Ender Kurt

Uludag University, Bursa, Bursa, Turkey

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Publications (42)56.16 Total impact

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    ABSTRACT: Background: Thymomas and thymic carcinomas are rare malignancies and devising clinically effective molecular targeted therapies is a major clinical challenge. The aim of the study was to analyze BLC2 and vascular endothelial growth factor receptor (VEGFR) expression and KRAS and EGFR mutational status and to correlate them with the clinical characteristics of patients with thymomas and thymic carcinomas. Materials and Methods: A total of 62 patients (mean age: 50.4±13.2 years) with thymomas and thymic carcinomas were enrolled. The expression of BLC2 and VEGFR in tumor cells and normal tissues was evaluated by RT-PCR. The mutational status of the KRAS and EGFR genes was investigated by PCR with sequence specific primers. Results: The BLC2 and VEGFR expression levels did not differ significantly between tumor and normal tissues. Moreover, there were no clearly pathogenic mutations in KRAS or EGFR genes in any tumor. None of the molecular markers were significantly related to clinical outcomes. Conclusions: Changes in levels of expression of BLC2 and VEGFR do not appear to be involved in thymic tumorigenesis. Moreover, our data suggest that KRAS and EGFR mutations do not play a major role in the pathogenesis of thymomas and thymic carcinomas.
    Asian Pacific journal of cancer prevention: APJCP 01/2014; 15(8):3457-60. · 1.27 Impact Factor
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    ABSTRACT: Background: Previous reports have shown that human epidermal receptor (HER)-3 overexpression may be associated with poor prognosis in patients with breast cancer, but results have been conflicting. In this study, we sought to investigate the prognostic significance of HER-3 immunohistochemical expression in patients with metastatic breast cancer. Methods: We retrospectively analyzed HER-3 immunohistochemical expression profiles in 45 paraffin-embedded specimens from patients who had been treated between 1996 and 2006 in the Department of Oncology of the Uludag University School of Medicine, Bursa, Turkey. Membranous or cytoplasmic dominant expression patterns of HER-3 were analyzed using the Rajkumar score and a cytoplasmic 4-point scoring system, respectively. Progression-free survival (PFS) and overall survival (OS) served as the main outcome measures. Results: The median PFS in the study participants was 9 months (interquartile range: 4.5-13 months), whereas the median OS was 20 months (interquartile range: 7.5-28 months). Categorization of the patient population according to HER-3 positive immunohistochemical expression did not reveal any statistically significant difference in terms of both PFS (p=0.70) and OS (p=0.81). The results of multivariable Cox regression analysis indicated that tumor size was the only independent predictor of PFS, whereas estrogen and progesterone receptor status was independently associated with OS. Conclusions: HER-3 immunohistochemical expression did not correlate with outcomes in Turkish patients with metastatic breast cancer. Although our results suggest that HER-3 expression in cancer specimens is not of prognostic significance, further prospective studies are warranted to confirm these results.
    Asian Pacific journal of cancer prevention: APJCP 01/2013; 14(7):4115-9. · 1.27 Impact Factor
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    ABSTRACT: Background: Suppressor of cytokine signaling (SOCS)-1 acts as a key regulator of many cytokine signaling pathways and its abnormal expression has been identified in several human malignancies, suggesting potential roles in carcinogenesis. The aim of this study was to investigate any association between the functional SOCS- 1 -1478CA>del polymorphism and colorectal cancer (CC) as well as age at onset in a Turkish clinical sample. Materials and Methods: A total of 122 subjects were enrolled in this case-control study (70 CC cases and 52 controls). The SOCS-1 -1478CA>del polymorphism was genotyped using a polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Results: The odds ratio of the del allele for CC relative to the CA allele was not significantly different between the groups (OR=0.71, 95% CI=0.41-1.22, p=0.27). This result did not change after adjustment for age and sex on multivariable regression analysis (OR=0.84, 95% CI=0.59-1.34, p=0.53). When the SOCS-1 -1478CA>del polymorphism was analyzed among CC patients in relation to the age at disease onset, we found no significant differences between subjects with the del/del, CA/del, and CA/CA genotypes. Conclusions: The results of our study did not point towards a major role of the SOCS-1 -1478CA>del polymorphism in the pathogenesis of CC in Turkish subjects.
