Publications (16)20.91 Total impact
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Article: An unusual case of recurrent endometrial cancer presented with isolated cervical lymph node metastasis
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ABSTRACT: Endometrial cancer (EC) is the most common malignancy of the female genital tract. Lymph node involvement is one of the major prognostic factors. Therefore, pelvic and paraaortic lymph nodes dissection is a part of the surgical management of these patients. Isolated peripheral lymph node metastasis has not been previously reported as a finding of recurrence in EC. We report a 67-year-old woman with recurrent EC presented with an isolated cervical lymph node metastasis (ICLM). Following the combination chemotherapy of doxorubicin, cisplatin and cyclophosphamide, her cervical lymph node was completely regressed. To our knowledge, this is the first case of recurrent EC presented with ICLM. We suggest that for women with EC who had isolated peripheral lymphadenopathies, peripheral lymph node metastasis should be considered as the finding of recurrence in patient with EC.Archives of Gynecology and Obstetrics 04/2012; 280(1):153-156. · 1.28 Impact Factor -
Article: Is subdivision of pT2 tumors superior to lymph node metastasis for predicting survival of patients with gastric cancer? Review of 224 patients from four centers.
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ABSTRACT: The prognostic significance of the subclassification of pT2 tumors and the association of these categories with other clinicopathological factors in gastric cancer patients were investigated. A total of 224 patients with pT2 gastric cancer who had undergone curative gastrectomy and lymph node dissection were retrospectively analyzed. The prognostic role of the subclassification of pT2 tumors was evaluated by univariate and multivariate analysis. Of 224 patients, 75 (33.5%) were classified as having pT2a tumors and 149 (66.5%) as having pT2b tumors. The prevalence of large-sized tumors (P < 0.003), lymph node involvement (P < 0.018), and lymphatic (P = 0.016), blood vessel (P = 0.001), and perineural invasion (P = 0.001) was significantly higher for pT2b tumors than for pT2a tumors. The rate of recurrence for pT2a cancers was significantly lower than that for pT2b cancers (P = 0.001).Median overall survival (OS) times and three-year OS of patients with a pT2b tumor were significantly worse than for patients with a pT2a tumor (P < 0.001).When patients were analyzed according to lymph node involvement, the prognosis of patients with pT2aN(1) cancers was significantly better than that of patients with pT2bN(1) (P < 0.001). Multivariate analysis indicated that the pT2 subdivision was an independent prognostic factor for OS (P = 0.006), as were pN stage, clinical stage, and recurrence. Our results showed that subclassification of pT2 tumors into pT2a or pT2b was an important prognostic indicator for patients with pT2 gastric cancers who underwent curative gastrectomy. In the TNM staging system, subdivision of pT2 tumors should be undertaken routinely to detect gastric cancer patients who have a poor prognosis and to define patients more accurately in terms of their mortality after curative resection in accordance with the new 2010 AJCC TNM staging classification. This may also help as a guide to more appropriate therapy for tumors with subserosal invasion (old pT2b or new pT3).Digestive Diseases and Sciences 06/2011; 56(11):3226-34. · 2.12 Impact Factor -
Article: The effect of tumor size on overall survival in patients with pT3 gastric cancer: experiences from 3 centers.
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ABSTRACT: Although a number of studies have investigated whether tumor diameter is a prognostic factor in gastric cancer, no consensus was reached on its clinical importance. In this study, we aimed to determine the effect of tumor size on survival in patients with pT3 gastric cancer. A total of 232 patients with pT3 gastric cancer, who underwent curative gastrectomy with D2 lymph node dissection, were retrospectively analyzed. Receiver operating characteristics analysis showed that the cutoff value for tumor size was 8 cm. On the basis of this cutoff point, patients were divided into 2 groups: small-size tumors (SST, ≤8 cm) and large-size tumors (LST, >8 cm). The prognostic significance of tumor size and the relationship between tumor size and other prognostic factors were evaluated. LST was detected in 44% of patients. Resection type, tumor site, lymph node metastasis, tumor differentiation, lymphatic vessel invasion, and blood vessel invasion were correlated with tumor size. The median survival of patients with SST was significantly better than that of patients with LST (107 vs. 18.2 months; p < 0.001). Multivariate analysis indicated that tumor size was an independent prognostic factor (p = 0.001; hazard ratio (HR): 0.43) as were resection type and blood vessel invasion. Our results show that tumor size is an important prognostic indicator in patients with pT3 gastric cancer, who underwent curative gastrectomy, and that the rate of LST increased with aggressiveness and stage of disease. Tumor size may be a useful and reliable prognostic factor for detection and staging in patients with gastric cancer, who have a poor prognosis after curative resection.Onkologie 01/2010; 33(12):676-82. · 0.87 Impact Factor -
Article: Granulomatous reaction in mediastinal B-cell non-Hodgkin lymphoma and intracardiac thrombosis.
