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  • Küçük Resim
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    Intramedullary spinal cord metastasis and radiotherapy
    (2018) Benli Yavuz, Berrin; Aktan, Meryem; Kanyilmaz, Gul
    Aim: Intramedullary spinal cord metastasis (ISCM) is a rare but a severe condition. We aimed to evaluate the clinical features, the effect of radiotherapy on the functional results, and the quality of life and survival in patients with ISCM. Material andMethods: We retrospectively assessed the results of 15 patients. Patients underwent 3D conformal radiotherapy (3D-CRT). Patients were reviewed in terms of neurological deficits, the localization of primary tumors, the duration of symptoms, onset symptoms, the localization of ISCM,and the interval between diagnosis and spinal metastasis. Post-radiotherapy outcomes and factors influencing the survival and the quality of life were analyzed. Results: The mean duration of symptoms before diagnosis was 14.93 days (range; 1-52 days).The most common presenting symptoms of patients were lower back and back pain. Neurological deficit was present in 9 patients. Of these patients, partial improvement was observed following the radiotherapy in four patients. After the radiotherapy, the need of painkillers and pain were decreased in 10 of the patients with pain at the outset (66.7%). An association was detected between the initiation of radiotherapy within 10 days from the onset of symptoms and the quality of life (p=0.026).The mean survival rate was 5.9 months after being diagnosed with ISCM. Conclusions: Motor deficit and pain-related quality of life were corrupted in most of the patients with ISCM. Early diagnosis and suitable treatment might promote to the functional condition of the patient. It is important to initiate radiotherapy within a period of less than 10 days from the onset of symptoms.
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    Prognostic factors for survival in adult patients with grade II glial tumors
    (2018) Onder, Hatice; Kanyilmaz, Gul; Aktan, Meryem; Karahacioglu, Eray
    Aim: To investigate survival results of patients with low grade gliomas (LGGs) and to evaluate the predictive role of clinico-pathologic prognostic factors on survival. Material and Methods: Between 2003 and 2014, the adult patients with Grade II glial tumors were evaluated retrospectively. Several variables were investigated to find prognostic factors related with the overall survival (OS) and progression-free survival (PFS). Results: This study involved in 124 patients with median 40 (range; 6-132) months follow up. The average OS for the all patients was 7.8 years. 2-, 5- and 10- year OS ratios were 91%, 73% and 55%, respectively. Patients with low pignatti risk score had a longer OS than high pignatti risk score (p=0.01). Patients with seizure had a better OS (p=0.03). Patients with biopsy/partial resection had a poorer OS (p=0.02). Patients with residue after initial surgery had a worse OS (p=0.03). If the patients had recurrence or progression, the patients had poorer OS (p=0.01). Tumor with malignant transformation (p=0.01) and glioblastoma subtype after second surgery (p=0.003) had a poorer OS. The Pignatti risk score and seizure were the independent prognostic factors for PFS. Conclusion: The extent of surgery and recurrence or progression of Grade II glioma were the independent prognostic factors for OS. The Pignatti risk score and seizure were the independent prognostic factors for PFS.
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    Real-World Long-Term Outcomes of Operated and Non-Operated Rectal Cancer in the Elderly: A 14-Year Retrospective Multicentre Study
    (Wiley, 2025) Demir, Harun; Kanyilmaz, Guel; Babalioglu, Ibrahim; Dogan, Bedriye; Aktan, Meryem; Yavuz, Berrin Benli; Safi, Ayse Sumeyye
    Objective: Surgical resection is the cornerstone of rectal cancer treatment. Following neoadjuvant chemoradiotherapy (nCRT), many patients undergo surgery. Another group of patients may not undergo surgery for various reasons, regardless of nCRT response. This study investigates the differences in clinical characteristics and long-term oncological outcomes of operated and non-operated elderly rectal cancer patients. Methods: This multicentre observational retrospective cohort analysis included 296 elderly patients (169 surgery, 127 non-surgical) treated at three tertiary cancer centres in Turkey between January 2010 and April 2024. Clinicopathologic features and survival outcomes were compared between groups. Results: Patients in the surgery group were younger (p < 0.000) and had better performance scores (p < 0.000). There were no differences in initial clinical (c) T stages or cM stages; however, cN2 patients were more prevalent in the surgical group and cN1 patients were more prevalent in the non-surgical group (p = 0.010). No differences in radiotherapy treatment schedules were observed among the groups. The surgical group received more concurrent (p = 0.046) and adjuvant (p < 0.000) chemotherapy. Patient refusal (63.8%) was the most common reason among non-surgical patients. The surgery group showed better overall survival (OS) (median, 99 vs. 33 months) (p < 0.000), local recurrence-free survival (LRFS) (97.8% vs. 65.8% at 3 years, p < 0.000), and distant metastasis-free survival (DMFS) (80.3% vs. 73.3% at 3 years, p = 0.022). Conclusion: This study shows that elderly rectal cancer patients without surgery had poor survival and tumour control. Surgical resection in rectal cancer is very important and should be strongly recommended for all medically suitable elderly patients.