The aim of the present case report was to investigate the effects of a physiotherapy program combined with sirolimus in a child patient with upper extremity edema and joint limitation due to low-flow ...vascular malformation. This case report included an 11-year-old male patient (26 kg, 130 cm) diagnosed with congenital lymphovascular malformation on the left and right chest. The patient, who had edema on the upper left extremity and experienced joint limitations, was administered complete decongestive therapy (CDT) and manual therapy in combination with sirolimus. Physiotherapy included a total of 24 sessions, 3 sessions a week for 8 weeks. Following the physiotherapy, the patient was assigned to a home therapy program, and then the maintenance phase of the CDT was initiated. Evaluations were carried out at baseline, at the end of week 8, and after 12 months. Following the physiotherapy program combined with sirolimus, a decrease in extremity volume, an increase in joint movement range, and an improvement in disease-related complaints were observed. Physiotherapy methods combined with sirolimus may be an effective treatment method in patients with vascular malformations. However, further studies with larger sample size are warranted.
Colorectal cancer (CRC) is a significant cause of cancer mortality worldwide. Survival has improved with bevacizumab in metastatic CRC treatment. Our purpose was to analyse survival and prognostic ...factors in metastatic CRC patients treated with first-line bevacizumab-based treatment.
Files of CRC patients were examined retrospectively and 360 patients treated with first-line bevacizumab were included. Objective response rates (ORRs), median progression-free and overall survival (PFS and OS) of the patients were calculated. Survival was analyzed with the Kaplan-Meier method. Log-rank test and Cox regression model were used for univariate and multivariate analyses, respectively.
Median age at diagnosis was 59.5 years. Of the patients 74.4% had initially stage IV disease. Median PFS was 8.5 months, median OS 25.3 months and ORR was 51.4%. ORRs, median PFS and OS of KRAS mutant and wild-type or unknown patients were statistically similar. In left-sided disease, median PFS and OS (9.6 and 27.1 months) were superior compared to right-sided disease (7.3 and 19.4 months) (p=0.005 and 0.02, respectively). Primary disease location, histopathologic grade, primary surgery and metastasectomy affected OS significantly. Histopathologic grade (hazard ratio=1.77, p=0.002) and metastasectomy (hazard ratio=0.48, p=0.001) were independent prognostic factors.
Our study confirmed that after bevacizumab-based treatment, KRAS status might not be a prognostic factor. We have also shown that left CRC have more favorable outcomes than right CRC in bevacizumab therapy. Additionally, even in metastatic setting histopathologic grade of the primary CRC together with metastasectomy are independent prognostic factors.
Purpose
Malignant high-grade gliomas are the most common and aggressive type of primary brain tumor, and the prognosis is generally extremely poor. In this retrospective study, we analyzed the ...outcome of systemic treatment in recurrent high-grade glioma patients and the impact of prognostic factors on survivals.
Methods
Data from 114 patients with recurrent high-grade glioma who received systemic treatment and followed in our clinic between 2012 and 2018 were retrospectively analyzed. Eastern Cooperative Oncology Group (ECOG) performance status, age, gender, histology, type of surgical resection, side effects after systemic treatment (deep vein thrombosis, hypertension, proteinuria), IDH1 and alpha thalassemia/mental retardation syndrome X-linked (ATRX) mutation status were investigated as prognostic factors for progression-free survival and overall survival.
Results
At the time of diagnosis, the median age was 48 (17–77) and 68% of the patients were male. Most common pathologic subtype was glioblastoma multiforme (68%). Median follow-up duration was 9.1 months (1–68 months). Median progression-free survival and overall survival were 6.2 months and 8 months, respectively. In multivariate analysis, ECOG PS, deep venous thrombosis and the presence of ATRX and IDH1 mutation were found to be independent prognostic factors for progression-free survival (p < 0.05) and, ECOG PS, the presence of ATRX and IDH1 mutation for overall survival (p < 0.05).
Conclusion
Our study is real life data and the median progression-free survival and overall survival rates are similar to the literature. We have found ECOG PS, presence of ATRX and IDH1 mutation to be independent prognostic factors for both progression-free survival and overall survival.
