Introduction
The combination of fluorouracil, leucovorin, irinotecan, and oxaliplatin (FOLFIRINOX) is more toxic than gemcitabine, but it is a safe regimen with manageable toxicities.
Case report
We ...report a case with steatohepatitis mimicking liver metastasis as toxicity that was not seen in study patient population.
Management and outcome: In the adjuvant statement with FOLFIRINOX due to biopsy, we give the same regimen by excluding metastasis.
Discussion
The adverse events of drugs are important predictive factor for treatment management, as important as efficacy. Especially the new lesion and metastasis is the most important factor for changing treatment. The clinicians must be careful about adverse events of regimens.
Conclusion
FOLFIRINOX regimen is the most important combination in pancreas cancer adjuvant setting. This case shows us the different presentation of usual adverse event.
Objective
The study aims to investigate the estrogen-agonistic effects of tamoxifen on voice parameters in premenopausal women diagnosed with breast cancer.
Methods
A total of 108 premenopausal women ...were included, segmented into distinct treatment groups and a control group. Objective sound analysis was conducted using robust statistical methods, employing SPSS 25.0 for data analysis.
Results
The study identified a statistically significant reduction in Jitter values across all treatment groups compared to the control group. No significant changes were observed in other voice quality parameters such as F0, Shimmer, NHR, and HNR.
Conclusions
The findings suggest that tamoxifen may have an estrogen-agonistic effect on voice quality, thereby potentially influencing future treatment protocols. This research fills a critical void in existing literature and sets the stage for more comprehensive studies that consider affects of hormonal therapies to voice.
Approximately 20-33% of all cancer patients are treated with acid-reducing agents (ARAs), most commonly proton pump inhibitors (PPIs), to reduce gastroesophageal reflux disease symptoms. Palbociclib ...and ribociclib are weak bases so their solubility depends on different pH. The solubility of palbociclib dramatically decreases to < 0.5 mg/ml when pH is above 4,5 but ribociclibs' solubility decreases when pH increases above 6,5. In the current study, we aimed to investigate the effects of concurrent PPIs on palbociclib and ribociclib efficacy in terms of progression-free survival in metastatic breast cancer (mBC) patients.
We enrolled hormone receptor-positive, HER2-negative mBC patients treated with endocrine treatment (letrozole or fulvestrant) combined palbociclib or ribociclib alone or with PPI accompanying our observational study. During palbociclib/ribociclib therapy, patients should be treated with "concurrent PPIs" defined as all or more than half of treatment with palbociclib/ribociclib, If no PPI was applied, it was defined as 'no concurrent PPI', those who used PPI but less than half were excluded from the study. All data was collected from real-life retrospectively.
Our study included 217 patients, 105 of whom received palbociclib and 112 received ribociclib treatment. In the study population CDK inhibitor treatment was added to fulvestrant 102 patients ( 47%), to letrozole 115 patients (53%). In the Palbociclib arm fulvestrant/letrozole ratio was 53.3/46.7%, in the ribociclib arm it was 41.07/58.93%. Of 105 patients who received palbociclib, 65 were on concomitant PPI therapy, 40 were not. Of the 112 patients who received ribociclib, 61 were on concomitant PPI therapy, 51 were not. In the palbociclib group, the PFS of the patients using PPIs was shorter than the PFS of the patients not using (13.04 months vs. unreachable, p < 0.001). It was determined that taking PPIs was an independent predictor of shortening PFS (p < 0.001) in the multivariate analysis, In the ribociclib group, the PFS of the patients using PPIs was shorter than the PFS of the patients not using (12.64 months vs. unreachable, p = 0.003). It was determined that taking PPIs was single statistically independent predictor of shortening PFS (p = 0.003, univariate analysis).
Our study demonstrated that concomitant usage of PPIs was associated with shorter PFS in mBC treated with both ribociclib and especially palbociclib. If it needs to be used, PPI selection should be made carefully and low-strength PPI or other ARAs (eg H2 antagonists, antacids) should be preferred.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Purpose: Testicular cancer is the most common solid tumor in young men between the ages of 20-35 and has excellent clinical outcomes with appropriate treatment. Neutrophil-to-lymphocyte-ratio (NLR) ...is related with prognosis and relapse in different solid tumors. We aimed to investigate the relation of presence and size of regional lymph node metastasis with NLR in testicular cancer.