    Asian Pacific journal of cancer prevention: APJCP 01/2013; 14(12):7583-6. · 1.27 Impact Factor
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    ABSTRACT: BACKGROUND: Overexpression of the gene c-erbB2, which encodes a receptor tyrosine kinase, has been associated with prognosis and response to therapy in several solid tumors. This study was designed to test whether c-erb-B2 overexpression can be related to prognosis of patients with metastatic gastric cancer. METHODS: Between 2005 and 2010, 46 cases of metastatic gastric cancer were evaluated immunohistochemically for c-erb-B2 overexpression. Overall survival (OS) and time-to-progression (TTP) served as the main outcome measures. RESULTS: c-erbB2 was overexpressed in 19 (41.3 %) cases and 8 patients (17.4 %) had a c-erbB2 score of 3+ (a strong complete membrane staining observed in >10 % of the tumor cells). c-erbB2 expression was not associated with the clinicohistological characteristics of the study participants. The mean OS was 11.48 ± 1.03 months, whereas the mean TTP was 8.28 ± 0.8 months. Compared with patients with a score of 2+ or less (n = 38), those with a c-erbB2 score of 3+ (n = 8) had both a significantly lower OS (15.55 ± 1.63 vs. 8.22 ± 0.88 months, respectively, p < 0.05) and TTP (10.72 ± 1.81 vs. 6.11 ± 0.61 months, respectively, p < 0.05). After allowance for potential confounders, Cox regression analysis identified a c-erbB2 score of 3+ as an independent predictor of both OS (hazard ratio = 1.9; 95 % confidence interval = 1.1-3.7, p < 0.05) and TTP (hazard ratio = 1.8; 95 % confidence interval = 1.1-4.1, p < 0.05). CONCLUSION: Our results suggest that c-erbB-2 overexpression may have a prognostic significance in patients with metastatic gastric cancer.
    Clinical and Translational Oncology 08/2012; · 1.28 Impact Factor
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    ABSTRACT: Background: Pulmonary actinomycosis may create a diagnostic and therapeutic dilemma especially in cancer patients. Case Report: A 64-year-old male patient presented with a productive cough, bloody sputum, and weight loss. Thoracic computed tomography (CT) showed a 5-cm mass in the upper lobe of the right lung, and a 2-cm mass in the lower lobe of the left lung. Bronchoscopic examination did not show any endobronchial lesions. CT-guided needle biopsy of the right pulmonary lesion showed lung adenocarcinoma. Wholebody positron emission tomography/CT revealed an increase in fluorodeoxyglucose accumulation in the upper lobe of the right lung, in the lower lobe of the left lung, and in the right hilar and paratracheal lymph nodes. Before chemotherapy was initiated, the patient had to be admitted to the hospital because of massive hemoptysis. Bronchoscopic examination indicated persistent bleeding in the left lower lobe bronchus. The patient underwent diagnostic left thoracotomy, and wedge resection of the lower lobe mass. The diagnosis was pulmonary actinomycosis, and the patient received oral amoxicillin. He underwent successful surgery for the primary disease following 6 cycles of chemotherapy. Conclusion: Oncologists should be aware of rare diseases that may affect management approaches in the treatment of cancer.
    Onkologie 01/2012; 35(10):604-6. · 1.00 Impact Factor
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    ABSTRACT: Polymorphisms in the X-ray repair cross complementing 1 (XRCC1) gene have been found to be associated with susceptibility to various types of cancers. We investigated the association between the XRCC1 gene Arg399Gln polymorphism and the susceptibility to lung cancer in Turkish patients. To determine the association of this polymorphism with the risk of lung cancer in Turkish patients, a hospital-based case-control study was designed, involving 67 patients with lung cancer and 60 control subjects with no cancer history who were matched for age and gender. XRCC1 genotypes (Arg/Arg, Arg/Gln, and Gln/Gln) were determined using polymerase chain reaction–restriction fragment length polymorphism (PCR-RFLP) analysis on genomic DNA. No statistically significant relationship was determined between the lung cancer and control groups (p>0.05). Among the patients, 61% were Arg/Arg, 28% were Arg/Gln, and 11% were Gln/Gln. Among the controls, 50% were Arg/Arg, 38% were Arg/Gln, and 12% were Gln/Gln. There was no difference in the distribution of XRCC1 genotypes or the frequencies of the Arg (75% versus 69%) and Gln (25% versus 31%) alleles between the lung cancer patients and controls. Our results suggest that the XRCC1 gene Arg399Gln polymorphism is not associated with an increased risk for the development of lung cancer in Turkish patients.