Most data on prognostic factors for patients with high-grade undifferentiated pleomorphic sarcoma (HGUPS) is obtained from analyses of soft tissue sarcomas. The purpose of this study was to evaluate ...the clinicopathologic features and their impact on outcomes specifically in patients diagnosed with HGUPS. In this multicenter trial, we retrospectively analyzed 112 patients who were diagnosed and treated at 12 different institutions in Turkey. We collected data concerning the patients, tumor characteristics, and treatment modalities. There were 69 males (61.6 %) and 43 females (38.4 %). Median age was 56 years (19–90). The most common anatomic site of tumor origin was the upper extremity. Pleomorphic variant was the predominant histological subtype. Median tumor size was 8.2 cm (0.6–30 cm). Tumors were mainly deeply seated (57.1 %). Fifty-seven patients (50.9 %) were stage II and the remainder were stage III at the time of diagnosis. Median follow-up was 30 months (2–160). The primary site of distant metastasis was the lung (73.5 %) and the second most common site was the liver (11.7 %). The 5-year overall survival, distant metastasis-free survival, and local recurrence-free survival rates were 56.3, 53.4, and 67.2 %, respectively. Multivariate analysis showed that Eastern Cooperative Oncology Group (ECOG) performance score of II (
p
= 0.033), deep tumor location (
p
= 0.000), and development of distant metastasis (
p
= 0.004) were negatively correlated with overall survival, and perioperative radiotherapy and negative microscopic margins were significant factors for local control rates (
p
= 0.000 for each). Deep tumor location (
p
= 0.003) was the only adverse factor related to distant metastasis-free survival. Deep tumor location, ECOG performance score of II, and development of distant metastasis carry a poor prognostic implication on overall survival. These will aid clinicians in predicting survival and treatment decision.
Abstract only
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Background: Wnt signal transduction pathway plays an important role in carcinogenesis. Wnt signal transduction pathway is a key component of the β-catenin-TCF / LEF family of ...transcription factors interact with and activate the transcription of Wnt target genes. The aim of this study is to evaluate the prognostic value of β-katenin and LEF-1 expression in patients with operable gastric cancer and the relationship between demographic and histopathological variables. Methods: In this study, 82 gastric cancer patients treated with adjuvant treatment after operation and followed in Oncology Department between 2006-2010 were included. β-katenin and LEF-1 expression were examined by immunuhistochemical analysis in paraffin embedded tumor tissues of the patients. Results: In this study, median age was 56 (26-81) years and median follow up was 19 (4-61) months. Performance status (ECOG PS) were 0-1 in all patients. Men/women ratio was 53/29 (64.6/35.4%). Median disease free survival (DFS) time was 17 months (SE:3 95% CI: 11-23) in 19 months of follow up. 3 years DFS rate was 39.7%. In all patients group, median overall survival (OS) time was 28 months (SE:4 95% CI: 20-36) and 3 years OS rate was 41,2%. There was no statistical correlation between β-catenin and LEF-1 expression and age, gender, performance status, tumor localization, T and N stage, lymphovascular, perinoral invasion, grade and operation type (>0.05). In addition, there was also no correlation between β-catenin and LEF-1 expression. According to univariate analysis, we did not find significant effect on age, gender, T stage, lymphovascular, perinoral invasion, grade and operation type on overall survival (p>0.05). Good performans status (ECOG 0), tumor infiltration without diffuse type like linitis plastica, and lower N stage had positive effect on survival (p=0.04, 0.033 and 0.005, respectively). In multivariate cox regression analysis, only N stage was found as an independent prognostic factor (p<0.05). Conclusions: In this study group, we found that the only N stage as an independent prognostic factor. Demographic features of the patients, histopathological characteristics other than N stage, β-catenin and LEF-1 prognostic effects have not been shown.
To analyze the relationship between clinical features, hormonal receptor status, and survival in patients who were diagnosed with medullary breast cancer (MBC). Methods: Demographic characteristics, ...histopathological features, and survival statuses of 201 patients diagnosed with MBC between 1995 and 2015 were retrospectively recorded. Survival analyses were conducted with uni- and multivariate cox regression analysis.
Median follow-up time was 54 (4-272) months. Median patient age at the time of diagnosis was 47 years old (26-90). Of the patients, 91.5% were triple negative. Five-year recurrence free survival time (RFS) rate was 87.4% and overalll survival (OS) rate 95.7%. For RFS, progesterone receptor (PR) negativity, atypical histopathological evaluation, absence of lymphovascular invasion, smaller tumor, lower nodal involvement were found to be favourable prognostic factors by univariate analysis (p less than 0.05). The PR negativity and smaller tumor were found to be favourable factors by univariate analysis (p less than 0.05). However, none of these factors were determined as significant independent prognostic factors for OS (p greater than 0.05). Conclusion: Turkish MBC patients exhibited good prognosis, which was comparable with survival outcomes achieved in the literature. The PR negativity was related to a better RFS and OS rates.
