Kaposi sarcoma is a malignant angioproliferative disease, and human herpesvirus-8 plays a major role in its etiology. Iatrogenic Kaposi sarcoma (IKS) can occur in patients undergoing ...immunosuppressive therapy. The treatment strategy for patients with IKS is immunosuppressive therapy modification. However, it is unclear which chemotherapy drug is the most effective and safe in the treatment of IKS. Therefore, we investigated the efficacy and safety of systemic treatment in patients with IKS at our tertiary cancer center. This cross-sectional retrospective study analyzed the clinical data of 22 patients diagnosed with IKS between January 2000 and January 2020. The patients were divided into the following 2 groups according to the transplantation status: organ transplant recipient (OTR) group and non-organ transplant recipient (non-OTR) group. Of the 22 patients, 12 were included in the OTR group and 10 were included in the non-OTR group. The median patient age at diagnosis was 52.1 years in the OTR group and 68.1 years in the non-OTR group. The median overall survival (OS) was 65.4 months in the OTR group, while the median OS was not reached in the non-OTR group. There was no statistically significant difference in OS between the 2 groups ( P = .45). The 5-year OS rate among all patients was 54%. In the OTR group, the objective response rate and disease control rate were 50% and 83%, respectively, and in the non-OTR group, the objective response rate and disease control rate were 60% and 90%, respectively. Chemotherapy was well tolerated in both groups. Hematological toxicities were the main dose-limiting adverse events. Grade III/IV leucopenia and neutropenia were observed in 5 and 4 patients, respectively; however, no patient experienced febrile neutropenia. No chemotherapy-related death occurred. Systemic chemotherapy is an effective treatment and can be considered for disease control in patients with an aggressive disease course, who do not experience regression with immunosuppressive therapy modification.
Background: Patients with skin cancer apply to medical oncology outpatient clinics for follow-up after the completion of local treatments or in case of progression despite locoregional treatments ...(surgical and/or radiotherapy). In this study, we aimed to determine the demographic and clinicopathological characteristics of patients with skin cancer who were followed up and treated in the medical oncology outpatient clinic, as well as to determine their ratio compared to other cancers. Materials and Methods: Age, gender and demographic information of the patients diagnosed between C00 and C80 according to International Classification of Diseases-10, followed in University of Health Sciences Turkey, Basaksehir Cam and Sakura City Hospital Medical Oncology Clinic between April 2021 and April 2022. Results: The ratio of skin cancer patients to all cancer patients was 1.55%. The most common skin cancer subgroup presenting to the medical oncology outpatient clinic was cutaneous melanoma (10, 0.65%), followed by cutaneous Kaposi's sarcoma (9, 0.58%), squamous cell carcinoma (4, 0.26%), and basal cell carcinoma (1, 0.06%). Conclusion: We have determined that the number of skin cancer patients and its rate among other organ cancers is quite low. We found that patients with a diagnosis of skin cancer were referred from various centers other than dermatology. Keywords: Cutaneous malign melanom, Kaposi sarcoma, Squamous cell carcinoma, Basal cell carcinoma
Aim:Medullary thyroid carcinoma (MTC) originating from parafollicular C cells is a sporadic endocrine tumor. A unique aspect of the disease is that it is 25% familial and component of multiple ...endocrine neoplasia 2 syndromes. Surgical resection has curative potential in the early stages. Systemic treatment options are available for unresectable or advanced disease. Due to the rare and limited treatment options for the disease, we found it appropriate to share the results of our patients in our center.Materials and Methods:We enrolled 47 progressive MTC patients in the study between June 2000 and June 2019. Demographic and clinical characteristics of the patients, as well as treatment outcomes, were evaluated. Statistical analyses were performed to identify risk factors associated with survival.Results:The median age was 46 years, and the male to female ratio was 32/15. All patients’ Eastern Cooperative Oncology Group - Performance Status (ECOG-PS) was 0 (66.7%) or 1 (33.3%). While 73% of the patients had lymph node metastasis, 22% had distant organ metastasis at initial diagnosis. Local recurrence was found to be the most common progression type (80.9%). The most frequent distant metastatic sites at progression were the bone (68.1%) and lung (23.4%). From the start of systemic therapy, the median progression-free survival and median overall survival (OS) were 51.7 months and 55.6 months, respectively. Vandetanib was associated with a better OS than systemic treatments (84.7 months vs. 37.1 months, respectively; p=0.047). Patients whose ECOG-PS was 0 had better OS than those with ECOG-PS 1 (77.2 months vs. 34.4 months, respectively; p=0.002). Also, ECOG-PS was determined as an independent prognostic factor hazard ratio (HR): 14.7; 95% confidence interval (CI): 1.7-124.7; p=0.013.Conclusion:Although the patients with progressive MTC have relatively long survival, systemic treatment options are limited. The ECOG-PS needs to be evaluated in absolute terms in patient management. In addition to tyrosine kinase inhibitors, chemotherapy and 177Lu-octreotate may be effective in selected patients.
