. During follow-up, 3 patients experienced local relapse and 5 distant relapse. The median progression-free and overall survival times were 17.0 ± 9.9 months (range: 5-31) and 27.3 ± 1.3 months (range: 16-58), respectively. Paratesticular RMS is an uncommon malignancy in adults. We confirm that patients with localized paratesticular RMS may have different prognoses. Retroperitoneal lymphadenectomy can be avoided as a treatment for paratesticular RMS after radical inguinal orchiectomy.
  Canadian Urological Association journal = Journal de l'Association des urologues du Canada 02/2012; 6(1):42-5. · 1.24 Impact Factor
• Source

  Available from: Ibrahim Yildiz

  Article: Response rates and adverse effects of continuous once-daily sunitinib in patients with advanced renal cell carcinoma: a single-center study in Turkey.

  Ibrahim Yildiz, Fatma Sen, Mert Basaran, Meltem Ekenel, Fulya Agaoglu, Emin Darendeliler, Hayri Murat Tunc, Faruk Ozcan, Sevil Bavbek
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  ABSTRACT: Therapy targeted against the vascular endothelial growth factor pathway is a standard of care for patients with metastatic renal cell carcinoma. This study assessed the response rates and toxicity profiles of sunitinib on a continuous once-daily dosing regimen in Turkish patients with metastatic renal cell carcinoma. Between April 2006 and August 2010, 74 patients with metastatic renal cell carcinoma who received sunitinib on a continuous, once-daily dosing regimen were included. Sunitinib was administered daily at a dose of either 37.5 mg (94% of the patients) or 25 mg (6% of the patients), without interruption, either as a second-line treatment after interferon-α or as a first-line treatment. Response, toxicity, progression-free survival and overall survival were evaluated. Of the 74 patients, 65 (88%) were diagnosed with clear cell renal cell carcinoma. The median treatment duration was 10 months (range, 2-42 months). The most common treatment-related adverse events were fatigue (75%), stomatitis (51%) and hypertension (50%). The most common Grade 3 or 4 adverse events were anemia (10%) and hand-foot syndrome (7%). Dose reductions were required in 50% of the patients, and early treatment discontinuation was necessary in 16% of the patients. Cardiovascular events were the most common adverse events that resulted in drug discontinuation. The objective response rate and the disease control rate were 30 and 78%, respectively. The median progression-free survival and overall survival were 13 and 25 months, respectively. Continuous, once-daily administration of sunitinib was generally well tolerated in Turkish patients with advanced renal cell carcinoma in a daily practice setting. This study's response rates were comparable to those in previous randomized trials.
  Japanese Journal of Clinical Oncology 12/2011; 41(12):1380-7. · 1.78 Impact Factor
• Article: Induction chemotherapy with docetaxel and cisplatin is highly effective for locally advanced nasopharyngeal carcinoma.

  Meltem Ekenel, Serkan Keskin, Mert Basaran, Canan Ozdemir, Rasim Meral, Musa Altun, Ismet Aslan, Sevil E Bavbek
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  ABSTRACT: Radiotherapy (RT) with concomitant chemotherapy (CT) has improved the therapeutic outcome of patients with locally advanced nasopharyngeal carcinoma (LANC). However, the importance of induction CT before definitive therapy is still undefined. Patients (n=59) who had LANC were included in this retrospective study. They received induction CT consisting of cisplatin and docetaxel followed by definitive RT with cisplatin. The median age was 49 years (18-68). All patients were of stages II (15%), III (63%) and IV (22%). Fifty eight patients could receive 3 cycles of CT. Except one patient, there was no grade 3 or 4 toxicity during induction CT. Chemoradiotherapy could be given to 49 patients (83%). Twelve percent of patients had complete response after induction CT and this number had increased to 95% after the completion of the therapy. Objective responses (complete and partial) were 100% after the completion of the therapy. Median follow up time was 29 months. Nine patients had relapse (2 had local only, 4 distant, 3 local and distant). Three patients who had both local and distant relapse died during follow-up. Three year overall and progression free survival rates were 94.9% and 84.7%, respectively. Induction CT with docetaxel and cisplatin is a feasible and tolerable treatment for patients with LANC.
  Oral Oncology 07/2011; 47(7):660-4. · 2.86 Impact Factor
• Article: The first case of primary testicular germ cell tumor containing nephroblastoma as the only one non-germ cell component.