    Indian Journal of Human Genetics 01/2012;
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    ABSTRACT: INTRODUCTION The identification of novel prognostic markers may help to better assess survival probability in different subgroups of patients with non-small-cell lung cancer (NSCLC) and to tailor treatment according to the molecular profile of the tumour. AIM We sought to examine whether the immunohistochemical expression of excision repair cross-complementing 1 (ERCC1), an essential component of the nucleotide excision repair pathway, may predict prognosis in NSCLC. MATERIAL AND METHOD Formalin-fixed paraffin-embedded tumour samples from 44 Turkish patients with NSCLC treated by adjuvant platinum-based chemotherapy were included in the study. Immunohistochemical expression levels of ERCC1 were correlated with clinical outcomes by Kaplan-Meier curves and multivariable Cox proportional hazards regression analysis. RESULTS A total of 29 patients had ERCC1-negative tumours while 15 had ERCC1-positive tumours. The mean progression- free survival (PFS) was significantly lower in patients with ERCC1-positive tumours (13±2 months) than in those with ERCC1-negative tumours (27±5 months, p<0.05). Similarly, the mean overall survival (OS) was significantly lower in patients with ERCC1-positive tumours (20±3 months) than in those with ERCC1-negative tumours (33±5 months, p<0.05). After allowance for potential confounders, Cox regression analysis demonstrated that ERCC1 expression was significantly associated with both PFS and OS (both p<0.05). CONCLUSION This study provides support for the prognostic value of ERCC1 immunohistochemical expression in patients with NSCLC treated by adjuvant platinum-based chemotherapy. If independently confirmed, these findings may improve prognostic stratification in this group of patients.
    Clinical and Translational Oncology 11/2011; 13(11):826-30. · 1.28 Impact Factor
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    ABSTRACT: In this study we aimed to investigate the genotoxic effects of antineoplastic agents in occupationally exposed oncology nurses. Genotoxic effects mean the disruptive effects in the integrity of DNA and they are associated with cancer development. Biomonitoring of health care workers handling antineoplastic agents is helpful for the evaluation of exposure to cytostatics. The study included an exposed and two control groups. The exposed group (n=9) was comprised of oncology nurses. The first (n=9) and second (n=10) control groups were comprised of subjects who did not come into contact with antineoplastic drugs working respectively in the same department with oncology nurses and in different departments. Genotoxicity evaluation was performed using SCE analysis. After applying culture, harvest and chromosome staining procedures, a total of 25 metaphases were analyzed per person. Kruskal Wallis test was used to perform statistical analysis. A statistically significant difference of sister chromatid exchange frequencies was not observed between the exposed and control groups. Lack of genotoxicity in medical oncology nurses might be due to good working conditions with high standards of technical equipment and improved personal protection.
