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Öğe Assessment of Prognostic Factors in Epithelial Ovarian Cancer(Kare Publ, 2017) Onal, Yilmaz; Kostek, Osman; Hacioglu, Muhammet Bekir; Erdogan, Bulent; Kodaz, Hilmi; Bekmez, Esma Turkmen; Hacibekiroglu, IlhanObjectives: Ovarian cancer is the second most common gynecological cancer, and has a 5-year survival rate of about 40% to 45%. This ratio ranges from 15% to 95%, based on prognostic factors. There are numerous clinical, pathological and biological factors related to prognosis. The aim of this study was to assess prognostic factors in advanced epithelial ovarian cancer. Methods: A total of 119 stage III and stage IV ovarian cancer patients were evaluated. The patients age, menopausal status, age of menarche, number of children, height and weight values, surgery, tumor histopathological features, presence of metastasis, residual tumor volume, presence of ascites, abdominal lavage cytology, chemotherapy regimen, number of chemotherapy cycles, the first and last chemotherapy dates, relapse, and recent status were evaluated. Results: The median age of the study patients was 54 years (minimum: 34, maximum: 79 years). The pathological stages were 10 (8.6%) patients with IIIA, 6 (5%) patients with IIIB, 76 (63.9%) patients with IIIC, and 27 (22.7%) patients with stage IV. In multivariate analysis, age of diagnosis (hazard ratio [HR]: 0.44; 95% confidence interval [CI], 0.22-087; p=0.01), postoperative tumor residual status (HR: 0.32; 95% CI, 0.14-0.71; p<0.01), number of adjuvant chemotherapies (HR: 0.48; 95% CI, 0.23-0.98; p=0.04), and platinum sensitivity (HR: 0.37; 95% CI, 0.18-0.74; p<0.01) were found to be independent variables related to longer survival. Notably, a patient treated with more than 6 cycles of chemotherapy had a worse prognosis. Conclusion: Independent indicators of a poor prognosis in our study were determined to be advanced age at diagnosis, a residual tumor more than 2 cm in size, more than 6 cycles of chemotherapy, and the presence of platinum-resistant disease. A multidisciplinary approach is needed to improve prognosis.Öğe Changes in skeletal muscle area and lean body mass during pazopanib vs sunitinib therapy for metastatic renal cancer(Springer, 2019) Kostek, Osman; Yilmaz, Erdem; Hacioglu, Muhammet Bekir; Demircan, Nazim Can; Gokyer, Ali; Uzunoglu, Sernaz; Tuncbilek, NerminPurposeTo evaluate whether sunitinib and pazopanib treatments are associated with change in skeletal muscle area (SMA) and total lean body mass (LBM) as well as to compare their efficacies and safety profiles in patients with metastatic renal cell cancer (mRCC).MethodsThirty-six patients treated with a tyrosine kinase inhibitor were included. Eighteen of them received sunitinib and the rest/remaining received pazopanib in the first line of mRCC treatment. Baseline and follow-up computed tomography studies of the patients were performed to measure cross-sectional areas (cm(2)) of muscle tissues.ResultsAbout 69% of patients were male and median age was 60 (49-68)years. Median time interval between two CT imagings was 6.1 (3.1-7.7)months and it was similar between the two groups (for sunitinib, 4.9 (2.5-6.9)months vs for pazopanib, 7.3 (3.2-9.5)months, p=0.16, respectively). Disease control rate was 77.7% in all patients. Of these, 66.6% in sunitinib group was consisted of four partial responses and eight stable diseases. In addition, 88.8% in pazopanib group was consisted of three partial responses and 13 stable diseases. A significant decrease in SMA and LBM was observed after sunitinib therapy, whereas SMA and LBM values of pazopanib group did not change significantly (p=0.02 and p=0.70, respectively). No significant differences were observed between patients with sunitinib, and pazopanib group median PFS [11.9 (95% CI 6.1-17.6) vs 8.1months (95% CI 7.2-9.1), respectively; p=0.28] and median OS [28.6 (95% CI 24.3-32.9) vs 25.5months (95% CI 18.9-52.7), respectively; p=0.42]. Dose-limiting toxicities were significantly more frequent in sunitinib group than in pazopanib group (66.7% vs 22.2%, p=0.02, respectively).ConclusionsLoss of SMA and LBM with sunitinib was more substantial than with pazopanib. Treatment efficacies of both drugs were similar, but dose-limiting toxicity was more frequent in sunitinib group. Loss of SMA had no significant association with prognosis. Further studies are needed to clarify the possible association between SMA and prognosis in mRCC patients who receive sunitinib or pazopanib.