  Serkan Keskin, Meltem Ekenel, Mert Başaran, Can Aksu, Işin Kiliçaslan, Murat Tunç, Sevil Bavbek
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  ABSTRACT: Adult extrarenal nephroblastomas (Wilms' tumor) are extremely rare tumors. They show a higher incidence of non-seminomatous elements and these so-called 'teratoid' Wilms' tumors are suggested to be of germ cell origin. To date, however, the number of reported cases with gonadal teratoma containing nephroblastoma is very low, and due to this reason, there are no standardized criteria for the categorization and treatment of these lesions. To our knowledge, the first case of nephroblastoma arising in a non-atrophic testis has been reported and it is associated with a teratoma as morphologically identifiable germ cell tumor and rhabdomyosarcoma as a second non-germ cell element. We report the second case of an adult nephroblastoma that arose within the primary testicular teratoma in a non-atrophic testis. Teratoma and nephroblastoma within the same testis may have an important point to clarify the developmental mechanism in nephroblastomatous differentiation of germ cell tumors.
  Japanese Journal of Clinical Oncology 06/2011; 41(8):1037-40. · 1.78 Impact Factor
• Article: Surveillance results of patients with stage I nonseminomatous germ cell testicular cancer.

  Serkan Keskin, Meltem Ekenel, Mert Başaran, Sevil Bavbek
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  ABSTRACT: The aim of this study was to evaluate the efficacy of active surveillance after radical orchiectomy in patients with clinical stage I nonseminoma. Between 2002 and 2009, the charts of 80 patients who were offered active surveillance were studied retrospectively. Patients underwent clinical, radiologic, and biochemical examinations according to NCCN follow-up guidelines in nonseminoma. 70 of 80 patients who accepted this strategy were analyzed. 12 of the 70 patients (17%) had relapses with a median follow-up of 18.5 months (6-76). Relapses were found in retroperitoneal lymph nodes in 3 patients. 5 patients had marker relapse, and 4 patients developed both marker relapse and retroperitoneal lymph node metastases. 10 of the 12 patients (83%) had relapsed within 1 year. There were no statistically significant differences in lymphovascular invasion and germ cell components between relapsed and non-relapsed patients. 11 of the 12 patients were treated with cisplatinbased combination chemotherapy, and 1 patient underwent retroperitoneal lymph node dissection. Only 2 patients underwent primary retroperitoneal lymph node dissection for rest nodules. Surveillance could be a reliable strategy in compliant stage I nonseminoma patients. Recurrences can be detected early and treated successfully.
  Onkologie 01/2011; 34(4):173-6. · 0.87 Impact Factor
• Article: Primary central nervous system lymphoma: the role of consolidation treatment after a complete response to high-dose methotrexate-based chemotherapy.

