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Öğe Clinical Evaluation of TNM-7 and TNM-8 Stages in Patients with Non-Small Cell Lung Cancer(2022) Gülmez, Ahmet; Akdeniz, NadiyeObjectives: The AJCC/UICC TNM (tumor, node, metastasis) classification is a system used to describe the anatomical extent and stage grouping of solid malignant tumors. This system provides a worldwide standardization and is updated periodically. In this study, we aimed to compare the staging of patients with operated Non-Small Cell Lung Cancer (NSCLC) according to TNM-7 and TNM-8. Methods: In this study, we retrospectively analyzed data from 113 NSCLC patients resected without neoadjuvant therapy. Patients with another malignancy diagnosis were excluded from the study. Patients with multiple nodules were excluded because a clear TNM classification could not be made. We evaluated patients individually by restaging them using their post-operative pathology reports. Results: The stage distribution according to TNM7 was as follows: IA: 30 (26.5%), IB: 14 (12,3%), IIA: 36 (31,8%), IIB: 16 (14.2%), IIIA: 13 (11,5%), IIIB: 2 (1,7%). Staging the cases according to TNM8, there is no case was down-staged, 60 (53%) were upstaged; most pronounced between stages IIA (TNM7) to IIB (TNM8), and IIB (TNM7) to IIIA (TNM8). Most of the up stages did not change the adjuvant treatment decision. Approximately 6% of patients experienced a change from IB to IIA. Conclusion: In conclusion, a significant stage change was detected in patients whose stages were reevaluated using TNM7 and TNM8. Most of these upgrades do not change the treatment plan. This stage change may affect the adjuvant treatment decision in a small number of patients. With both classification systems, there was no statistical significance for disease-free survival (DFS) among subgroups, but the statistical significance for overall survival (OS).Öğe Clinicopathological Features of Young Gastric Cancer and New Inflammatory Prognostic Markers(2023) Gülmez, Ahmet; Dikilitaş, MustafaINTRODUCTION: This study aimed to evaluate the clinicopathologic features of young gastric cancer (GC) patients and to investigate the factors affecting survival (OS). METHODS: In this study, the data of 55 patients diagnosed under the age of 40 were obtained by retrospective evaluation of hospital records. Clinicopathological features and some laboratory parameters of this patient group and new inflammatory prognostic markers (IPM) obtained from these parameters were evaluated. RESULTS: The mean age of the patients in this study was 33 years. The majority of the patients were male. Patients were evaluated according to human C-erbB2 positivity too. The identified patients as positive were only 7% of all patients. Also, the patients were evaluated for platinum sensitivity too. It was found that 30% of the patients were sensitive to platinum treatments. Also, survival times of the patients were evaluated with IPM. Neutrophil-lymphocyte ratio (NLR), mean platelet volume/platelet count, C-reactive protein/albumin ratios were calculated separately. Survival results were analyzed based on the mean values of all 3 prognostic markers. Even though there was a significant numerical difference, no statistical significance was found. DISCUSSION AND CONCLUSION: This study was conducted to examine the clinicopathological features and survival time of young GC patients. Low C-erbB2 positivity and high platinum resistance were found among this patient population. In addition, inflammatory prognostic markers, which were found to be associated with survival in most cancers, were found to cause significant numerical differences in terms of survival in our study.