    Work 01/2011; 39(4):485-9. · 0.52 Impact Factor
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    ABSTRACT: ZET Lokal ileri ve metastatik mide kanserli 70 hastanın tedavi öncesi AFP, CEA ve CA 19-9 serum seviyeleri retrospektif olarak araştırıldı. Bu markerlar için pozitiflik oranı sırasıyla %55.7, %40 ve %32.9 bulundu. Tümör belirteçlerinin pozitif seviyeleri için univaryet analizleri, AFP pozitifliğinin karaciğer metastaz varlığı (p=0.033) ve rezektabilite oranı ile anlamlı ilişkisinin olduğunu (p=0.041), CEA pozitifliğinin ileri tümör evresi (p=0.011), tümör boyutu (p=0.004), karaciğer metastaz varlığı (p=0.001), serozal invazyon sıklığı (p=0.004) ve rezektabilite (p=0.011) ile anlamlı ilişkisinin olduğunu ve son olarak CA 19.9 pozitifliğinin ileri tümör evresi (p=0.006), tümör boyutu (p=0.002), serozal invazyon sıklığı (p=0.002), periton metastaz sıklığı (p=0.005) ve asit gelişimi (p=0.005) ile anlamlı ilişkisinin olduğunu gösterdi. Sonuç olarak, kanser hastalarında tedavi kararı verilirken tümör markeri kullanımı, klinik ve radyolojik olarak tespit edilemeyen uzak organ metas-taz varlığını gösterebilir. ABSTRACT Pre-treatment serum levels of AFP, CEA and CA 19-9 were retrospectively investigated in 70 patients with locally advanced and metastatic gastric cancer. The positivity rates for these markers were 55.7%, 40% and 32.9%, respectively. Multiple logistic regression analysis for positive levels of tumor markers indicates that AFP positivity is significantly related to the presence of hepatic metastasis and resectability rates (p=0.041), CEA positivity is related to advance stage (p=0.011), tumor size (p=0.004), presence of hepatic metastasis (p=0.001), the frequency of serosal invasion (p=0.004) and resectability rates (p=0.011). Finally, CA 19-9 positivity is related to advance stage (p=0.006), tumor size (p=0.002), the frequency of serosal invasion (p=0.002), the frequency of peritoneal metastasis (p=0.005) and ascites (p=0.005). In summary, in cancer patients, the use of tumor markers for the decision of treatment might indicate the existence of any organ metastasis which could not be clinically or radiologically revealed...
    uludag üniversitesi tıp fakultesi. 01/2011; 37:139-143.
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    ABSTRACT: ZET Bu çalışmada, lokal ileri mesane kanseri nedeniyle adjuvant kemoterapi alan hastalar retrospektif olarak analiz edildi. Toplam 32 hasta gemsitabin (%18.8), sisplatin+gemsitabin (%50), carboplatin+gemsitabin (%15.6) veya MVAC (Metotreksat, vinblastin, doksorubisin ve sisplatin) (%15.6) tedavisi aldı. Tedaviler sırasında en sık görülen yan etki kemik iliği toksisitesi idi. Tedaviye bağlı ölüm gözlenmedi. Medyan genel ve hastalıksız sağkalım süreleri sırasıyla 23 ay (18.7-27.4) ve 17.8 ay (12.7-22.9) idi. Verilerimizin literatür ile uyumlu olduğu sonucuna varıldı. ABSTRACT In this study, patients who received adjuvant chemotherapy for locally advanced bladder cancer were retrospectively analyzed. A total of 32 patients received gemcitabine (%18.8), cisplatin plus gemcitabine (%50), carboplatin plus gemcitabine (%15,6) or MVAC (Methotrexate, vinblastine, doxorubicin, and cisplatin). The most common adverse effect was myelosuppression during chemotherapy administration. Treatment-related died was not observed. The median overall and disease-free survival was 23 months (range, 18.7-27.4) and 17.8 months (range, 12.7-22.9), respectively. We concluded that our results were comparable to those in the literature.
    uludag üniversitesi tıp fakultesi. 01/2011; 37:123-125.