The aim of this research is to determine the role of multiple representations such as problem picture, ray diagram, and equation used by the students in solution of the image projection problems. The ...study is performed by the survey method. The participants of this study were prospective physics teachers of a faculty of education from a state university in Turkey. Fifty-three teacher candidates solved open-ended questions and 20 of them were also interviewed. The results have shown that the students used two different types of solution method; in solution 1, they used the solution method where “problem pictures, mirror/lens equations and ray diagrams” are used, and in solution 2, they used the solution method where “problem pictures and mirror/lens equations” are used. The results show that students mostly prefer the second solution method, however, the students who prefer the first solution method are more successful than them. Also, it is found that the students have various alternative ideas about the usage of these multiple representations. The reasons of these alternative ideas are discussed at the end of the study.
Aim: Non-small cell lung cancer (NSCLC) accounts for 85% of all lung cancers. Although curative treatment is surgery in the early stages, disease relapse is common. In this study, we retrospectively ...evaluated the prognostic factors and outcomes of operated NSCLC cases.Materials and Methods: Retrospective analysis of data from 166 patients with early stage NSCLC who presented after surgery and treated and followed in our clinic between 2006-2018 was performed. Histopathologic features and clinical findings were investigated as prognostic factors.The findings were analyzed using SPSS.Results: At the time of diagnosis, median age was 61 (39-82) and 84% of the patients were male. Most common pathologic subtype was adenocarcinoma. Median disease free survival (DFS) and overall survival (OS) were 76 months (%95CI:32.1-110.0) and 87 months (95%CI:59.8-114.1). ). In multivariate analysis, presence of vascular invasion was found to be independent prognostic factors for both DFS and OS (HR:2.5 and 2.3, respectively). Adenocarcinoma solid pattern was only associated with worse disease-free survival (HR: 1.7).Conclusion: In our study, we showed that the presence of vascular invasion and solid-type adenocarcinoma is associated with poor survival.
OBJECTIVE This study aims to evaluate the predictive impacts of cigarette smoking on treatment outcomes of EGFR tyrosine kinase inhibitors (TKIs) in Non-Small Cell Lung Cancer (NSCLC) patients with ...activating EGFR mutations. METHODS We retrospectively evaluated the data of 46 patients with metastatic NSCLC (adenocarcinoma) and EGFR mutation (exon 19 deletion, exon 21 mutation, and exon 18 activating mutation) treated with EGFR-TKI between 2012 and 2017. RESULTS Median age was 61 (range 30-80), and 56.5% (26/46) was female. Median follow-up was 39 months. The rate of smoking was 41.3% (19/46). The EGFR mutations were present in the patients, exon 19 deletion in 29 patients (64%), exon 21 mutation in 13 patients (28%) and exon 18 activating mutations in four patients (8%). Progression-free survival (PFS) was 21 months in smokers, whereas it was 25 months in non-smokers (p=0.330). Median PFS was 21 months for patients using EGFR TKI in the first-line (35 patients), and 13 months in the second-line setting (11 patients). CONCLUSION There were no statistically significant PFS differences between the smoker and non-smoker groups. Smokers should be tested for EGFR mutations, as some patients may benefit from EGFR TKI treatment for longer than reported in the literature.
Efficacy of chemotherapy plus bevacizumab has been shown in patients with metastatic colorectal cancer (mCRC) compared with chemotherapy alone. The aim of the present study was to evaluate the ...efficacy and safety of FOLFIRI or XELIRI regimens in combination with bevacizumab for mCRC patients in a first-line setting.
A total of 132 patients with previously untreated and histologically confirmed mCRC were included. They were treated with either FOLFIRI-Bevacizumab (Bev) or XELIRI-Bev according to physician preference. The efficacy and safety of the two regimens were compared.
Between 2006 and 2010, 68 patients were treated with the XELIRI-Bev regimen, while the remaining 64 patients received the FOLFIRI-Bev regimen. The median age was 58.5 years (53.6 years in the FOLFIRI-Bev and 59.7 years in the XELIRI-Bev arm, p=0.01). Objective response rate was 51.6% for FOLFIRI-Bev versus 41.2% for XELIRI-Bev (p=0.38). At the median follow-up of 24.5 months, the median progression-free survival (PFS) was not different between two groups (14.2 months in FOLFIRI-Bev vs. not reached in the XELIRI-Bev, p=0.30). However, median overall survival time for the FOLFIRI-Bev arm was better than that for patients treated with XELIRI- Bev, but these differences was not statistically significant (37.8 months vs. 28.7 months, respectively, p=0.58). Most commonly reported grade 3-4 toxicities (FOLFIRI-Bev vs XELIRI-Bev) were nausea/vomiting (7.8% vs. 14.7%, p=0.27), diarrhea (10.9% vs 22.1%, p=0.10), hand-foot syndrome (0% vs 8.8%, p=0.02) and neutropenia (18.7% vs 27.9%, p=0.22).
Our results showed that FOLFIRI-Bev and XELIRI-Bev regimens were similarly effective treatments in a first-line setting for patients with untreated mCRC, with manageable adverse event profiles.
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