Materials and Methods: A total of 72 testicular cancer patients were included in the study. All medical records were retrospectively collected. NLR was calculated as the count of neutrophil divided by the count of lymphocyte. Chest and abdomen computed tomograpy (CT) scans of all patients were evaluated for metastases.
Results: The mean age was 32.18±8.89 years. The pathologic classification was seminoma in 43% and nonseminoma in 57% of patients. Of 72 patients, 32 (44.4%) had lymph node positivity and 40 (55.6%) hadnot. The mean NLR value was 2.63±1.79 for all cohort. The mean NLR was significantly lower in patients with lymph node negative disease (for lymph node positive and negative disease 3.19±2.32 and 2.25±1.06, respectively.). In the ROC analysis, 2.5 was determined as the cut-off value for NLR to assess lymph node status. Conclusion NLR is a cheap and readily available index that can be used to determine lymph node metastases in testicular GCTs.
Amaç: Testis kanseri 20-35 yaş arası genç erkeklerde en sık görülen solid tümördür ve uygun tedavi ile çok iyi klinik sonuçlara sahiptir. Nötrofil-lenfosit oranının (NLR), farklı solid tümörlerde prognoz ve nüks ile ilişkili olduğu gösterilmiştir. Testis kanserinde lenf nodu metastazını varlığını göstermede NLR ile ilişkisini araştırmayı amaçladık.
Gereç ve Yöntem: Çalışmaya toplam 72 testis kanseri hastası alındı. Tüm veriler geriye dönük olarak toplandı. NLR, nötrofil sayısının lenfosit sayısına bölünmesiyle hesaplandı. Tüm hastaların toraks ve batın bilgisayarlı tomografi (BT) taramaları metastaz açısından değerlendirildi.
Bulgular: Ortalama yaş 32.18±8.89 idi. Patolojik sınıflama hastaların %43'ünde seminom ve %57'sinde nonseminom şeklindeydi. 72 hastanın 32'sinde (%44,4) lenf nodu pozitif, 40'ında (%55,6) lenf nodu negatifti. Hastaların ortalama NLO değeri 2,63±1,79 idi. Ortalama NLO, lenf nodu negatif hastalığı olan hastalarda anlamlı olarak daha düşüktü (lenf nodu pozitif hastalık için 3.19±2.32 ve lenf nodu negatif hastalık için 2.25±1.06). ROC analizinde, lenf nodu durumunu değerlendirmek için NLR için cut-off değeri olarak 2.5 belirlendi.
Sonuç: Çalışma verilerimiz, NLR'nin testiküler GHT'lerde lenf nodu metastazlarını belirlemede kullanılabilecek düşük maliyetli ve hazır bir indeks olduğunu göstermektedir.
Objective: COVID-19 has rapidly spread and has become a pandemic by affecting the whole world. During this period, many scientific congresses and educational meetings had to be canceled because of ...preventive measures. In this report, we aimed to share our first live virtual congress experience, described its process of transformation from face to face to virtual congress and report the attendees and speakers’ satisfaction. Material and Methods: Eurasian Uro-oncological Association (EUA) decided to organize the 10th Eurasian Uro-oncology congress in June 2020 at Göbeklitepe, Şanlıurfa in Turkey. However, due to the COVID-19 pandemic, the organizing committee decided to organize the first virtual scientific congress in Turkey. The planned duration of the congress was reduced from 4 days to 2 days and each speaker was planned to give the speech online during the presentation via ZOOM program (San Jose, CA). Results: A total of 704 persons registered to the congress. It was the highest number of participants among whole congresses that was organized by EUA. In this congress, there were 199 oral presentations, 25 interactive e-posters and 12 video presentations. During the congress, each participant attended the congress for an average of 387 minutes. It was identified that the majority of the participants were quite satisfied with the program offered. In general, participants were fairly satisfied with the quality of images and sound, chat functionality, questions & answers section and technical support. Conclusion: In this report, we shared the outcomes of our first virtual congress experience in Turkey through the 10th Eurasian Uro-oncology Congress. Today, virtual congresses have become the "new normal" and offer cheaper events with larger participation in the comfort of home. Keywords: Congress, COVID-19, online, virtual, urology
An increasing number of biomarkers of primary glioblastoma (GBM) have recently been described. We aimed to investigate the biological and clinical factors that affect survival in Turkish patients ...with primary GBM.