  Meltem Ekenel, Fabio M Iwamoto, Leah S Ben-Porat, Katherine S Panageas, Joachim Yahalom, Lisa M DeAngelis, Lauren E Abrey
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  ABSTRACT: The most effective treatment for a new diagnosis of primary central nervous system lymphoma is high-dose methotrexate (MTX)-based chemotherapy followed by whole-brain radiation therapy (WBRT). However, this combined modality treatment carries an increased risk of delayed neurotoxicity. For patients who achieve a complete response (CR) after induction that uses high-dose MTX-based chemotherapy, it is not clear if consolidation treatment is necessary. Therefore, a retrospective study was conducted to assess the impact of consolidation treatment after a CR to initial induction chemotherapy on disease control and survival. The authors retrospectively analyzed 122 patients who achieved a CR after initial MTX-based chemotherapy. The benefit of consolidation WBRT, high-dose cytarabine (HDAC), or both on failure-free (FFS) and overall survival (OS) was assessed. With a median follow-up of 60 months, FFS was longer in patients who received WBRT plus HDAC as consolidation treatment (P = .03 by univariate analysis); there was no difference in OS observed among patients who received no consolidation treatment, HDAC alone, WBRT plus HDAC, or WBRT alone. Age and Karnofsky performance scale (KPS) were the only independent prognostic factors. Patients who received WBRT alone or in combination with HDAC had higher rates of neurotoxicity. Consolidation treatment with WBRT, HDAC, or both does not appear to improve survival in patients who achieved a CR with induction MTX-based therapy. Age, KPS, and risk of delayed neurotoxicity must be considered in the choice of consolidation regimens.
  Cancer 08/2008; 113(5):1025-31. · 4.77 Impact Factor
• Article: Capecitabine therapy of central nervous system metastases from breast cancer.

  Meltem Ekenel, Adilia M Hormigo, Scott Peak, Lisa M Deangelis, Lauren E Abrey
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  ABSTRACT: Central nervous system (CNS) metastases from breast cancer carry a poor prognosis. Systemic chemotherapy is often ineffective due to the impermeability of the blood-brain barrier (BBB) and inherent chemoresistance of CNS metastases. There are limited data supporting the use of capecitabine in this setting. Medical records of seven patients with brain metastases from breast cancer who received capecitabine treatment at Memorial Sloan-Kettering Cancer Center from 1994-2006 were reviewed. Treatment outcomes were analyzed retrospectively in those patients. Median time from breast cancer diagnosis to the development of CNS metastasis was 48 (18-165) months. Four patients had brain metastases alone, two patients had both leptomeningeal and brain metastases and one patient had leptomeningeal metastasis alone. Five out of seven patients had failed other treatment modalities before capecitabine. Three patients showed complete response (CR) and three patients had stable disease (SD) after capecitabine. The patient with leptomeningeal disease improved clinically, but refused repeat cerebrospinal fluid (CSF) studies. Median overall and progression-free survival from initiation of capecitabine was 13 and 8 months, respectively, for all patients. Capecitabine may achieve a CR and provide long-term control in patients with both leptomeningeal and parenchymal CNS metastases from breast cancer.
  Journal of Neuro-Oncology 12/2007; 85(2):223-7. · 3.21 Impact Factor
• Article: Treatment of primary central nervous system lymphoma.

  Meltem Ekenel, Lisa M Deangelis
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  ABSTRACT: Primary central nervous system lymphoma (PCNSL) is a rare form of extranodal non-Hodgkin's lymphoma that is typically confined to brain, eyes, and cerebrospinal fluid without evidence of systemic spread. The prognosis of patients with PCNSL has improved during the past decade with the introduction of high-dose methotrexate with or without whole brain radiotherapy. However, despite recent progress, results following treatment are durable in few patients, and therapy can be associated with late neurotoxicity. PCNSL is an uncommon tumor, and no phase III trial has been completed so far, leaving many questions about its optimum first-line and salvage treatments unanswered. This review summarizes the literature regarding the treatment of PCNSL in immunocompetent patients.
  Current Treatment Options in Neurology 08/2007; 9(4):271-82. · 1.29 Impact Factor
• Article: Vascular endothelial growth factor, hypoxia-inducible factor 1 alpha and CD34 expressions in early-stage gastric tumors: relationship with pathological factors and prognostic impact on survival.