Öğe Clinical features of the patient with multiple primary tumors: Single center experience(Kare Publ, 2017) Gokyer, Ali; Kostek, Osman; Hacioglu, Muhammet Bekir; Erdogan, Bulent; Kodaz, Hilmi; Turkmen, Esma; Hacibekiroglu, IlhanOBJECTIVE: Multiple primary tumors are the ones that develop in the same patient at the same or different times. They are usually examined under two groups. If the second tumor is diagnosed 6 months after the first tumor is diagnosed, it is named as metachronous tumor. If it is diagnosed in 6 months after the first diagnosis, it is called as synchronous tumor. The malignancy of tumors should be proved histologically. At least 2 cm of solid tissue should be present between two tumors. If they are at localized at the same place, a gap of at least 5 years should be present between them. Metastatic disease should be eliminated. This study aimedto review the clinical, demographic, and pathological features of multiple primary tumors, detect the prevalence, compare the results with literature findings, and evaluate and improve the approach to multiple primary tumors. METHODS: A total of 170 patients diagnosed with multiple primary tumors were included in this study. Patient data were obtained from pathology and medical reports of the patients. RESULTS: Most of the multiple primary tumors were metachronous. The number of male patients was more than that of female patients. The median time between double tumors was 3 monthsforsynchronous tumorsand 26 months for metachronous tumors. Synchronous tumors with the highest prevalence of comorbidity were lung-larynx and lung-colon, whereas metachronous tumors with the highest prevalence of comorbidity were lung-bladder, lung-larynx, breast-endometrium, and breast-colon. The history of smoking and alcohol was found to be higher in male patients andsynchronous tumors. CONCLUSION: The detection of the first tumor in the metastatic stage and an accompanying synchronous secondary tumor was found to be a poor prognostic factor. The treatment of the first tumor, smoking, squamous cell histology, and male gender were among the other factors negatively affecting survival, although they were not statistically significant.Öğe Combination of Docetaxel and Gemcitabine Ineffective in Metastatic Eccrine Porocarcinoma: A Case Report(Kare Publ, 2017) Kodaz, Hilmi; Hacioglu, Muhammet Bekir; Kostek, Osman; Erdogan, Bulent; Tastekin, Ebru; Kodaz, Cagnur Elpen; Cicin, IrfanMalignant eccrine porocarcinoma is a very rare tumor and the etiology is not known. Treatment is surgical removal of the tumor. The benefit of chemotherapy and radiotherapy is unclear. A 49-year-old male patient presented with the complaint of left inguinal swelling. Ultrasonography examination revealed 5x4 cm inguinal lymphadenopathy. The inguinal lymph nodes were excised. Pathology report indicated eccrine porocarcinoma. The patient was treated with cisplatin 40 mg/m(2) week as well as concurrent radiotherapy for 5 weeks. After 6 weeks of dual therapy, liver metastases were detected. KRAS, NRAS, and BRAF tests were negative. Gemcitabine was administered at a dose of 1000 mg/m(2) on days 1 and 8 every 21 days, and docetaxel was administered at a dose of 75 mg/m(2) on day 8, every 21 days. There was progression after 2 cycles of chemotherapy. The patient lived 7 months. In this case, use of synchronous cisplatin and radiotherapy as adjuvant treatment could not prevent tumor metastasis. The combination chemotherapy of docetaxel and gemcitabine applied after metastatic disease development was ineffective.Öğe Comparison of skeletal muscle mass loss in patients with metastatic colorectal cancer treated with regorafenib or TAS-102(Imprimatur Publications, 2019) Hacioglu, Muhammet Bekir; Kostek, Osman; Kurt, Nazmi; Kucukarda, Ahmet; Gokyer, Ali; Ustabasioglu, Fethi Emre; Karatas, FatihPurpose: To assess whether regorafenib and TAS-102 treatments are associated with a change in Skeletal Muscle Area (SMA) as well as to compare Skeletal Muscle Mass (SMM) loss levels between regorafenib and TAS-102 treatments and prognostic significance in the patients with metastatic colorectal cancer (mCRC). Methods: A total of 36 mCRC patients, who received regorafenib or TAS-102 in the third-line and subsequent settings were assessed in the analysis. SMM changes were assessed with CT scans findings, and they were categorized into two groups as SMM-loss (SMM decrease >= 2%) and SMM-stable (SMM change <2%). Results: The SMM change after regorafenib therapy was significantly worse compared with TAS-102 therapy (p=0.001). The median overall survival (OS) was longer in SMM-stable group than in SMM-loss group (12.8 months; 95%CI:9.8-15.7) vs. 6.4 months; 95%CI:5.2-7.7, respectively;p=0.04). Cox regression analysis showed that SMM loss was independent prognostic indicator for OS (HR, 2.87; 95%CI: 1.07-7.42, p=0.03). Conclusion: Although patients who received regorafenib had more SMM loss than those who received TAS-102, there was no difference in OS between drugs.