Introduction The aim of this work was to treat patients with leaky gut syndrome (LGS) and gastrointestinal flora loss in a simple, inexpensive, permanent and effective way without the need for ...further treatment. Methods A total gastrointestinal flora transplantation (TGFT) procedure is performed by simultaneously transferring the "flora" taken from approximately 30 different anatomical sites, from the mouth to the anus, of healthy donors to the corresponding anatomical site of the patient using the endoscopic lavage method. Results Of the patients, 25 (44.6%) were female and 31 (55.4%) were male, totaling 56 (100%). The mean age was 32.88±15.78 years. Among the 56 patients enrolled in the study, TGFT had no efficacy in one patient, five patients underwent repeat TGFT during a mean follow-up period of 23.73±16.74 months, and the treatment was permanent in 50 patients; our success rate during the follow-up period was 89.3%. Conclusion In LGS, TGFT should be the gold standard treatment.
Although many surgical methods have been described for sacrococcygeal pilonidal sinus treatment, the best option is still controversial. We aimed to compare postoperative outcomes of these different ...methods in terms of advantages and disadvantages.
The records of 320 patients undergone surgery for primary or recurrent pilonidal sinus between May 2013 and May 2017 were retrospectively analyzed. Demographical data, pre operative stories, wound site infection, seroma development, wound dehiscence, time of healing, duration of return to work, and if there is any recurrence of 303 patients included in the study were recorded. Upon wide local excision, the first surgeon performed marsupialisation and the lay open technique, second surgeon performed vertical excision and primary closure, third surgeon performed Limberg flap transposition and fourth surgeon performed Karydakis' flap transposition.
There was no significant difference between the patients in terms of demographical characteristics. The duration of surgery was statistically significantly higher in primary closure method (p = 0.001). The mean duration of return-to-work was statistically significantly lower in primary closure method (p = 0.002). In primary closure method, the recurrence rate was found to be statistically significantly higher than the other methods (p = 0.009).
We do not suggest the use of primary closure method in treatment of pilonidal sinus. Because of lower rates of recurrence and shorter durations of return to work, the Karydakis and Limberg methods are seen as safer methods when compared to lay-open and marsupialization method.
Splanchnic artery aneurysms are rare vascular lesions with a high risk of rupture regardless of their size. Symptoms may vary from simple abdominal pain or vomiting to morbid conditions like ...haemorrhagic shock; however, most aneurysms are asymptomatic and difficult to diagnose. In this study, it was aimed to present the case of a 56-year-old female with a ruptured pancreaticoduodenal artery aneurysm treated by coil embolization.
Background: Skin cancers have become a significant public health problem and increasing over the years. Two crucial risk factors for skin cancers are; phenotypic traits and sun-induced ultraviolet ...exposure. The risk of disease can be significantly reduced with sun protection. This study aimed to determine the knowledge levels of sun protection and sun avoidance behaviors of healthcare professionals and other professionals who have not yet been diagnosed with any cutaneous cancer. Materials and Methods: Between February and August 2022, the participants without a diagnosis of malignancy were evaluated. Demographic and clinical characteristics of patients related to skin cancer, including age and gender, were recorded. The questionnaire was applied to each participant, including the level of knowledge about sun protection and sun protection habits. Results: The mean age was 37 years. Of the participants, 116 were healthcare workers, and 392 were other professionals. The knowledge of sun protection among healthcare workers was given by doctors significantly higher than in others. However, other professions obtained sun protection information primarily through media communication tools (p<0.0001). The knowledge of using sunscreen half an hour before going out in the sun was higher in healthcare workers (p=0.009). Also, knowledge of reapplying sunscreen after swimming was higher among healthcare workers (p=0.009). We determined that sunscreen use and sunscreen >30 sun protection factor were higher in healthcare workers (p<0.0001, p=0.001, respectively). It is noteworthy that there was an insufficient number of nevus screening in both groups. Conclusion: Although the level of knowledge of individuals about taking protective measures against sun exposure is high, it was observed that individuals' attitudes and behaviors related to sun protection were insufficient. Campaigns to encourage the public to protect themselves from the sun within a general health program through doctor-supported social media tools may contribute to the elimination of the deficiencies we have identified. Keywords: Sun exposure, Melanoma, Cancer, Ultraviolet light, Sunscreen
Aim: Gallbladder cancer is the sixth most common cancer of the gastrointestinal system. Clinical presentation may not be distinguished from cholelithiasis or cholecystitis and most patients are ...diagnosed intraoperatively or in the postoperative histologic examination. In this study, we aimed to investigate the association of incidentally detected gallbladder cancer with gallbladder premalignant lesions, age, gender, ultrasonography features and gallbladder stones.
Methods: Demographic and clinical characteristics and pathology results of 5206 patients who underwent cholecystectomy between January 2012 and December 2015 were evaluated retrospectively.
Results: Three thousand eight hundred and eighty four (74.6%) patients were female. Pathologic reports showed pre-malignant and malignant lesions in 102 (1.95%) cases. Metaplasia was significantly more common in females, while no significant difference was found in development of dysplasia and cancer between genders. Gallbladder stone was found to be a risk factor for the development of metaplasia. Gallbladder wall thickening and advanced age are the most important risk factors for gallbladder cancer.
Conclusion: Female gender and gallstone are important risk factors for the development of metaplasia. Advanced age, gallstone and gallbladder wall thickening on ultrasonography are the most important factors in the development cancer. Cholecystectomy should be kept in mind as the most effective method to prevent cancer development in elderly patients with gallbladder stones.
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