Objective:The prognostic value of neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and systemic immune-inflammatory index has been studied in many cancer types. Our aim is to show the ...prognostic value of neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and systemic immune-inflammatory index in resected gastric cancer patients. In addition, to determine which parameter is a better predictor of survival. Material and methods:The study included 95 patients resected gastric cancer between 2014-2018. Receiver operating curve analysis was used to determine neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and systemic immune-inflammatory index cut-off values. Systemic immune-inflammatory index was evaluated as neutrophil × platelet/lymphocyte. Long rank and cox regression analysis were used. Results:The median age was 62 (22-84) years. The median overall survival was 33 months. 49 (51.6%) patients were in stage 3 and 46 (48.4 %) patients were in stage 1-2. High neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and systemic immune-inflammatory index values, tumor depth, stage of metastatic lymph node and tumor-node-metastasis stage were poor prognostic factors for overall survival and disease-free survival. When multivariant cox regression analysis was performed, only platelet-lymphocyte ratio was found to be independent prognostic factor (p = 0.037 for overall survival, p = 0.024 for overall survival). Conclusion: High neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and systemic immune-inflammatory index were found to be poor prognostic factors in predicting both overall survival and disease-free survival before treatment in patients who undergo curative resection for gastric cancer. As a result of multivariant analysis, only high platelet-lymphocyte ratio was determined as an independent poor prognostic factor for both overall survival and disease-free survival.
Ewing's family of tumors is aggressive tumors and frequently arises from bone and soft tissue. They might also arise from nonosseous structures such as gastrointestinal tract, adrenal glands, or ...kidney. Primary renal Ewing's sarcoma (ES)/primitive neuroectodermal tumor is an extremely rare entity which has aggressive clinical course. These high-grade malignant tumors predominantly affect adolescents and young adults. Patients mostly present with nonspecific symptoms such as pain, hematuria, mass, and sensitivity. It is confused with renal cell cancer in imaging techniques. The definitive diagnosis is based on the histopathological examination. Surgical or radiotherapy treatment is used for local control and multiagent chemotherapy used for systemic treatment. Despite all treatment options, prognosis is poor. We aimed to describe the diagnosis and follow-up and treatment of renal ES case that was considered as renal cell carcinoma in imaging but diagnosed as ES via histopathology.
Purpose
We aim to compare the efficiency and toxicity of three different 5-fluorouracil (5-FU) administration types in 5-FU, leucovorin, and oxaliplatin (FOLFOX) combination treatment for adjuvant ...therapy in colorectal cancer (CRC).
Methods
Five hundred and seventy patients with stage III colorectal carcinoma who received different FOLFOX regimens after curative resection were included. Patients were divided into three groups as FOLFOX-4, modified FOLFOX-6 (mFOLFOX-6), and mFOLFOX-4 for comparison of toxicity and disease-free survival (DFS) and overall survival (OS) times.
Results
Three-year DFS rates for FOLFOX-4, mFOLFOX-6, and mFOLFOX-4 groups were 65%, 72%, and 72%, respectively. Five-year OS rates for FOLFOX-4, mFOLFOX-6, and mFOLFOX-4 groups were 69%, 75%, and 67%, respectively. There was no statistically significant difference between the three treatment groups in terms of DFS and OS (
p
= 0.079, and
p
= 0.147, respectively). Among grade 1–2 adverse events (AE), thrombocytopenia, neuropathy, and stomatitis were more common in the mFOLFOX-6-treated group. The frequency of grade 1–2 nausea and vomiting were similar in mFOLFOX-6 (36.3% and 24%, respectively) and mFOLFOX-4 (32.4% and 24.7%, respectively) groups but were higher than that in the FOLFOX-4 (19.5% and 11.3%, respectively) group. Among the most common grade 3–4 AE, neutropenia (53.4%, 9%, and 13.5%, respectively) and diarrhea (10.5%, 2.2%, and 2.4, respectively) were more common in FOLFOX-4. The rate of anemia and febrile neutropenia was similar in treatment groups (
p
= 0.063, and
p
= 0.210, respectively).