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ABSTRACT: Epithelioid cell granulomas may be associated with several neoplasms. Lymphomas may mimic or are associated with epithelioid granulomas. In this article the authors report a child with granulomatous reaction in B cell non-Hodgkin lymphoma and intracardiac thrombosis. Although cancer alone is a risk factor for thromboembolism, thrombosis is a multifactorial disorder with both hereditary and acquired risk factors. This is the first reported case of intracardiac thrombosis with MTHFR A1298C and factor XIII V34L mutations together with granulomatous reaction in non-Hodgkin lymphoma.Pediatric Hematology and Oncology 07/2009; 25(3):217-26. · 0.89 Impact Factor -
Article: The comparison of weekly and three-weekly cisplatin chemotherapy concurrent with radiotherapy in patients with previously untreated inoperable non-metastatic squamous cell carcinoma of the head and neck.
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ABSTRACT: Several studies have shown that the concurrent administration of chemotherapy (CHT) and radiotherapy (RT) is superior to RT alone in patients with inoperable non-metastatic squamous cell carcinoma of the head and neck (InSCCHN). We compared the efficacy and safety profile of RT and concurrent cisplatin CHT given in two different schedules to patients with previously untreated InSCCHN. Fifty patients with previously untreated InSCCHN admitted to our oncology department were included in the study. Thirty of 50 (60%) patients with a younger age or good performance status (PS) (ECOG 0-1) received cisplatin 100 mg/m(2) on a 21-day schedule (group A). Other 20 (40%) patients with older age or poor PS (ECOG 2) received cisplatin 40 mg/m(2) on a 7-day schedule (group B). Each of the 50 patients received concurrent conventional dose RT according to primer tumor location. The median follow-up is 12 months for group A and 12.5 months for group B. Twenty-eight (93.3%) patients in group A and 18 (90%) in group B were evaluable for response. The complete response rate was 50% in group A and 40% in group B (P > 0.05). The objective response rate was 92% in group A and 90% in group B (P > 0.05). All grade 3-4 toxic events were seen in 16 (53.3%) of group A patients and 8 (40%) of group B patients (P > 0.05). Comparison between two treatment modalities appears to result in statistically similar response rates and adverse event profile. A randomized phase III trial is required to confirm the safety and efficacy of weekly cisplatin therapy in patients with poor PS and/or older age at diagnosis.Cancer Chemotherapy and Pharmacology 01/2009; 64(3):601-5. · 2.83 Impact Factor -
Article: The role of surgery and radiotherapy in treatment of soft tissue sarcomas of the head and neck region: review of 30 cases.
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ABSTRACT: Thirty adult patients with head and neck soft tissue sarcoma (HNSTS) treated between 1987 and 2000 were retrospectively analysed. The most frequent histopathological subtypes were chondrosarcomas (27%) and malignant fibrous histiocytoma (20%). The surgical resection was performed in 25 of the 30 patients (83%). Twenty-three patients in the surgical resection arm received postoperative radiotherapy. Five-year local control rates for patients with negative surgical margins (n=9), microscopically positive disease (n=10), gross residual disease (n=6) and inoperable cases (n=5) were 64, 70, 20 and 0%, respectively. However, there was no significant difference in local control between patients with negative or microscopically positive disease who received postoperative radiotherapy (71 vs. 70%). The patients who received doses>or=60 Gy had significantly higher local control rates than the ones who received doses lower than 60 Gy (p=0.048). The local control rates were lower in patients with grade 2-3 tumours when compared with grade 1 tumours (44 vs. 83%). The median overall survival of whole group was 31 months. Median survivals of patients receiving both surgery and radiotherapy with negative and microscopically positive margins were significantly better than patients who were not treated with surgery (34.8 and 36 vs. 13.3 months). Our results confirm that the optimal treatment of HNSTSs is complete surgical excision, and that postoperative adjuvant radiotherapy clearly improves local control.Journal of Cranio-Maxillofacial Surgery 10/2008; 37(1):42-8. · 1.64 Impact Factor -
Article: Breast involvement in nodular lymphocyte predominant type Hodgkin lymphoma in childhood.