  Devrim Cabuk, Gul Basaran, Cigdem Celikel, Faysal Dane, P Fulden Yumuk, M Salih Iyikesici, Meltem Ekenel, N Serdar Turhal
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  ABSTRACT: Angiogenesis is one of the key steps in solid tumor growth and metastasis. We planned to investigate the prognostic significance of vascular endothelial growth factor (VEGF), hypoxia-inducible factor 1alpha (HIF-1alpha) and CD34 expressions as markers of angiogenesis in gastric cancer. We retrospectively reviewed the medical records of 51 gastric cancer patients who had total or subtotal gastrectomy at Marmara University Hospital from 1990 to 2004 and evaluated the expression of VEGF, HIF-1alpha and CD34 by immunohistochemistry in their archival tumor tissues. We recorded the clinical and pathological characteristics of these patients and analyzed their survival outcome. Thirty out of 51 patients were males. The median age was 63 years (range 34-81). The median follow-up was 17 months. Thirty-six patients had node-positive disease. The majority of patients (n = 43) had T2 and T3 disease. Vascular and lymphatic invasions were present in 57 and 77% of tumors, respectively. VEGF and HIF-1alpha were positive in 65 and 71% of tumors. The median CD34 staining score was 19 (3-68). VEGF, HIF-1alpha and CD34 expressions were more frequent in tumors without serosal invasion (p = 0.01, p = 0.01 and p = 0.003, respectively). CD34 expression was significantly more frequent in tumors with VEGF and HIF-1alpha expression (p = 0.00, p = 0.00). HIF-1alpha expression was more frequent in tumors with VEGF expression (p = 0.00). The 5-year overall survival was 45%. VEGF, HIF-1alpha, CD34 expressions and other pathological characteristics were found to have no impact on survival. VEGF, HIF-1alpha and CD34 expressions were more common in tumors without serosal invasion. As a future perspective, biological agents targeting VEGF and HIF-1alpha might be more effective at earlier stages of gastric cancer.
  Oncology 02/2007; 72(1-2):111-7. · 2.27 Impact Factor
• Article: Does the incidence of anal canal cancers differ in Moslem societies?

  P Fulden Yumuk, Ufuk Abacioglu, Gokhan Demir, Devrim Cabuk, Faysal Dane, Mahmut Gumus, Mustafa Ozguroglu, Meltem Ekenel, Gul Basaran, N Serdar Turhal
  International Journal of Colorectal Disease 02/2005; 20(1):76. · 2.38 Impact Factor
• Article: D-dimer--can it be a marker for malignant gastric lesions?

  Mehmet Aliustaoglu, Perran F Yumuk, Mahmut Gumus, Meltem Ekenel, Fusun Bolukbas, Cengiz Bolukbas, Nilgun Mutlu, Gul Basaran, Erol Avsar, Nazim S Turhal
  Acta Oncologica 02/2004; 43(8):770-1. · 3.33 Impact Factor
• Article: Attitude toward genetic testing for cancer risk in Istanbul.

  Perran Fulden Yumuk, Mahmut Gumus, Meltem Ekenel, Gul Basaran, Mehmet Aliustaoglu, Aslihan Topal, Nazim Serdar Turhal
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  ABSTRACT: To identify attitudes toward genetic testing, and the effects of this information on decisions regarding issues such as pregnancy, abortion, and prophylactic surgery, several subsets of the Turkish population were surveyed in hospital settings. Individuals (n = 179) chosen arbitrarily from four different subsets of a Turkish population were asked to participate in a confidential 23-question survey. Survey participants were familiar with the concept of cancer being a familial disease (85.5%), and 84.7% of them expressed interest in genetic testing to determine cancer risk, 83.9% would have their fetuses tested for such cancer risk, 65.1% would terminate their pregnancies, 92.2% would have their children tested if they were determined to have an increased cancer risk, 71.9% would agree to undergo prophylactic oophorectomy or orchiectomy and 67.6% would have mastectomy/prostatectomy should there be an increased cancer risk to these organs. It appears that at least the sampled segment of a Turkish population is willing to undergo genetic testing to determine if they are at increased risk for cancer. The feasibility and acceptance of genetic testing and the influence of education and genetic counseling in the Turkish people should further be evaluated with a larger stratified sample of the population.
  Genetic Testing 02/2004; 8(2):169-73. · 1.17 Impact Factor
• Article: Port Needles