Conclusion
In the adjuvant treatment of stage III CRC patients, three different 5-FU administration types in FOLFOX combination treatment can be used with similar efficiency and manageable toxicity.
The prevalence of depression is high in cancer patients. In the process of initiation, maintenance and completion of treatment, the detection of depression is closely associated with treatment ...outcomes. Therefore, awareness of this issue is of great significance at present. In view of the aforementioned information, the aim of the present study is to investigate the severity of depressive symptoms and factors that can lead to depression in cancer patients receiving outpatient chemotherapy. Patients receiving chemotherapy in Diskapi Training and Research hospital and volunteering to participate in the study, were administered Beck Depression Inventory and asked to fill sociodemographic data form. The present study was carried out with 100 patients (55 female, 45 male) receiving treatment in outpatient chemotherapy unit. High depression score was detected in 21 (%) patients. In the evaluation of the factors influencing high depression score, the rate of high depression score was found to be higher in female patients (p: 0.03). Similarly the rate of high depression score was higher in patients at metastatic stage (p: 0.01). Apart from these, no other factor was found to be associated with high depression score. Depression is one of the factors that affect treatment compliance and prognosis of the disease. Therefore, awareness of this issue is quite important. Cancer treatment requires a multidisciplinary approach and in this patient groups, those with depressive characteristics should be especially supported.
Aim: The prognostic value of platelet distribution width to lymphocyte ratio (PDWLR) in patients with metastatic renal cell cancer using tyrosine kinase inhibitors is not clearly known. Our aim in ...this study is to evaluate the prognostic importance of PDWLR in patients with metastatic renal cancer. Meterial and results: This retrospective study included 66 patients with metastatic renal cell cancer who were currently receiving Tyrosine kinase inhibitor treatment between January 2010 and December 2020. The cut off value was determined by ROC curve analysis. The best cut-off value for RDWLR was determined as 9.33. Sensitivity and specificity for RDWLR were 55.3% and 57.9%, respectively. Chi-square and Fisher exact tests were used to evaluate the relationship between PDWLR and clinicopathological variables. Cox proportional hazards model was used for multivariate analysis. Conclusion: It has been determined that PDWLR measured during treatment in metastatic RCC patients using TKIs has no significant effect on Pfs, which is an important prognostic factor in predicting OS. In patients with metastatic renal cell cancer, PDWLR level can be used as a prognostic marker, but studies with a larger number of patients are needed.
Tuberous sclerosis is a multisystem neurocutaneous genetic disease that might be seen in one live birth in 6,000-10,000. Angiomyolipomas (AML) are the most common renal lesions that could be seen in ...80% of tuberous sclerosis patients. Nephron-sparing surgery or selective arterial embolization are methods that could be used in the treatment of AML. Here in we present the case who has been admitted to our emergency department with retroperitoneal bleeding due to bilateral giant AML and treated with the endovascular method. A 55-year-old woman, who has been followed regularly in our hospital since 2016 with the diagnosis of tuberous sclerosis. The patient was admitted to the emergency department of our hospital with complaints of right upper quadrant pain and dizziness. On computed tomography, 4 cm of free fluid was observed at the posterior part of the right kidney posterior, consistent with hemorrhage. On renal angiography, selective arterial angioembolization (SAE) was performed on the inferior segmental artery, which is feeding the AML. Surgical intervention was not considered in the foreground because the patient has bilateral giant AML and would not be anephric. It was decided to begin the patient on everolimus (mTOR inhibitor) treatment. In the patient’s first year follow-up, imaging was performed with non-contrast computed tomograpy. Computed tomograpy showed no size change in giant AML in both kidneys. Although the patient’s creatinine levels increased to 3.04 mg/dL and urea to 148 mg/dL during the follow-ups, she did not need hemodialysis. AML, which is seen as a part of tuberous sclerosis, is one of the important causes of mortality in tuberous sclerosis, which causes life-threatening bleeding and requires surgical or endovascular treatments. Nephron-sparing surgery could be difficult in bilateral cases. Therefore, SAE should be considered an important treatment option in emergencies.