Pediatric Hematology and Oncology 04/2008; 25(2):159-61. · 0.89 Impact Factor -
Article: The efficiency of single agent docetaxel in patients with platinum-refractory non-small cell lung carcinoma.
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ABSTRACT: To evaluate the efficiency of docetaxel as second line chemotherapy in patients with platinum-refractory non-small cell lung carcinoma (NSCLC). Fifty-two patients with locally advanced or metastatic NSCLC who had platinum-refractory disease (progressed through or within 3 months of completion of first line therapy) and an Eastern Cooperative Oncology Group performance (ECOG) status 0-2 were treated with second-line chemotherapy consisting of single agent docetaxel (100 mg/m(2), intravenously, on day 1 of a 21-day cycle). The median number of treatment cycles was 4 (2-6). Disease-free (DFS) and overall survival (OS), response rates and toxicity were evaluated. The median progression-free survival of patients was 3 months (95% CI: 0.01-5.99) and overall survival was 7.2 months (95% CI: 2.2-9.5). One-year overall survival rate was 29%. Disease control (complete response, partial response, or stable disease) was achieved in 25 patients (48%) and overall response rate was 13% (7 patients). There were no complete responses. Seventeen patients (33%) had stable disease and twenty-seven patients (52%) had progressive disease. Age, gender, stage at diagnosis (IIIB vs. IV), performance status at initiation of second-line therapy (0-1 vs. 2) histopathological type (epidermoid vs. others), grade, LDH, albumin, weight loss were evaluated as prognostic factors; however, none of these had a significant affect on survivals. The protocol was well tolerated and there were no toxic deaths. Grade III-IV anemia was present in 8 patients (15%) and thrombopenia in 12 (23%) patients. The most frequent grade 3-4 toxicities were leucopenia (52%) and neutropenia (48%). Febril neutropenia occurred in 14 patients (26%). No patients experienced grade III-IV mucositis and diarrhea. Totally, the need of a dose reduction was about 25% and treatment delay (4-9 days) occurred in 5 patients (10%) and 7 patients (13%), respectively, because of toxicity. Second-line chemotherapy with single-agent docetaxel offers a small but significant survival advantage with acceptable toxicity for patients with advanced NSCLC who have platinum-refractory disease.Medical Oncology 04/2008; 25(4):408-14. · 2.14 Impact Factor -
Article: Spinal cord compression due to vertebral hemangioma.
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ABSTRACT: This article presents a case of multiple vertebral hemangiomas in a 58-year-old man with pain in the dorsal region and bilateral progressive foot numbness. Magnetic resonance imaging revealed multiple vertebral hemangiomas. One hemangioma at the T7 level demonstrated epidural extension, causing spinal cord compression. After treatment with radiotherapy, the patient's symptoms improved significantly.Orthopedics 03/2008; 31(2):169. · 2.66 Impact Factor -
Article: Malignant peripheral primitive neuroectodermal (pPNET) of tongue.
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ABSTRACT: Primitive neuroectodermal tumors (PNETs) are relatively rare tumors. Tumors that once would have been diagnosed as Ewing's sarcoma are now often designated as peripheral neuroepithelioma or synonymously PNET. This paper reports a case of PNET located orally on the tongue, which is, to our knowledge, the first case reported in medical literature. The patient was treated with postoperative radiotherapy and chemotherapy. Multiple liver metastases occurred 5 months after the initial diagnosis and following extensive chemotherapy the patient was only able to survive for a further 10 months.Auris Nasus Larynx 04/2007; 34(1):115-8. · 0.76 Impact Factor -
Article: Cutaneous paraneoplastic syndrome (acrokeratosis paraneoplastica) preceding squamous cell carcinoma of the glottic larynx.
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ABSTRACT: Paraneoplastic syndromes that occur in the minority of cancer patients are the produced signs and symptoms at distant sites from the tumour or its metastases. These syndromes may occur due to the production of substances by tumoural lesions that directly or indirectly cause distant symptoms or depletion of normal substances or host response to the tumours. A paraneoplastic syndrome may be the first sign of a malignancy so its recognition may be critical for early cancer detection. Most of the paraneoplastic syndromes associated with head and neck tumours are endocrinologic or neurologic; dermatologic syndromes are less common. Head and neck cancers also have occasionally been reported in association with paraneoplastic syndromes and to date there are only a few cases in the literature about the presence of a cutaneous paraneoplastic syndrome as the first manifestation of a laryngeal cancer, especially glottic larynx cancer. A wide variety of cutaneous syndromes are associated with malignancies and these syndromes may precede, follow, or be concurrent with the underlying malignancy. In this report we present a case with cutaneous syndrome of acrokeratosis paraneoplastica preceding squamous cell carcinoma of glottic larynx, and review the other cutaneous paraneoplastic syndromes reported in the literature.The New Zealand medical journal 02/2006; 119(1235):U2006. -
Article: Prognostic features and survival of inoperable hepatocellular carcinoma in Turkish patients with cirrhosis.