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    ABSTRACT: ZET Solid organ tümörlerinde alkilleyici ajanların ve topoizomerazların yaygın kullanılmaya başlanması kanser hastalarının yaşam süresinin uzamasına bağlı olarak ikincil lösemi insidansını arttırmıştır. Tedavi ilişkili lösemiler tüm lösemilerin yaklaşık %10-20 sini oluşturur. Olgu-muz Mart 2008 tarihinde endometrium kanseri tanısı almış olup, sisplatin-doksorubisin-radyoterapi tedavisi sonrası takiplerinde trombositopeni saptandı. Bunun üzerine yapılan kemik iliği materyali değerlendirilmesi sonucunda French American British (FAB) sınıfla-masına göre AML M4 tanısı alan olgumuzun kemik iliği materyaline yapılan moleküler sitogenetik (FISH) analizinde de inv 16 pozitif olarak bulularak tanı doğrulandı. Olgumuz, kısa sürede lösemiye bağlı komplikasyonlar nedeniyle kaybedildi. Primer malignitenin tedavisi takibinde kısa süre bile olsa hematolojik durumlar dikkatli olarak incelenirse bir çok tedavi bağımlı AML saptanabilir. Sonuç olarak, tedaviy-le ilişkili akut löseminin 5 ay gibi kısa sürede gelişen ve inv 16 pozitif saptanan endometrium kanserli olgumuz, literatürde nadir görülmesi sebebiyle önem taşımaktadır. SUMMARY In solid organ tumors, the increasing use of alkalizing agents and topoisomerases have increased the incidence of secondary leukemia in connection with extension of the life expectancy of cancer patients. The treatment related leukemia forms 10-20% of all cases of leukemia. Our case was diagnosed with endometrium cancer in March 2008 and during follow up of sisplatin-doxorubisin-radiotherapy treatment thrombocytopenia was detected. Then upon investigation of the bone marrow material our case was diagnosed with AML M4 based on French American British (FAB) classification AML M4 and then the diagnoses was verified after molecular cytogenetic (FISH) analysis conducted on bone marrow material, since inv 16 was positive. Our patient died in a short time because of complications related to leukemia. If after treatment of primary malign tumors the hematologic conditions are monitored carefully, even for a short term, AML might be de-tected related to various treatments. To conclude, we consider our case to be of importance since acute leukemia has developed with inv 16 positivity within a very short period of five months after treatment, which is a case rarely observed in the literature.
    uludag üniversitesi tıp fakultesi. 01/2011; 37:105-107.
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    ABSTRACT: Pancreatic cancer (PC) is one of the most troublesome solid tumors, and remains a major challenge to oncologists. Approximately 40% of patients with PC present with locally advanced disease, and generally the treatment of this situation is not curative. Locally advanced PC (LAPC) is commonly defined as the tumor invading the celiac axis, superior mesenteric artery, inferior vena cava, aorta, or the encasement or occlusion of the superior mesenteric vein-portal vein confluence. The most common clinical evaluations for the determination of disease extension are obtained from the computed tomography scan and magnetic resonance imaging of the abdomen, endoscopic ultrasound with fine needle aspiration biopsy, angiography, and endoscopic retrograde cholangiopancreatography. Being an effective diagnostic intervention, 18-fluorodeoxyglucose-positron emission tomography gives additional information on the findings of these more conventional examinations. More invasive diagnostic utilities, such as laparoscopy and laparoscopic ultrasonography, may be helpful in selected cases, which are able to show the hepatic and peritoneal dissemination as well as the vascular invasion of a pancreatic tumor more accurately (Russo et al., 2007).
    12/2008: pages 227-236;
  • Clinical Oncology 03/2008; 20(1):93-6. · 2.86 Impact Factor
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    ABSTRACT: 5-Fluorouracil-based chemoradiotherapy is the most widely used treatment modality in the adjuvant treatment of rectal cancer. Capecitabine represents a valuable alternative to 5-Fluorouracil in this situation. Patients with stage II and stage III rectal adenocarcinoma, who were included in this analysis, received adjuvant chemoradiotherapy consisting of external-beam radiotherapy (50.4-54Gy) either with 5-Fluorouracil at a median dose of 300 mg/m2/day by protracted venous infusion for 5 days a week, or capecitabine at a median dose of 1650 mg/m2/day for 5 days a week after surgery. The data concerning the toxicity and the efficacy of the treatments were compared in patients treated with 5-Fluorouracil- and capecitabine-based chemoradiotherapy. Forty-three patients received 5-Fluorouracil, and 24 patients received capecitabine during adjuvant radiotherapy. Although there were no differences between the groups in terms of toxicity rates, distant metastasis-free survival, disease-free survival, and overall survival rates; a trend for improved loco-regional recurrence-free survival rate was observed in the capecitabine arm (p = 0.063). Capecitabine is at least as effective as 5-Fluorouracil in the postoperative treatment of rectal adenocarcinoma. Considering the trend for improved loco-regional recurrence-free survival rate in the capecitabine arm, it seems that the drug exerts better synergy with radiotherapy in this situation.
