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Öğe Amenore ile seyreden De Morsier Sendromu: Olgu sunumu(2015) Kutlu, Orkide; Şahin, İbrahim; Sakin, Abdullah; Evren, BahriÖz: Septa Optik Displazi, De Morsier Sendromu olarak da bilinen nadir bir konjenital durumdur. Sendromun klasik triadındaki bulgular; beyin orta hat yapılarında anomaliler, optik sinir hipoplazisi ve hipofiz hormon disfonksiyonlarıdır. Triaddaki bulguların en az ikisinin bulunması ile tanı konulur. Burada primer amenore ile gelen ve de Morsier sendromu tanısı konulan bir olguyu sunduk. Optik sinir hipoplazisi, hipofizer yetmezlik veya beyin orta hat yapılarda anomali saptanması durumunda triada ait diğer bulguları araştırmalıdır ve gereğinde hormon replasman tedavileri başlanmalıdır.Öğe The efficacy and reliability of sequential adjuvant anthracycline-based chemotherapy and weekly paclitaxel regimen in human epidermal growth factor receptor 2 negative breast cancer: A retrospective analysis of a multicentre study(Imprimatur Publications, 2019) Kaplan, Muhammet Ali; Oruc, Zeynep; Gumus, Mahmut; Ozaydm, Sukru; Elkiran, Emin Tamer; Dine, Nur Sener; Sakin, AbdullahPurpose: To analyze the reliability and the effectiveness of chemotherapy and prognostic factors for survival in patients with HER2 (human epidermal growth receptor 2) negative early-stage breast cancer treated with adjuvant sequential anthracycline-based chemotherapy and paclitaxel. Methods: This analysis retrospectively evaluated the medical records of 756 HER2 negative early-stage breast cancel-patients who received adjuvant sequential anthracycline-based chemotherapy and weekly paclitaxel in 15 medical oncology centers in Turkey between 2008-2015. Estrogen receptor (ER), progesterone receptor (PR), HER2, age, tumor size and grade, nodal status, perineural and lymphatic invasion, disease-free survival (DFS) and overall survival (OS) were analyzed. Results: The median patient age was 50 years (22-82). Median follow up period was 46 months (13-82). The rates of recurrence and death detected in this period were 14.8% and 7.4%, respectively.Median OS and PFS were not reached in this period. Five-year DFS and OS rates were 87% and 89%, respectively. Age (OR:0.35, 95%CI 0.12-0.96, p=0.04), PR status (OR:.0.44, 95%CI 0.18-1, p=0.05), lymphatic invasion (OR:.2.6, 95%CI 0.97-7.4, p=0.05) were independent prognostic factors.Most common grade 3-4 toxicides were fatigue (6.7%), neutropenia (1.7%) and nausea (1.3%). Neutropenic fever developed in 1.8% o f the patients and peripheral neuropathy in 16.9%. Dose reduction was necessary for 10%of the patients due to grade 3-4 toxicity, whereas postponement of chemotherapy was neccessary for 7% of the patients. Conclusions: This multicentric retrospective study confirmed that sequential adjuvant therapy with anthracycline-based chemotherapy and paclitaxel for HER2 negative breast cancer is an effective and reliable regimen.Öğe Gastric Hepatoid Adenocarcinoma: A Case Report and Literature Update(2015) Ecirli, Şamil; Akgül, Yavuz Sultan Selim; Kutlu, Orkide; Güngör, Gökhan; Sakin, AbdullahAbstract:Hepatoid adenokarsinomalar (HAC) çok nadir rastlanan ve oldukça kötü prognozlu ekstrahepatik tümörlerdir. Bu tümörlerin büyük çoğunluğu serumda AFP yüksekliği ile tanınmaktadır. İnsidansı en sık görüldüğü Uzakdoğu için gastrik tümörlerin %1,3-15 olarak bildirilmiş, diğer bölgelerden vakalar şeklinde bildirim mevcuttur. İyi differansiye papiller/tubuler ve poligonal hücrelerden oluşan medüller tip olmak üzere iki tipi tanımlanmıştır. AFP, CEA, CK7 ve CK20 nin survi üzerine etkisi gösterilmiştir. HAC lar da klasik mide adenokarsinomaları gibi tedavi edilmeye çalışılır. Adjuvan kemo-radyoterapi verilebilir. Midenin hepatoid adenokanseri kötü prognozludur. Genellikle tanı konduğunda metastatik olup, ortalama yaşam beklentisi 4,7 aydır. Burada kliniğimizde hepatoid adenokarsinoma tanısı koyduğumuz ve kemoterapiye dirençli hastamızı nadir rastlanması sebebi ile sunduk.