The clinical and demographic data of all patients with primary GBM diagnosed between 2007 and 2016 were evaluated. In all the patients' pathological specimens, O6 methylguanine-DNA methyltransferase (MGMT) methylation and isocitrate dehydrogenase (IDH) 1 mutation were detected retrospectively by immunohistochemistry. Kaplan-Meier survival analysis, log-rank test, and multivariate analyses of the Cox hazard proportional model for all the variables were performed using the SPSS statistical package. The treatment details and other patient-related factors were identified, and their correlations were analyzed.
We enrolled 137 primary GBM patients to the study. Median progression free survival (PFS) was 8.57 months (95% CI: 6.8-9.5) and median overall survival (OS) was 12 months (95 % CI: 10.8-13.3). IDH-1 mutations were detected in 21 primary GBMs (15.3%). PFS was 15.43 ± 1.95 months. Survival rates were higher, but no statistically significant difference (p: 0.074). MGMT methylation was detected in 40 primary GBMs (29.2%). OS and PFS of MGMT (+) cases were higher than MGMT(-)cases (p: 0.001; p: 0.001 respectively). Ki67 (%) measurement (10%-90%) average is 32.64 ± 16.56.No statistically significant between higher and lower ki67 levels (p : 0.510, p: 0.505 respectively). KPS(%) more than 70 at the time of diagnosis statistically significant longer median OS and PFS (p: 0.001) .PFS and OS were higher in all treatment modalities.
The most important factors that affected survival were performance score, MGMT methylation status, systemic oncologic therapy, and IDH mutation in the Turkish population with primary GBM. We demonstrated that MGMT methylation and higher KPS levels were associated with significiantly longer OS and PFS.
Background and objective
Male breast cancer (MBC) is a rare malignancy, and it accounts for less than 1% of all cancers in men. The pathogenesis of MBC remains unclear, with most available data ...obtained from single-center studies and retrospective series. The aim of this study was to share our experiences of MBC cases and to describe the characteristics of MBC patients.
Materials and methods
We retrospectively reviewed the records of 41 MBC cases and recorded the pathological, clinical, and demographic features of the patients. Data on progression-free survival (PFS) and overall survival (OS) were also recorded.
Results
The mean age of the patients was 64.1 ± 10.0 years. The most common histopathological subtype was invasive ductal carcinoma. Hormone receptor positivity was detected in 39 (95.1%) patients. Human epidermal growth factor receptor 2 (HER2) positivity was present in five (12.2%) patients. Most of the patients had early-stage disease. Surgery was the treatment of choice for most primary tumors. Thirty-nine (95.1%) patients received hormonotherapy, and 21 (51.2%) received systemic chemotherapy. OS was found to be 126.4 months and PFS was 83.2 months. The OS and PFS time in patients with a Nottingham Prognostic Index (NPI) score of <5.4 were longer than those with an NPI score of >5.4.
Conclusion
The hormone receptor status of most of the MBC patients was positive, and their HER2 status was negative. A multimodality approach was associated with longer survival, which has been reported in female patients with breast cancer as well. The NPI score is a useful tool for predicting survival time in MBC patients.
As part of the vascular access procedures, venous ports, commonly referred to as catheters, are placed under the skin to enable safe and easy vascular access for administration of repeated drug ...treatments. 122 patients who had received a venous port catheter insertion procedure in the general surgery department between January 1012 and January 2014 were involved in this study. Patients were divided into two groups: those who had undergone a fluoroscopy (group 1) and those who had not undergone a fluoroscopy (group 2). Complications that emerged during and after the port catheter insertion procedure and successful insertion rates were recorded in the database. Data of these patients were presented in a prospective manner. There were 92 to 30 patients in groups 1 and 2, respectively. In group 1, the mean age was approximately 56.8, total catheter stay time was 20,631 days, and mean time of port use was 224.2 days. In group 2, the mean age was approximately 61.2, total catheter stay time was 13,575 days, and mean time of port use was 452.5 days. Successful insertion rate was 100% and 90% in groups 1 and 2, respectively (P < 0.05). The proper insertion of the port catheter accompanied by monitoring methods can decrease procedure-related complications. Statistical comparisons between the two groups in terms of malposition and successful insertion rates also support this view (P < 0.05). The findings support the view that in cancer patients, a venous port catheter insertion accompanied by a fluoroscopy can be safely performed by general surgeons.
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