    Hepato-gastroenterology 01/2008; 55(85):1158-63. · 0.77 Impact Factor
  • Southern Medical Journal 09/2007; 100(8):852-3. · 0.92 Impact Factor
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    ABSTRACT: We would like to report fatal ischemic bowel necrosis (IBN) as an unexpected complication of docetaxel and cisplatin in a patient with non-small cell lung cancer.
    Lung Cancer 05/2007; 56(1):143-4. · 3.39 Impact Factor
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    ABSTRACT: Capecitabine exerts considerable therapeutic efficacy in metastatic breast cancer (MBC) patients previously treated with anthracyclines and taxanes. In this study, the efficacy and safety of lower dose capecitabine (2000 mg/m(2)/d) in patients with anthracycline- and taxane-pretreated MBC were studied with a special emphasis on the potential predictors of time to tumor progression (TTP) and response to the capecitabine treatment. The overall response rate (ORR) was 17%. The median TTP was 5 months. Among various factors analyzed, univariate analysis showed that a performance status (PS) of 2 and the presence of visceral metastases were inversely correlated with TTP. Multivariate analysis showed that a poor PS score was associated with impaired TTP. Our study indicates that lower dose capecitabine has substantial antitumor activity and a favorable safety profile in the treatment of anthracycline- and taxane-pretreated MBC. Also, only performance score was demonstrated to be a significant parameter affecting TTP.
    Southern Medical Journal 02/2007; 100(1):27-32. · 0.92 Impact Factor
  • Journal of Postgraduate Medicine 01/2007; 53(2):146. · 1.26 Impact Factor
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    ABSTRACT: Insulin resistance (IR) and obesity may be risk factors for breast cancer. The mechanism of IR in patients with cancer has not been fully clarified yet. This study was conducted to evaluate the possible role of circulating cytokines; tumor necrosis factor-alpha (TNF-alpha) and interleukin 6 (IL-6) in inducing IR in 20 overweight or obese patients with early stage breast cancer and to compare their levels with that of body mass index matched 20 healthy controls. IR was calculated by homeostasis model assessment (HOMA) method. Four groups were formed according to a 2.7 HOMA-IR cut-off value as breast cancer with or without IR and controls with or without IR. IL-6 and HOMA-IR values were found to be higher in breast cancer patients with IR compared to other groups. There was no significant difference in TNF-alpha levels between groups. HOMA-IR values correlated with estradiol and IL-6 levels in all breast cancer patients but not TNF-alpha. HOMA-IR values, serum insulin, estradiol and IL-6 levels in the receptor positive group were significantly higher than those of the receptor negative group. These results suggested a possible contribution of endogenous IL-6 production and hyperinsulinemia to the development of breast cancer in overweight or obese patients with prominent IR.
    Cytokine 09/2005; 31(4):264-9. · 2.52 Impact Factor
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    ABSTRACT: In this study, we aimed to investigate the clinicopathological characteristics with special emphasis on c-kit expression and the treatment results of patients with extrapulmonary small cell carcinoma (EPSCC). The medical records of the patients with EPSCC were reviewed, and the data regarding patient and tumour characteristics, treatment and clinical outcome were retrieved and analysed. A total of 28 patients with the diagnosis of EPSCC were identified. There were 19 males and 9 females, with a mean age of 56.5 years. Patients with limited disease (LD) (n = 13) were treated with surgery, chemotherapy (CT) and radiotherapy with different sequences. Patients with extensive disease (ED) (n = 15) were mainly treated with combination CT. The median overall survival was 14.5 months in patients with LD compared to 11 months in those with ED (p = 0.029). Ten patients (36%) showed c-kit overexpression. There was no significant difference between the survival of c-kit-positive and c-kit-negative patients (p = 0.367). In conclusion, our study demonstrates that the prognosis of EPSCC is poor despite currently available treatments. C-kit may be considered as a potential target for novel therapeutical approaches.
    International Journal of Clinical Practice 06/2005; 59(5):537-43. · 2.43 Impact Factor