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ABSTRACT: Primary hepatocellular carcinoma (HCC) is common in Turkey and its prognosis is poor. In the current study the authors analyzed the prognostic factors and survival in Turkish patients with inoperable HCC with cirrhosis. Clinical and demographic data of 91 patients consecutively admitted to the authors' institute from 1988 to 2000 were reviewed. A univariate analysis was performed using the Kaplan-Meier method to identify predictors of survival and were compared using the Mantel log-rank test. Independent factors correlated with survival were determined using the Cox regression analysis. Cirrhosis was diagnosed in all patients. Coinfections with HCV and HBV were not observed. Overall median survival was 16.9 months. On univariate analysis, poor performance status (Eastern Cooperative Group); high alpha-fetoprotein (AFP); low albumin; high bilirubin; high alkaline phosphatase; high lactic dehydrogenase; high alanine and aspartate aminotransferase; high gamma-glutamyl transpeptidase; high platelet count; low prothrombin activity; hepatitis B surface antigen positivity; the presence of ascites, encephalopathy, and portal vein thrombosis; poor differentiation and diffuse type of tumor; and no treatment were associated with shorter survival. Multivariate analysis showed that only independent risk factors were related to performance status (Eastern Cooperative Group) at initial presentation and with pathologic characteristic of the tumor: abnormal AFP level. HCC occurred only in patients with liver cirrhosis. Survival time can be predicted from information collected by the physician at the initial assessment.American journal of clinical oncology 11/2004; 27(5):489-93. · 2.21 Impact Factor -
Article: Colon cancer with isolated metastasis to the kidney at the time of initial diagnosis.
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ABSTRACT: Blood-borne metastases to the kidneys from solid tumors have received little attention in the medical literature because they usually occur in a setting of advanced systemic disease, and renal involvement is a relatively minor cause of symptoms. Although the frequency of metastases to the kidney in cancer patients is 7-13% in large autopsy series, incidental discovery of a renal metastasis as the first manifestation of a primary tumor is a very rare event. The most common primary malignancy to involve the kidney is bronchogenic carcinoma,followed by breast and gastrointestinal cancers. In this article, we report a patient with left colon cancer and isolated metastasis to the right kidney at the time of initial diagnosis. Left hemicolectomy and right nephrectomy were performed. Adjuvant systemic chemotherapy consisting of 5-fluorouracil (5-FU) and folinic acid (FA) was given. 5-FU and FA were stopped after four cycles because metastases to the lung and liver occurred about 3 mo after the surgery during adjuvant chemotherapy. Capecitabine was started. The patient died 9 mo after the discovery of the isolated renal metastasis. Nephrectomy is more for diagnostic clarification in the setting of synchronous primary because it has no effect on survival and its effect on quality of life is minimal; as seen in our case, the other organ metastases rapidly occur and the survival is limited. Nephrectomy may also compromise the choice of chemotherapy agents that require renal clearance, thus a careful evaluation of renal functions is necessary if a nephrectomy is performed. In the matter of a decreased renal clearance,the doses of these drugs should be decreased or the choice should be reevaluated.International Journal of Gastrointestinal Cancer 02/2003; 34(2-3):73-7. -
Article: Primary glioblastoma multiforme in younger patients: a single-institution experience.