Öğe Gastric Hepatoid Adenocarcinoma: A Case Report and Literature Update(2015) Ecirli, Şamil; Akgül, Yavuz Sultan Selim; Kutlu, Orkide; Güngör, Gökhan; Sakin, AbdullahAbstract:Hepatoid adenokarsinomalar (HAC) çok nadir rastlanan ve oldukça kötü prognozlu ekstrahepatik tümörlerdir. Bu tümörlerin büyük çoğunluğu serumda AFP yüksekliği ile tanınmaktadır. İnsidansı en sık görüldüğü Uzakdoğu için gastrik tümörlerin %1,3-15 olarak bildirilmiş, diğer bölgelerden vakalar şeklinde bildirim mevcuttur. İyi differansiye papiller/tubuler ve poligonal hücrelerden oluşan medüller tip olmak üzere iki tipi tanımlanmıştır. AFP, CEA, CK7 ve CK20 nin survi üzerine etkisi gösterilmiştir. HAC lar da klasik mide adenokarsinomaları gibi tedavi edilmeye çalışılır. Adjuvan kemo-radyoterapi verilebilir. Midenin hepatoid adenokanseri kötü prognozludur. Genellikle tanı konduğunda metastatik olup, ortalama yaşam beklentisi 4,7 aydır. Burada kliniğimizde hepatoid adenokarsinoma tanısı koyduğumuz ve kemoterapiye dirençli hastamızı nadir rastlanması sebebi ile sunduk.Öğe Gastrik hepatoid adenokarsinoma: olgu sunumu ve literatür güncellemesi(İnönü Üniversitesi Tıp Fakültesi Dergisi, 2015) Ecirli, Şamil; Akgül, Yavuz Sultan Selim; Kutlu, Orkide; Güngör, Gökhan; Sakin, AbdullahHepatoid adenokarsinomalar (HAC) çok nadir rastlanan ve oldukça kötü prognozlu ekstrahepatik tümörlerdir. Bu tümörlerin büyük çoğunluğu serumda AFP yüksekliği ile tanınmaktadır. İnsidansı en sık görüldüğü Uzakdoğu için gastrik tümörlerin %1,3–15 olarak bildirilmiş, diğer bölgelerden vakalar şeklinde bildirim mevcuttur. İyi differansiye papiller/tubuler ve poligonal hücrelerden oluşan medüller tip olmak üzere iki tipi tanımlanmıştır. AFP, CEA, CK7 ve CK20 nin survi üzerine etkisi gösterilmiştir. HAC lar da klasik mide adenokarsinomaları gibi tedavi edilmeye çalışılır. Adjuvan kemo-radyoterapi verilebilir. Midenin hepatoid adenokanseri kötü prognozludur. Genellikle tanı konduğunda metastatik olup, ortalama yaşam beklentisi 4,7 aydır. Burada kliniğimizde hepatoid adenokarsinoma tanısı koyduğumuz ve kemoterapiye dirençli hastamızı nadir rastlanması sebebi ile sunduk.Öğe Mitotic Activity in Gastrointestinal Stromal Tumors: Can we use Phosphohistone H3 Immunohistochemistry Instead of Hematoxylin and Eosin for Mitotic Count?(Kare Publ, 2022) Erhan, Selma Sengiz; Sensu, Sibel; Keser, Sevinc Hallac; Kangal, Elis; Gul, Aylin Ege; Gundogan, Gokcen Alinak; Sakin, AbdullahObjectives: In gastrointestinal stromal tumors (GIST), malignancy potential is determined by the prognostic disease risk stratification based on mitosis, tumor size, and location. Phosphohistone H3 (PHH3) is an immunohistochemical marker showing mitotic activity in cells. In this study, we aimed to evaluate mitosis in GIST with PHH3, compare the results with hematoxylin and eosin (HE) stained slides, and examine its relationship with other prognostic data. Methods: Clinicopathological findings and survival were determined in GIST cases diagnosed between 2006 and 2017. The prognostic risk score was calculated according HE- and PHH3-based mitosis. The cases were classified as Group I: HE + and PHH3 + and Group II: HE + and PHH3-. They were also grouped as those diagnosed before and after 2012 and the staining results of HE and PHH3 were re-analyzed. Results: Ninety-eight cases were included in the study. Mitosis was detected with both HE and PHH3 in 63.3% of the cases (62/98 cases) (Group I) while in 36.7% of cases, it was detected with HE but not with PHH3 (Group II). In only two cases, the risk score changed with PHH3 (very low -> intermedier grade). The ratio of HE + and PHH3 + cases in 2012 and after was significantly higher than HE + and PHH3 - cases. A statistically significant relation was found between HE- and PHH3-based risk scores (p<0.05). There was a significant difference between HE-based risk score groups in terms of survival (p<0.05), while no difference was observed between the PHH3-based risk score groups (p>0.05). Conclusion: In GIST cases, PHH3 can be used to determine mitosis in more recent blocks, taking into account the technical conditions of the laboratory, but it does not seem to be superior to mitosis detected by HE. Research should continue on new survival determinants for GIST.