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Öğe Assessment of general characteristics of patients with primary metastatic breast carcinoma: single center experience(Termedia Publishing House Ltd, 2013) Üyeturk, Ümmügül; Budakoğlu, Burçin; Türker, İbrahim; Helvacı, Kaan; Sönmez, Özlem Uysal; Aktaş, Gülali; Arslan, Ülkü Yalçıntaş; Öksüzoğlu, Ömür Berna ÇakmakIntroduction: Breast cancer (BC) is a heterogeneous disease. Several subgroups have been identified, according to the clinical presentation and radiographic, pathological, biological, and molecular characteristics of the tumor. Intrinsic genetic heterogeneity may be responsible for these differences. To date, little is known about the clinical features and outcome of patients with primary metastatic BC (PMBC) defined as those presenting with stage IV disease. Material and methods: Between September 2007 and May 2011, BC patients who were admitted to a clinic were assessed. Patients with PMBC were included in this retrospective analysis. The patients' demographic characteristics, treatment schedules, and survival data were recorded. Results: Of 2478 BC patients, 102 (4.1%) with PMBC were included in the analysis. The median age of the patients was 50 (26-90) years. Only four patients (3.9%) had previously undergone mammography. The median progression-free survival (PFS) and overall survival (OS) were 30 and 66 months, respectively. The PFS and OS were unaffected by age, menopausal status, ECOG, histology, or tumor grade. Both PFS and OS were affected by HR status (log rank p = 0.006, log rank p = 0.04), HER2 status (p = 0.001, p = 0.005), site of metastasis (p = 0.01, p = 0.04), radiotherapy (p = 0.04, OS p = 0.03), and bisphosphonate treatment (p = 0.02, p = 0.006). PFS was greater in the hormone therapy group (43 months, p = 0.03) while OS was greater in the patients that received chemotherapy (76 months, p = 0.01). Conclusions: Mammography should be given greater emphasis, considering its importance in the prevention of PMBC. As a treatment option for bone and soft tissue metastatic PMBC patients, hormone therapy should be effective as a first-line treatment.Öğe Effect of hypericin on the ADAMTS-9 and ADAMTS-8 gene expression in MCF7 breast cancer cells(Verduci Publisher, 2013) Ocak, Zeynep; Acar, Muradiye; Gündüz, E.; Gündüz, Mehmet; Demircan, Kadir; Üyeturk, Ümmügül; Özlü, TülayAIM: To investigate the effects of hypericin which is obtained from the plant Hypericum perforatum on the expression and the regulation of ADAMTS8 and ADAMTS9 genes in MCF7 breast cancer cells and on the viability of these cells. MATERIALS AND METHODS: MCF7 cells were cultured and were separately exposed to 2, 10 and 50 mu l/mL of hypericin. After 24 hours, RNA was isolated from these cells and converted to cDNA. The expression levels of ADAMTS8 and ADAMTS9 genes were evaluated using the Reverse Transcription Polymerase Chain Reaction. XTT (2,3-bis-( 2-methoxy-4-nitro-5-sulfophenyl)-2Htetrazolium-5-carboxanilide, disodium salt) cell viability assay was used to determine cytotoxicity. RESULTS: ADAMTS9 expression in MCF7 cells were increased 1.8 and 3.6 fold with the use of 2 and 10 mu l/mL of hypericin, respectively; and decreased 0.7 fold with the use of 50 mu l/mL of hypericin. There was no significant change in the ADAMTS8 expression. Rapid cell death was observed in the cancer cells when hypericin was used at a dose of >= 50 mu l/mL. CONCLUSIONS: The increase in ADAMTS9 expression can be a useful factor in the prevention of possible metastasis in breast cancer and for the occurrence of a tumor suppressive effect. Hypericin increases the expression of ADAMTS9, therefore, it may show its antitumoral and anti-apoptotic effects by means of ADAMTS9.