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    THE ALBUMIN-GLOBULIN RATIO PREDICTING MORTALITY IN GASTRIC CARCINOMA
    (Carbone Editore, 2016) Aksoy, Asude; Durak, Serdar; Ozturk, Turkan; Avci, Nilufer; Cirak, Yalcin; Deger, Ayse Nur; Bilgic, Yilmaz
    Introduction: The potential effects of serum albumin and albumin-globulin rate on survival were investigated in patients with gastric carcinoma. Materials and methods: The biochemical values of 204 patients under chemotherapy evaluation were obtained retrospectively from archive data. Albumin-globulin ratio values were calculated using albumin/total protein-albumin formula. The values of albumin-globulin ratio and albumin were categorized as 3 groups using receiver operating characteristic analysis and a descending order. Results: The calculated cut-off value for albumin-globulin ratio was 1.14: 34.4-79.7 by receiver operating characteristic. The median survival was 20.7 months (15.9-25.5), 20.1 months (15.1-25.1), 16 months (11.8-20.1), respectively in 1st, 2nd, 3rd groups for albumin-globulin ratio (p=0.46). The median overall survival was 18.3 months (123-24.2), 21.6 months (16.8-26.3), 18.01 months (13.5-22.4) in 1st, 2nd, 3rd groups for albumin, respectively (p=0.52). There were no statistical significant differences by Kaplan-Meier method for albumin-globulin ratio, albumin p>0.05. The effects of clinicopathological and biochemical characteristics on mortality were assessed by Cox-proportional hazard regression analysis. The independent predictors of mortality were observed high grade, the presence of perineural invasion of the tumor, high nodal involvement (p:0.01, p:0.001, p:0.01), respectively. Conclusion: Albumin-globulin ratio and albumin values alone may not be useful parameters to predict mortality and survival in patients with gastric carcinoma.
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    Predictive and Prognostic Factors in Ovarian and Uterine Carcinosarcomas
    (Galenos Publ House, 2016) Cicin, Irfan; Ozatli, Tahsin; Turkmen, Esma; Ozturk, Turkan; Ozcelik, Melike; Cabuk, Devrim; Gokdurnali, Ayse
    Background: Prognostic factors and the standard treatment approach for gynaecological carcinosarcomas have not yet been clearly defined. Although carcinosarcomas are more aggressive than pure epithelial tumours, they are treated similarly. Serous/clear cell and endometrioid components may be predictive factors for the efficacy of adjuvant chemotherapy (CT) or radiotherapy (RT) or RT in patients with uterine and ovarian carcinosarcomas. Heterologous carcinosarcomas may benefit more from adjuvant CT. Aims: We aimed to define the prognostic and predictive factors associated with treatment options in ovarian (OCS) and uterine carcinosarcoma (UCS). Study Design: Retrospective cross-sectional study Methods: We retrospectively reviewed the medical records of patients with ovarian and uterine carcinosarcoma from 2000 to 2013, and 127 women were included in this study (24 ovarian and 103 uterine). Patients admitted to seventeen oncology centres in Turkey between 2000 and December 2013 with a histologically proven diagnosis of uterine carcinosarcoma with FIGO 2009 stage I-III and patients with sufficient data obtained from well-kept medical records were included in this study. Stage IV tumours were excluded. The patient records were retrospectively reviewed. Data from 104 patients were evaluated for this study. Results: Age (>= 70 years) was a poor prognostic factor for UCS (p=0.036). Pelvic +/- para aortic lymph node dissection did not affect overall survival (OS) (p=0.35). Macroscopic residual disease was related with OS (p<0.01). The median OS was significantly longer in stage I-II patients than stage III patients (p=0.03). Adjuvant treatment improved OS (p=0.013). Adjuvant radiotherapy tended to increase the median OS (p=0.075). However, this tendency was observed in UCS (p=0.08) rather than OCS (p=0.6). Adjuvant chemotherapy had no effect on OS (p=0.15). Adjuvant radiotherapy significantly prolonged the median OS in patients with endometrioid component (p=0.034). A serous/clear cell component was a negative prognostic factor (p=0.035). Patients with serous/clear cell histology for whom adjuvant chemotherapy was applied had significantly longer OS (p=0.019), and there was no beneficial effect of adjuvant radiotherapy (p=0.4). Adjuvant chemotherapy was effective in heterologous tumours (p=0.026). In multivariate analysis, the stage and chemotherapy were prognostic factors for all patients. Age was an independent prognostic factor for UCS. However, serous/clear cell histology and radiotherapy tended to be significant prognostic factors. Conclusion: The primary location, the histological type of sarcomatous and the epithelial component may be predictive factors for the efficacy of chemotherapy or radiotherapy in UCS and OCS.
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    Treatment preferences in stage IA and IB testicular seminoma: multicenter study of Anatolian Society of Medical Oncology
    (Springer, 2015) Bilici, Ahmet; Ozturk, Turkan; Turkmen, Esma; Odabas, Hatice; Cihan, Sener; Selcukbiricik, Fatih; Erdogan, Bulent
    Approximately 75 % of patients with testicular seminoma present with stage I disease, and the probability of long-term survival approaches 100 %. However, the standard adjuvant treatment for stage I seminoma patients remains controversial, and there is no uniform consensus in the literature. The present study was performed to evaluate treatment preference and outcomes for men with stage I testicular seminoma. From 1997 to 2013, 282 patients with histologically confirmed stage IA and IB testicular seminoma who underwent orchiectomy were included. The outcomes of three management options and survivals were retrospectively analyzed. The prognostic significance of risk factors for relapse on survival was evaluated by univariate and multivariate analysis; in addition, the factors predicting relapse were also evaluated by logistic regression analysis. Of the 282 patients with stage I seminoma, 130 (46.1) received adjuvant radiotherapy (RT), 80 (28.4 %) were treated with adjuvant carboplatin, while the remaining 72 patients (25.5 %) underwent surveillance. At the time of analysis, the median follow-up period of 38.5 months; relapses were observed in 16 patients (22.3 %) on surveillance, in one patient (1.2 %) treated with adjuvant carboplatin and in ten patients (%7.7) who received adjuvant RT. The 5-year disease-free survival (DFS) rate for patients who underwent surveillance was worse than those of patients treated with adjuvant carboplatin and RT (64.2 vs. 97.7 vs. 91.9 %, respectively; p < 0.001). However, the 5-year overall survival (OS) rate for patients on surveillance was similar compared with the adjuvant treatment groups (100 vs. 92.3 vs. 97.4 %, respectively; p = 0.44). Univariate analysis showed that only the treatment approach (surveillance vs. adjuvant carboplatin vs. adjuvant RT) for DFS (p < 0.001), invasion of the rete testis (p = 0.041) and the presence of relapse (p < 0.001) for OS were important prognostic indicators. Multivariate analysis indicated that the treatment strategy for DFS (p < 0.001, HR 0.34) was an independent prognostic factor. Furthermore, a logistic regression analysis showed that adjuvant treatment was found to be an independent factor for predicting relapse (p = 0.004, odds ratio: 0.39). Our results indicate that adjuvant treatment with carboplatin or RT is associated with improved DFS compared with surveillance for men with stage I testicular seminoma after orchiectomy. Moreover, the treatment strategy is an important prognostic indicator for DFS and a predictive factor for relapse. Although adjuvant treatment, especially carboplatin, seems to be a suitable treatment for patients with risk factors for relapse, surveillance is still feasible and the preferred management option after radical orchiectomy in men with stage I seminoma. More reliable predictive factors are needed to make treatment decisions.