Öğe Prognostic factors of perioperative FLOT regimen in operable gastric and gastroesophageal junction tumors: real-life data (Turkish Oncology Group)(Tubitak Scientific & Technological Research Council Turkey, 2022) Erol, Cihan; Sakin, Abdullah; Basoglu, Tugba; Ozden, Ercan; Cabuk, Devrim; Dogan, Mutlu; Oksuzoglu, BernaBackground/aim: Perioperative FLOT regimen is a standard of care in locally advanced operable gastric and GEJ adenocarcinoma. We aimed to determine the efficacy, prognostic factors of perioperative FLOT chemotherapy in real-life gastric and GEJ tumors. Materials and methods: The data of patients who were treated with perioperative FLOT chemotherapy were retrospectively analyzed from 34 different oncology centers in Turkey. Baseline clinical and demographic characteristics, pretreatment laboratory values, histological and molecular characteristics were recorded. Results: A total of 441 patients were included in the study. The median of age our study population was 60 years. The majority of patients with radiological staging were cT3-4N(+) (89.9%, n = 338). After median 13.5 months (IQR: 8.5-20.5) follow-up, the median overall survival was NR (95% CI, NR to NR), and median disease free survival was 22.9 (95% CI, 18.6 to 27.3) months. The estimated overall survival at 24 months was 62%. Complete pathological response (pCR) and near pCR was achieved in 23.8% of all patients. Patients with lower NLR or PLR have significantly longer median OS (p = 0.007 and p = 0.033, respectively), and patients with lower NLR have significantly longer median DFS (p = 0.039), but PLR level did not affect DFS (p = 0.062). The OS and DFS of patients with better ECOG performance scores and those who could receive FLOT as adjuvant chemotherapy instead of other regimens were found to be better. NLR was found to be independent prognostic factor for OS in the multivariant analysis. At least one adverse event reported in 57.6% of the patients and grade 3-4 toxicity was seen in 23.6% patients. Conclusion: Real-life perioperative FLOT regimen in operable gastric and GEJ tumors showed similar oncologic outcomes compared to clinical trials. Better performance status, receiving adjuvant chemotherapy as same regimen, low grade and low NLR and PLR improved outcomes in real-life. However, in multivariate analysis, only NLR affected OS.Öğe Real life experience of patients with locally advanced gastric and gastroesophageal junction adenocarcinoma treated with neoadjuvant chemotherapy: a Turkish oncology group study(Taylor & Francis Ltd, 2023) Basoglu, Tugba; Sakin, Abdullah; Erol, Cihan; Ozden, Ercan; cabuk, Devrim; Cilbir, Ebru; Tataroglu ozyukseler, DenizNeoadjuvant chemotherapy (NACT) in gastroesophageal junction (GEJ) and gastric cancer (GC) was shown to improve survival in recent studies. We aimed to share our real-life experience of patients who received NACT to compare the efficacy and toxicity profile of different chemotherapy regimens in our country. This retrospective multicentre study included locally advanced GC and GEJ cancer patients who received NACT between 2007 and 2021. Relation between CT regimens and pathological evaluation were analysed. A total of 794 patients from 45 oncology centers in Turkey were included. Median age at the time of diagnosis was 60 (range: 18-86). Most frequent NACT regimens used were FLOT (65.4%), DCF (17.4%) and ECF (8.1%), respectively. In the total study group, pathological complete remission (pCR) rate was 7.2%, R0 resection rate 86.4%, and D2 dissection rate was 66.8%. Rate of pCR and near-CR (24%), and R0 resection (84%) were numerically higher in FLOT arm (p > 0.05). Patients who received FLOT had also higher chemotherapy-related toxicity rate compared to patients who received other regimens (p > 0.05). Median follow-up time was 16 months (range: 1-154 months). Estimated median overall survival (OS) was 58.4months (95% CI: 35.2-85.7) and disease-free survival (DFS) was 50.7 months (95% CI: 25.4-75.9). The highest 3-year estimated OS rate was also shown in FLOT arm (68%). We still do not know which NACT regimen is the best choice for daily practice. Clinicians should tailor treatment regimens according to patients' multifactorial status and comorbidities for to obtain best outcomes. Longer follow-up period needs to validate our results.