Öğe Factors affecting survival in upfront metastatic breast carcinoma patients(Amer Soc Clinical Oncology, 2012) Üyeturk, Ümmügül; Budakoğlu, Burçin; Türker, İbrahim; Helvacı, Kaan; Sönmez, Özlem UysalMetastatic breast cancer is a heterogenous disease. There are several subgroups according to pathological, biological and molecular behaviours of the tumor. Recurrent metastatic breast carcinoma (RMBC) and upfront metastatic breast carcinoma (UMBC) may differ according to clinical and prognostic characteristics. Intrinsic genetic heterogeneity may be responsible for these differences. To date, little is known about the clinical features and outcome of patients with UMBCÖğe Isolated ovarian metastasis of gastric cancer: Krukenberg tumor(Termedia Publishing House Ltd, 2013) Üyeturk, Ümmügül; Arslan, Şerife Hülya; Bal, Öznur; Arslan, Ülkü Yalçıntaş; Öksüzoğlu, Ömür Berna ÇakmakIntroduction: Gastric cancer, one of the most common cancers in the world, rarely metastasizes to the ovaries. Ovarian metastases of gastric signet ring cell cancer (SRCC) are referred to as Krukenberg tumors and account for 1-2% of all ovarian cancers. Here, we analyze the characteristics, treatment, and prognosis of patients with Krukenberg tumors. Material and methods: We retrospectively analyzed the demographic characteristics, treatment modalities, progression-free survival (PFS), and overall survival (OS), of patients who were diagnosed with Krukenberg tumors of gastric cancer origin and who underwent treatment and follow-up between January 2005 and January 2012 in the Ankara Oncology Education and Research Hospital. Results: Among 1755 patients diagnosed with gastric cancer between January 2005 and January 2012, eight patients (0.45%) with histopathologically identified Krukenberg tumors were enrolled. The median age of the eight patients was 42.2 years (range, 32-69 years). Two (25%) of the patients were stage 3A, two (25%) were stage 3C, and four (50%) were stage 4 at the time of diagnosis. The median PFS was 13.2 months (1-25 months), the median OS after the original diagnosis was 16.7 months (1-41 months), and the median OS after ovarian metastasis Was 3.6 months (1-10 months). Discussion: Krukenberg tumors were seen particularly in young patients and More frequently during the premenopausal period. The prognosis was poor. when only the ovaries were affected, metastasectomy prolonged the survival time.Öğe Prognostic factors and clinical outcome of patients with Ewing's sarcoma family of tumors in adults : multicentric study of the Anatolian Society of Medical Oncology(Humana Press Inc, 2013) Arpacı, Erkan; Yetişyiğit, Tarkan; Şeker, Metin; Uncu, Doğan; Üyeturk, ÜmmügülThe aim of this study was to evaluate prognostic factors, survival rate and the efficacy of the treatment modalities used in patients with Ewing sarcoma family of tumors (ESFT). Data of patients with ESFTs followed up at different cancer centers in Turkey between 2001 and 2010 were retrospectively analyzed. The median age of 114 patients was 26 years (range 14-66). The median follow-up was 20 months (range 1-118 months). Tumor size was between 1.5 and 14 cm (median 8 cm). Eighty-six percent of patients had localized disease at presentation, and 14 % had metastatic disease. Local therapy was surgery alone in 31 % of patients, surgery combined with radiotherapy in 41 % and radiotherapy alone in 18 %. Approximately 70 % of patients were treated with vincristine, doxorubicin, cyclophosphamide and actinomycin-D, alternating with ifosfamide and etoposide every 3 weeks. In patients with localized disease at presentation, the 5-year disease-free survival and overall survival were 60 and 65 %, respectively. At univariate analysis, patients with tumor size >= 8 cm, high serum lactate dehydrogenase, metastasis at presentation, poor histological response to chemotherapy and positive surgical margin had significantly worse event-free survival. The significant predictors of worse overall survival at univariate analysis were tumor size <= 8 cm, high lactate dehydrogenase, metastasis at presentation, poor histological response to chemotherapy, radiotherapy only as local treatment and positive surgical margin. ESFTs are aggressive tumors with a high incidence of local recurrence and distant metastasis. Multimodality treatment consisting of adequate surgical resection, aggressive chemotherapy (VAC alternating with IE) and radiotherapy is recommended for patients with ESFTs.