Öğe Contrast nephropathy in cancer patients receiving anti-VEGF therapy: a prospective study(Springer Japan Kk, 2020) Gokyer, Ali; Kucukarda, Ahmet; Kostek, Osman; Hacioglu, Muhammet Bekir; Uzunoglu, Sernaz; Kula, Osman; Kurt, NazmiObjectives Contrast nephropathy risk has been increasing in cancer patients. Nephrotoxic side effects of anti-vascular endothelial growth factor/receptor (anti-VEGF/R) drugs used in oncologic treatment are also prominent. The purpose of this study was to identify the possible association among anti-VEGF/R drugs use and development of the contrast-induced nephropathy (CIN) in patients with cancers. Methods A total of 92 patients were included in this prospective cross-sectional study. Patients whose glomerular filtration rate (GFR) of < 50 ml/min, hemoglobin of < 10 g/dl, and eastern cooperative oncology group (ECOG) score of >= 2 and had received nephrotoxic drugs were not included in the study. Blood samples were collected baseline at pre computed tomography (CT) and day 2, day 3 and day 7 later CT imaging. CIN was defined as either an increased serum creatinine value of 0.5 mg/dl or increased 25% to baseline. CIN frequency between groups receivingand not receiving anti-VEGF/R was compared using the chi-squared test. CIN frequency between bevacizumab and other anti-VEGF/R was also analyzed. Results There were 39 patients in the anti-VEGF/R (+) group and 53 patients in the anti-VEGF/R (-) group. Eleven patients (28%) in the anti-VEGF/R (+) group and 3 patients (5.6%) in the anti-VEGF/R (-) group had CIN (p = 0.006). In the anti-VEGF/R (+) group, 23 patients received bevacizumab (combined with FOLFOX/FOLFIRI), while 16 patients received other anti-VEGF/R (sunitinib, axitinib, regorafenib, aflibercept) effective treatments. CIN ratio in patients who received bevacizumab or other anti-VEGFR therapy was similar (p = 0 = 50). Of the patients, one patient had acute kidney injury leading to death. Conclusion CIN was significantly more frequent in cancer patients who receiving anti-VEGF/R drugs than those not receiving anti-VEGF/R drugs.Öğe Efficacy of regorafenib in the second-and third-line setting for patients with advanced hepatocellular carcinoma: A real life data of multicenter study from Turkey(Imprimatur Publications, 2020) Hacioglu, Muhammet Bekir; Kostek, Osman; Karabulut, Senem; Tastekin, Didem; Goksu, Sema Sezgin; Alandag, Celal; Akagunduz, BaranPurpose: After failure of the first-line sorafenib treatment in advanced or metastatic stage hepatocellular carcinoma (HCC), regorafenib is one of the newly-approved targeted agents. We aimed to evaluate the efficacy of regorafenib in patients with advanced HCC treated in the secondor third-line setting. Methods: In this retrospective and multicenter study, advanced HCC patients not eligible for local therapies, who received a secondor third-line regorafenib therapy after progression on the first-line sorafenib or sequential therapy with chemotherapy (CT) followed by sorafenib, were included. Results: In the first-line setting, 28 (28.9%) patients received CT and 69 (71.1%) patients received sorafenib. There were 24 (24.7%) patients who were intolerant to sorafenib. Disease control rate (DCR) was 53.6% for all patients treated with regorafenib, 62.3% in patients who received regorafenib in the second-line, and 32.1% for those receiving regorafenib in the third-line (p=0.007). Median progression-free survival (PFS) and overall survival (OS) were 5.6 (range; 4.3-6.9) and 8.8 (range, 6.3-11.3) months for all patients treated with regorafenib vs. 7.1 months and 10.3 months for patients who received regorafenib in the second-line vs. 5.1 and 8.7 months for patients who received regorafenib in the third-line, respectively; however, there was no statistically significant difference (p(PFS)=0.22 and p(OS)=0.85). Conclusion: Although receiving CT as a first-line therapy in advanced HCC patients did not affect the survival rates of subsequent regorafenib therapy, it might diminish the DCR of regorafenib.