Öğe Definitif Kemoradyoterapi İle Tedavi Edilen Akciğer Kanseri Hastalarinda Yeni İnflamatuar Prognostik Belirteçler(2022) Yeniceri, Alper; Gülmez, Ahmet; Hakan, HarputluogluPrimer akciğer kanseri dünya çapında en sık görülen kanserdir ve giderek yaygınlaşan bir sorundur. Bu çalışmanın birincil sonlanım noktası; radyoterapi dozu ve nötrofil-lenfosit oranının (NLR) genel sağ kalım (OS) ve progresyonsuz sağ kalım (PFS) üzerindeki etkisini araştırmaktır. Tanı anında evre III A ve evre III B olan, cerrahi tedavi olmayan ve definitif kemoradyoterapi alan 99 hastayı retrospektif olarak inceledik. Hastalara ait cinsiyet, yaş, ECOG durumu, tümör yerleşimi, patolojik alt tip, radyoterapi dozu, kemoterapi tipi, nötrofil/lenfosit oranı (NLR), bazı biyokimyasal parametreler ve PFS ve OS gibi veriler hastaların detaylı dosya taraması yapılarak çalışmaya dahil edildi. Radyoterapi cut-off değeri 60 Gray olarak kabul edildi. OS, 60 Gray ve üzeri dozlarda radyoterapi alan hastalarda istatistiksel anlamlı olacak şekilde daha iyiydi. Radyoterapi dozu 60 Gy’nin altında olan hastalar ve 60 Gray’in üzerinde olan hastalar iki grupta değerlendirildiğinde genel sağ kalım sırasıyla 8.569 ± 1.404 / ay ve 14.326 ± 1.209 / ay idi. (p <0.05). Hastaları NLR’ye göre değerlendirdiğimizde; tanı anında NLR 4’ün altındaki hastaların genel sağ kalımının istatistiksel olarak anlamlı derecede daha iyi olduğu gözlendi. NLO <4.0 ve NLO> 4 olan hastaların genel sağ kalımları sırasıyla 14.32 ± 1.30/ay ve 10.54 ± 1.16/ay idi. (p <0.05)Öğe Effect of Inflammatory Markers on the Pathologic Complete Response in the Neoadjuvan Treatment of HER-2 Positive Local Advanced Breast Cancer(2022) Gülmez, Ahmet; Hakan, HarputluogluObjectives: This study aimed to retrospectively investigate the rate of pathological complete response (pCR) and markers predicting this response for trastuzumab and pertuzumab-containing regimens compared to trastuzumabcontaining regimens for stage II to III HER-2 positive breast cancer (BC). Methods: In this study, we retrospectively analyzed the data of patients with Her-2 positive advanced BC who were treated with trastuzumab or trastuzumab and pertuzumab in addition to neoadjuvant chemotherapy. Patients were classified according to their pre-treatment clinical stages, hormone receptor status, Her-2 immuno-histochemical score, ki-67 index, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and prognostic nutritional index (PNI) ratio. Results: For NLR, it was 1.9±0.85 in patients with pCR and 2.4±0.83 in patients without pCR. For PLR it was 112±53.3 and 129.4±36.2, respectively. For PNI, it was 51.6±5.8 and 48.1±5.9. Low NLR and PLR as well as high PNI were significantly associated with pCR. In addition, the pCR of patients with hormone receptor negativity and dual Her-2 blockade was statistically significant. Conclusion: This is the first study in the literature to show that prognostic scores such as NLR, PLR, and PNI have statistically significant benefits on pCR in patients treated with the neoadjuvant dual blockade.Öğe Factors affecting survival and recurrence in patients with operated non-small cell lung cancer(2023) Gülmez, Ahmet; Elkıran, EminAim: The most serious problem after curative treatment of non-metastatic lung cancer is disease recurrence. This study was designed to detect markers affecting disease recurrence and survival in operated lung cancer patients. Materials and Methods: In this study, the data of 109 patients diagnosed with lung cancer were analyzed retrospectively. Cut-off values for neutrophil-lymphocyte ra- tio (NLR), platelet-lymphocyte ratio (PLR), alkaline phosphatase (ALP), and gamma glutamyl transpeptidase (GGT) were determined by performing ROC Curve analysis. Ac- cording to these cut-off values, the patients were divided into two groups. Based on the cut-off value of the markers, their effects on both overall survival (OS) and disease-free survival (DFS) were examined. Results: In this study, the median OS of the patients was 53.9 months, and the median DFS was 20.6 months. The patients were re-evaluated by targeting the cut-off value of 2.35 for NLR obtained by ROC analysis. Below this value, mOS and mDFS were calculated as 78.2 and 43.2 months, respectively. Above this value, it was determined as 35.6 and 20.6 months, respectively. A similar evaluation was made for the PLR. As a result of the ROC analysis, the cut-off value was determined as 124.7. Below this value, mOS and mDFS were calculated as 72.4 and 36.9 months, respectively. Above this value, it was determined as 41.7 and 21.8 months, respectively. Both results were statistically significant (p<0.05). Conclusion: This study showed that NLR and PLR predict statistical significance for OS and DFS.
