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    Efficacy of sorafenib in advanced differentiated and medullary thyroid cancer: experience in a Turkish population
    (Dove Medical Press Ltd, 2015) Benekli, Mustafa; Yalcin, Suayib; Ozkan, Metin; Elkiran, Emin Tamer; Sevinc, Alper; Cabuk, Devrim; Coskun, Hasan Senol
    Background: Antivascular endothelial growth factor tyrosine kinase inhibitors have been used recently in the treatment of advanced differentiated thyroid cancer (DTC) and medullary thyroid cancer (MTC). Off-label sorafenib is used in Turkey with special permission by the Ministry of Health for this indication. Patients and methods: Patients with advanced DTC and MTC were retrospectively identified from the Turkish Ministry of Health database. Data on these patients were prospectively collected before permission is granted to use sorafenib. Results: Thirty patients with complete data were analyzed: 14 DTC (papillary number [n] = 10; follicular n=4) and 16 MTC. The median age of the patients was 57 years (range: 28-79 years), and there were 18 males and 12 females. All DTC patients were iodine refractory and had received a median three doses of radioactive iodine (range: 1-7 doses). Sorafenib was used for a median of 12 months (range: 1-49 months). The overall response rate was 20%, all partial responses, with no complete response. The overall response rate was 14% in DTC and 25% in MTC patients. The median progression-free survival (PFS) was 17.1 months (95% confidence interval [CI]: 7.3-26.8) and overall survival (OS) was not reached. The 2-year PFS and OS were 39% and 68%, respectively. DTC and MTC patients had similar survival outcomes: median PFS of 21.3 months (95% CI: 5.8-36.7) versus 14.5 months (95% CI: 3.7-25.2), respectively (P=0.36), with the median OS not reached in either group (P=0.17). Tumor marker levels did not have any prognostic or predictive role. The toxicity profile was similar to that of other sorafenib trials. Conclusion: Sorafenib is an effective and well-tolerated treatment in advanced thyroid cancers.
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    Epidemiology of colorectal cancer in Turkey: A cross-sectional disease registry study (A Turkish Oncology Group trial)
    (Aves, 2015) Aykan, Nuri Faruk; Yalcin, Suayib; Turhal, N. Serdar; Ozdogan, Mustafa; Demir, Gokhan; Ozkan, Metin; Yaren, Arzu
    Background/Aims: This study aimed to determine the epidemiological characteristics of colorectal cancer in Turkey. Materials and Methods: In this multicenter, prospective, and cross-sectional registry study, data for 968 patients with colorectal cancer from 21 centers in 7 geographic regions were analyzed. Results: Diagnosis was colon cancer in 662 (68.4%) and rectum cancer in 306 (31.6%) patients. In total, 60.9% of patients was male; mean age was 58.9 +/- 12.6 years. Among patients, 15.0% was drinking alcohol, 17.5% was smoking, 1.5% had familial history of polyposis, 15.0% had diabetes mellitus, 1.0% had inflammatory bowel disease. Fruit and vegetable consumption was low (<3 times/week) in 35.5% and red meat consumption was high (>= 3 times/week) in 47.4% of the patients. Median time-to diagnosis was 3.0 months and 4.0 months for patients with colon and rectum cancer, respectively. Mean body mass index was >25 in all group of patients. Distal rectum (61.3%) and sigmoid colon (36.8%) were the most common locations of cancer, for rectum and colon respectively. In total, 85.6% of patients were operated; 25.8% had emergency surgery. Low anterior resection rate was 64.2% in rectum cancer. In majority (89.8%) of the patients with rectum cancer who received preoperative treatment, conventional chemo-radiotherapy regimen was given. pTNM staging at diagnosis showed that stage III and IV patients were in majority (35.9% and 29.7%, respectively). Conclusion: Colon cancer is more frequent than rectum cancer in Turkey. Colorectal cancer patients are diagnosed at later stages. Most of the cases were operated. Interregional differences for risk factors are worthwhile for evaluation in future trials.
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    Serum tumor markers and their prognostic value in Turkish hepatocellular cancer patients
    (2020) Lacin, Sahin; Yalcin, Suayib
    Aim: Association between serum tumor markers and hepatocellular cancer (HCC) patients' survival has been investigating for decades. Despite glypican 3 has been reported superior to AFP in predicting the prognosis of HCC patients recently, the prognostic value of glypican 3 not clear. We aimed to investigate the prognostic value of serum glypican 3 and its relationship with the characteristic features in the Turkish HCC patients' cohort.Material and Methods: A total of 84 HCC patients were enrolled prospectively. Serum glypican 3 levels were analyzed and serum levels of glypican 3 were compared according to many different types of the clinicopathologic features of HCC.Results: A total of 84 patients, 71 of the patients were male and 13 were female. There were 36 hepatitis B (HBV) and 8 hepatitis C (HCV) infected patients. Forty-eight patients had cirrhosis and 35 patients did not. Serum glypican 3 levels were lower in cirrhotic than non-cirrhotic patients (p =0.6). Difference between overall survival (OS) of patients with serum glypican 3 levels ≥ 2 ng/mL and patient with serum glypican 3 level 2 ng/mL was not significant, the OS estimates were 7.8 and 6.1 months, respectively (p=0.3). The median OS was 7.38 months. There was a positive correlation between serum AFP level and glypican 3, but not statistically significant (p=0.07). Conclusion: The study results indicate that serum glypican 3 level is elevated in HCC patients with poorer features. Therefore, despite nonsignificant results, the method that contains the prediction of HCC patients' survival by serum glypican 3 level needs to be clarified with larger trials.