  Ayla Karamanoglu, Fulden P. Yumuk, Mahmut Gumus, Meltem Ekenel, Mehmet Aliustaoglu, Deniz Selimen, Meric Sengoz, Serdar N. Turhal
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  ABSTRACT: Protracted chemotherapy regimens are new treatment modalities used to treat patients with cancer. These treatments are preferred because of the ease of administration and limited side effects in the outpatient setting. Sixty patients were treated with continuous infusion chemotherapy via implanted infusion ports at Marmara University Hospital Outpatient Chemotherapy Unit in Istanbul, Turkey, from January 2000 to December 2001. Although usage of Huber needles for central venous catheters was limited to between 48 and 72 hours, needles were not removed unless there were signs of inflammatory reaction. The needles remained in place for 28 days (1‐49 days) on average. No catheter infections, signs of local irritation, or thrombus formation were observed despite prolonged stay of the Huber needles. Huber needles can be left in place up to several weeks without any untoward effects as long as proper aseptic technique is used.
  Journal of Infusion Nursing 06/2003; 26(4):239–242.
• Article: Effects of selective COX-2 inhibitors on the gastric permeability of sucrose: a controlled study with placebo and ibuprofen.

  Meltem Ekenel, Erol Avşar, Neşe Imeryüz, Meral Yüksel, Goncagül Haklar, Ozan Kocakaya, Nurdan Tözün
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  ABSTRACT: Acute and chronic use of non-steroidal anti-inflammatory drugs can increase gastrointestinal permeability. Celecoxib, which selectively inhibits the enzyme cyclooxygenase-2, is a novel anti-inflammatory drug with minimal gastrointestinal toxic effects while retaining anti-inflammatory efficacy. Our aim was to assess the potential effects of celecoxib on gastric permeability in comparison with placebo and ibuprofen. We conducted a prospective, double-blind, cross-over study. This study is carried out at Marmara University Hospital. Twenty-five healthy subjects entered the study but 19 subjects completed the treatment. Subjects were randomized to celecoxib 100 mg twice daily, ibuprofen 600 mg twice daily or placebo for 7 days in pre-defined sequences. Treatments were separated by a 7 day washout period. Gastric permeability was assessed by measuring urinary excretion of sucrose spectrophotometrically. Ibuprofen 600 mg twice daily produced greater increases in gastric permeability compared with placebo or celecoxib (geometric mean of urinary sucrose recovery was 59.15, 32.65 and 33.11 mg/h for ibuprofen, placebo and celecoxib, respectively) (P < 0.001). Celecoxib was generally better tolerated than ibuprofen. When compared with ibuprofen, celecoxib 100 mg twice daily has no significant effect on gastric mucosa in healthy subjects.
  European Journal of Gastroenterology & Hepatology 04/2003; 15(4):403-6. · 1.76 Impact Factor
• Article: Port needles: do they need to be removed as frequently in infusional chemotherapy?

  Ayla Karamanoglu, P Fulden Yumuk, Mahmut Gumus, Meltem Ekenel, Mehmet Aliustaoglu, Deniz Selimen, Meric Sengoz, N Serdar Turhal
  [show abstract] [hide abstract]
  ABSTRACT: Protracted chemotherapy regimens are new treatment modalities used to treat patients with cancer. These treatments are preferred because of the ease of administration and limited side effects in the outpatient setting. Sixty patients were treated with continuous infusion chemotherapy via implanted infusion ports at Marmara University Hospital Outpatient Chemotherapy Unit in Istanbul, Turkey, from January 2000 to December 2001. Although usage of Huber needles for central venous catheters was limited to between 48 and 72 hours, needles were not removed unless there were signs of inflammatory reaction. The needles remained in place for 28 days (1-49 days) on average. No catheter infections, signs of local irritation, or thrombus formation were observed despite prolonged stay of the Huber needles. Huber needles can be left in place up to several weeks without any untoward effects as long as proper aseptic technique is used.
  Journal of Infusion Nursing 26(4):239-42.