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ABSTRACT: To report our experience of patients with primary glioblastoma multiforme of young age by evaluating the characteristics, prognostic factors, and treatment outcomes. Seventy patients with primary glioblastoma multiforme (GBM) treated at our department between 1996 and 2004 were studied. The male-female ratio was 2.6:1. The median age was 53 (16-74). Sixty-eight patients (97%) were operated on before radiotherapy and 2 patients (3%) underwent only stereotactic biopsy. All patients received radiotherapy. Postoperative chemotherapy as an adjuvant to radiotherapy was given to 9 patients (12%). The patients were divided into 2 groups according to their age (group A < or = 35 years, n = 21 vs group B > 35 years, n = 49). Survival was determined with the Kaplan-Meier method and differences were compared using the log-rank test. Cox regression analysis was performed to identify the independent prognostic factors. Karnofsky performance status (> or = 70 vs < 70), age (< or = 35 vs > 35 years), gender, tumor size (< or = 4 vs > 4 cm), number of involved brain lobes (1 vs more than 1), type of surgery (total vs subtotal), preoperative seizure history (present vs absent), radiotherapy field (total cranium vs partial), total radiotherapy dose (60 vs 66 Gy), and adjuvant chemotherapy (present vs absent) were evaluated in univariate analysis. The median survival was 10.3 months in the whole group, 19.5 months in the younger age group and 5.7 months in the older age group. During follow-up re-craniotomy was performed in 2 patients (3%), and 1 patient (1%) developed spinal seeding metastases and was given spinal radiotherapy. In univariate analysis younger age vs older age: median 19.5 months vs 5.27 months (P = 0.0012); Karnofsky performance status > or = 70 vs < 70: median 15.3 months vs 2.67 months (P < 0.0001), and external radiotherapy dose 60 Gy vs 66 Gy: median 11.6 months vs 3 months (P = 0.02) were found as significant prognostic factors for survival. In regression analysis a worse performance status (KPS <70) was found to be the only independent factor for survival (P = 0.014, 95% CI HR = 0.0043 [0.0001-0.15]). Younger patients with primary glioblastoma multiforme had a relatively long survival (median, 19.5 months, with a 2-year survival rate of 30%) compared to older patients. This was due particularly to their better performance status.Tumori 92(5):407-11. · 0.86 Impact Factor -
Article: The value of postoperative radiotherapy in renal cell carcinoma: a single-institution experience.
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ABSTRACT: To evaluate the efficacy of postoperative irradiation in renal cell carcinoma. Forty patients with localized renal cell carcinoma admitted to our hospital between 1986 and 1999 were evaluated. All patients were initially treated with radical nephrectomy. Postoperative radiotherapy was given to 26 of 40 patients (65%). Fourteen patients (35%) received no adjuvant therapy. Median age was 55 years (range, 20-70 years). Twenty-four patients (60%) were men and 16 patients (40%) were women. Histopathological diagnosis was renal cell carcinoma in all of the patients. N+ disease was present in 3 patients (7%). Stage I and II disease was present in 25 patients (63%) and stage III and IV disease in 15 patients (37%). Two patients (5%) had T1a disease, 11 patients (27%) had T1b, 15 patients (38%) had T2, 11 patients (27%) had T3a and 1 (3%) patient had T3b. In the radiotherapy group, renal bed and regional lymphatic fields were irradiated with daily fractions of 180-200 cGy/fraction to a total dose of 46-50 Gy, using parallel opposing fields. The 5-year overall survival rates were 70% in the postoperative radiotherapy group and 20% in the no adjuvant treatment group, showing no significant difference (P = 0.1). The 5-year disease-free survival rates were 66% in the radiotherapy group and 16% in the no treatment group, with a significant difference in both univariate and multivariate analyses (P = 0.045 and P = 0.0007, respectively). Stage III and IV disease, tumor size 27 cm, presence of distant metastasis and lactate dehydrogenase level > 450 U/L were found to be adverse prognostic factors for overall survival in both univariate and multivariate analyses. Analyzing the factors affecting disease-free survival, absence of postoperative radiotherapy and tumor size > or = 7 cm were found to be adverse prognostic factors in univariate and multivariate analyses. Multi-institutional prospective randomized trials using modern radiotherapy techniques such as conformal radiotherapy and intensity-modulated radiotherapy are necessary to evaluate the real role of radiotherapy and its effect on survival in renal cell carcinoma, especially in selected patients with a high risk of local or regional failure.Tumori 92(3):202-6. · 0.86 Impact Factor -
Article: Posttraumatic stress disorder and risk factors in parents of children with a cancer diagnosis.
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ABSTRACT: The purpose of this study was to determine the prevalence of posttraumatic stress disorder (PTSD) in parents of children with cancer. Five questionnaires were administered to 104 parents, including a sociodemographic questionnaire, a traumatic events check list, the Structured Clinical Interview for DSM-IV PTSD and Major Depressive Disorder modules, and the self-rating instrument General Health Questionnaire-12. The prevalence of PTSD was 34.6%. The statistically significant tendency to develop PTSD were found in the female gender, better educational status, death of a loved one, previous history of psychiatric disorder, having a child with poorer prognosis, and the presence of radiotherapy in child's treatment. The vulnerable parents must receive psychosocial support.Pediatric Hematology and Oncology 25(1):27-38. · 0.89 Impact Factor
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2006–2012
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Kocaeli University
- Department of Radiation Oncology
Kocaali, Sakarya, Turkey
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