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Previous studies have reported the relationship between the risk of developing pancreatic cancer and blood groups. There have been conflicting results with respect to the prognostic significance of ...the AB0 blood group in pancreas cancer. We aimed to evaluate the impacts of blood groups on prognosis in our pancreatic cancer patient population. Patients diagnosed with pancreas cancer between January 2014 and December 2018 were analyzed retrospectively. We analyzed the prognostic significance of AB0 blood groups for PDAC (pancreatic ductal adenocarcinoma) patients based on stages of the disease (early stage, locally advanced stage, and metastatic). We evaluated 366 patients diagnosed with pancreatic cancer. The median age of the patients was 65 (27-83). The median overall survival (OS) was 11 months (95%9.49-12.50 months). Median survival based on blood groups were as follows: 13 months for blood group A (95% Cl, 10.59-15.41), 11 months for blood group B (95% Cl, 8.80-13.19), 12 months for blood group AB (95% 6.63-17.36), and eight months for blood group 0 (95% Cl, 5.43-10.56) (p = 0.171). 304 (83.3%) of the patients were not alive at the end of the study. We concluded that the survival of those with 0 blood group was shorter in patients with metastatic pancreatic cancer (p <0.001), taking into account the relationship between stages and blood groups. There was no prognostic effect of AB0 blood groups on pancreatic cancer in our patient group. However, we found that blood group 0 negatively affected OS in metastatic pancreas cancer patients, based on the subgroup analysis according to stages.
Objective: The prognostic value of red cell distribution width to platelet count ratio (RPR) in patients with breast cancer is not clear. This study aims to evaluate the prognostic significance of ...red cell distribution width to platelet count ratio in breast cancer patients. Material and Methods: A retrospective analysis was performed on 150 patients with non-metastatic breast cancer between January 2014-December 2018. The optimal cut off value of RPR was 0.54 for diseasefree survival (DFS). The chi-square test or Fisher’s exact test was used to evaluate relationships between the RPR and other clinicopathological variables. Kaplan-Meier log-rank test was used to determine the effect of variables on DFS. Cox’s proportional hazards model was used for multivariate analysis. Results: Median follow-up period was 39±1.174 (13-66) months and 5-year survival was 96.60%. There was no relationships between the RPR and clinicopathological variables. Kaplan-Meier analysis showed significant correlation between elevated RPR level (p=0.001) and high MPV(mean platelet volume)/Platelet(P) ratio (p=0.006) and DFS. DFS was found to be short in patients with high RPR and high MPV/P ratio. When multivariate analysis was performed with cox regression analysis, RPR level (p=0.025) and tumor size (p=0.047) were found to be independent prognostic factors . RPR was found to be a more valuable prognostic marker than mean platelet volume to platelet ratio (MPV/P). Conclusion: We found that high RPR levels before adjuvant treatment were associated with poor DFS in patients with curative resected breast cancer. Accordingly, the RPR level can be used as a prognostic marker in non-metastatic breast cancer. However, further studies conducted with a larger number of patients are needed.
Objective: Malignant melanoma situated in the parotid gland represents a rare clinical presentation, and the prognosis of these patients remains inadequately understood in comparison to other forms ...of malignant melanoma. This study aims to evaluate cases of parotid gland-located malignant melanoma under follow-up in our clinic. Material and Method: Records of five patients aged 18 and above, diagnosed with melanoma localized within or adjacent to the parotid gland, were retrospectively reviewed. Relevant clinical information such as patients’ demographic data including age and gender, medical histories, presenting symptoms, treatment modalities, and outcomes were evaluated. The overall survival of the patients was examined. Results: None of the patients included in the study had primary parotid gland melanoma. Among all patients, 4 patients had primary lesions that were cutaneous melanomas originating from the head and neck region, while in one patient, the primary lesion was uveal melanoma of the eye. While 3 patients included in the study had died, 2 patients were still being followed up. Conclusion: Primary melanomas localized to the parotid gland are extremely rare, and when encountered, a thorough medical history and careful physical examination can often reveal that the primary lesion is cutaneous melanoma, predominantly located in the head and neck region. It should be kept in mind that although rare, there may be primary intranodal melanoma cases whose primary is unknown or cannot be found in the parotid gland.
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