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Öğe Clinical outcomes and prognostic factors of adult's Ewing sarcoma family of tumors: single center experience(Termedia Publishing House Ltd, 2016) Üyetürk, Ümmügül; Helvacı, Kaan; Demirci, Ayşe; Sönmez, Özlem Uysal; Türker, İbrahimAim of the study was to investigate the demographics of Ewing sarcoma family of tumours (ESTF) patients, treatment alternatives, clinical outcomes, and prognostic factors for survival. Material and methods: We retrospectively reviewed 39 patients with ESFT who were admitted to our institute between September 2008 and September 2012. Results: The patients included 32 (82.1%) males and seven (17.9%) females of median age 24 (range, 18-66) years. Among the 27 patients with a primary osseous localization, 17 (43.5%) had a central axis localization. Fifteen patients (38.5%) had metastases at the time of diagnosis. Patients were followed up for a median period of 18 (range, 2-134) months. The median event-free survival (EFS) was 23 (range, 1-64) months, and the 1- and 4-year EFS were 60% and 48%, respectively. The median overall survival (OS) was 91 (range, 1-188) months, and the 1- and 4-year OS were 78% and 54%, respectively. Gender, age, primary tumor site, and local treatment modalities, either alone or in combination, did not have a significant effect on OS (p = 0.210, p = 0.617, p = 0.644, and p = 0.417, respectively). In contrast, osseous site of peripheral localization, limited stage, and metastasis to the bone significantly affected OS (p = 0.015, p < 0.001, and p = 0.042, respectively). Conclusions: ESFTs are aggressive tumors with a high rate of relapse and metastatic potential. Patients with peripheral bone involvement and limited stage had a good prognosis. Appropriate surgical resection, radiotherapy, and aggressive chemotherapy regimens are recommended.Öğe Long-term outcomes of prolonged bisphosphonates more than 2 years in bone metastatic breast cancer: risk vs benefit(Springer London Ltd, 2020) Bal, Öznur; Öksüzoğlu, Berna; Doğan, Mutlu; Durnalı, Ayşe; Üyetürk, Ümmügül; Demirci, Ayşe; Arslan, Ülkü YalçıntaşBackground Bisphosphonates are the mainstay therapeutic options for prevention of skeletal-related events and generally used for up to 2 years in bone metastatic cancer patients. Aim We aimed to evaluate the long-term outcomes of prolonged (> 2 years) bisphosphonate usage in bone metastatic breast cancer (BMBC) patients. Methods Ninety-nine BMBC patients who had prolonged bisphosphonates were evaluated retrospectively for long-term outcomes and survival rates. Results Median duration of bisphosphonate therapy was 46.8 (24-198) months. Seven patients had bisphosphonate-related adverse events (osteonecrosis of the jaw (ONJ) (n= 6), ONJ and renal failure (n= 1)). Bisphosphonate was switched to another one because of bone metastasis progression in more than one-third of the patients (n= 36, 36.3%). The patients who had bisphosphonate switch therapy had statistically significant longer overall survival (p< 0.01). Neither duration nor type of bisphosphonates had effect on frequency of bisphosphonate-related adverse events. Conclusion Bisphosphonates might be prolonged for more than 2 years in BMBC patients with an acceptable toxicity profile. In addition, bisphosphonates switch therapy should be preferred in those with progressive bone metastasis since it might contribute to better survival despite bisphosphonates could not have been shown to have survival benefit in previous studies.Öğe Progesterone receptor status in determining the prognosis of estrogen receptor positive/HER2 negative breast carcinoma patients(Imprimatur Publications, 2015) Bal, Öznur; Arslan, Ülkü Yalçıntaş; Durnalı, Ayşe; Üyetrk, Ümmügül; Demirci, AyşePurpose: To evaluate the impact of progesterone receptor (PR) status on estrogen receptor (ER)-positive and HER2-negative breast cancer. Methods: A total of 1673 operable breast cancer patients, diagnosed from June 1984 to June 2011 were retrospectively reviewed and 400 patients with ER-positive and HER2-negative tumors were identified and evaluated. ER-positive and HER2-negative patients were classified into two groups: group A: ER+/PR-/HER2- and group B: ER+/PR+/HER2- according to PR status. Results: Median follow-up was 14.2 years (range 10.1-18.2). The ratio of postmenopausal patients was significantly higher in group A (68.2%, p=0.015). Grade 1 tumor and stage I disease were significantly higher in group B (15%, p=0.007 and 15%, p=0.005, respectively). Mean overall survival (OS) and disease free survival (DFS) were significantly better in group B (15.3 +/- 1.5 years vs 8.7 +/- 0.8 years, p=0.032; 10.5 +/- 1.6 years vs 5.7 +/- 0.5 years, p=0.022) as compared with group A. Relative risk for recurrence and death were two-fold higher in group A (p=0.05 and p=0.01, respectively). Conclusion: PR status exerts a significant impact on prognosis of ER+/HER2- breast cancer.Öğe Treatment decision plans matter in elderly patients with gastrointestinal cancer: suboptimal or optimal?(Imprimatur Publications, 2014) Üyetürk, Ümmügül; Türker, İbrahim; Bal, Öznur; Demirci, Ayşe; Sönmez, Özlem UysalPurpose: Aging is an important risk factor for cancer. Molecular changes and defective immunity associated with aging result in increased susceptibility to many carcinogens of the gastrointestinal system (GIS). Comorbidities and changes in drug metabolism in elderly patients make the treatment of GIS cancers difficult. Methods: Between January 2009 and December 2012, a total of 790 patients diagnosed with GIS cancers were retrospectively evaluated. Among them, 357 patients aged >= 65 years constituted the study population in which the patient characteristics, disease location, TNM stage, ECOG PS, co-morbidities, chemotherapy regimens and overall survival (OS) were assessed. Results: The patient median age was 71 years (range 65-94). Cancer localizations were colorectal cancer (CRC), gastric cancer, and the pancreaticobiliary system (PBS) cancer in 178 (49.9%), 124 (34.7%), and 55 (15.4%) patients, respectively. A total of 260 (69%) patients underwent chemotherapy: 167 (64.3%) patients received optimal chemotherapy, and 93 (35.7%) suboptimal chemotherapy. The median OS was 47, 14, and 11 months in CRC, gastric, and PBS cancers, respectively. OS was better in the optimally-treated group than in the suboptimally-treated group among patients with all types of cancer. OS was 67 vs 19 months (p<0.001), 17 vs 8 months (p=0.004), and 12 vs 10 months (p=0.46) in CRC, gastric, and PBS cancers in the optimal and suboptimal chemotherapy groups, respectively. Multivariate analysis showed that the disease stage in all cancer types and optimal chemotherapy in the CRC group were important predictors of survival (p<0.001 and p=0.021, respectively). Conclusion: Cancer is usually in advanced stage at the time of diagnosis in these elderly patients and screening programs might improve outcomes in this age group. Patients with GIS cancers (especially CRC and gastric cancer) should be encouraged to receive optimal chemotherapy regimens.