Öğe Frequency of RAS Mutations (KRAS, NRAS, HRAS) in Human Solid Cancer(Kare Publ, 2017) Kodaz, Hilmi; Kostek, Osman; Hacioglu, Muhammet Bekir; Erdogan, Bulent; Kodaz, Cagnur Elpen; Hacibekiroglu, Ilhan; Turkmen, EsmaRAS oncogene affects numerous cellular functions including growth, proliferation, apoptosis, migration, division and differentiation of the cells. It has 3 known isoforms as Harvey- RAS (HRAS), Kirsten - RAS (KRAS) and Neuroblastoma-RAS (NRAS). RAS has an intrinsic GTPase activity. It encodes proteins binding the guanine nucleotides. KRAS and HRAS were discovered in studies carried out on viruses leading to cancer. Retroviral oncogenes related to murine sarcoma virus genes (Kristen Rat Sarcoma Virus and Murine Sarcoma Virus) were discovered in 1982. These two oncogenes are similar to human KRAS. Approximately 30% of all human cancers have ras genes. Mutations in KRAS account for about 85% for all RAS mutations in human tumors, NRAS is about 11-15%, and HRAS is about 1%.Öğe Is the Charlson Comorbidity Index a Prognostic Indicator for Toxicity and Mortality in Elderly Patients with Locally Advanced Rectal Cancer?(Acad Medical Sciences I R Iran, 2019) Kostek, Osman; Bozkaya, Yakup; Hacioglu, Muhammet Bekir; Ozdemir, Nuriye Yildirim; Yilmaz, Erdem; Demircan, Nazim Can; Erdogan, BulentBackground: Aging is significantly related to multiple comorbidities. Even with a good performance score, some elderly patients may have poor survival outcomes. We aimed to evaluate the prognostic value of the Charlson comorbidity index (CCI) for mortality and toxicity in elderly patients with locally advanced rectal cancer (LARC). Methods: Seventy-two elderly patients with LARC who were treated with neoadjuvant chemoradiotherapy (CRT) were included. Based on their CCI score, severity of the comorbidity was categorized into 2 groups: CCI<7 and CCI >= 7. Results: The overall survival (OS) at 5 years was 54.4 percent in patients treated with neoadjuvant CRT. Median OS was not reached for all patients as well as patients with CCI score <7, but median OS was 25 (95% CI 1.0-62.1) months in patients with CCI >= 7 (P=0.002). The OS at 2 years was 79.1 percent in the patients with CCI <7 and 50.0 percent in the patients with CCI score >= 7 (P=0.002). Moreover, there was a trend toward, patients with higher CCI score who had more treatment related to grade 3 or 4 toxicity compared to those with CCI score <7 (33.3% vs 13.3%, respectively, P=0.09). Multivariable analysis indicated that the CCI score=7, presence of down-staging after therapy and clinical stage (III) independently predict mortality (HR 6.14, 95% CI 2.45-15.35, P<0.001) in patients with LARC. Conclusion: Although CCI score was not significantly associated with both toxicity and disease-free survival (DFS), we suggest that baseline CCI score might be a valuable prognostic indicator for physicians to evaluate elderly patiens with LARC for optimal treatment.Öğe Major and minor salivary gland cancers: A multicenter retrospective study(Wiley, 2023) Hacioglu, Muhammet Bekir; Erdogan, Bulent; Bardakci, Murat; Algin, Efnan; Gulbagci, Burcu; Hacibekiroglu, Ilhan; Hamdard, JamshidBackgroundMost of the studies on salivary gland cancers are limited for various reasons such as being single-center, small number of patients, including only major or minor SGCs, or only including epidemiological data. MethodsA total of 37 medical oncology clinics from different regions of Turkey participated in this retrospective-multicenter study. The analyzed data included clinical and demographical features, primary treatment, metastasis localizations, and treatments and includes certain pathologic features. ResultsThe study included data from a total of 443 SGCs. 56.7% was in major salivary glands and 43.3% was in minor salivary glands. Distant metastasis in the major SGCs was statistically significantly more common than in the minor SGCs, locoregional recurrence was statistically significantly more common in the minor SGCs than in the major SGCs (p = 0.003). ConclusionsEpidemiological information, metastasis and recurrence patterns, treatment modalities, and survival analysis of the patients over 20 years of follow-up are presented.Öğe Metastasis of Transitional Cell Carcinoma of the Bladder to the Orbit: A Case Report(Kare Publ, 2017) Genc, Ahmed Cihad; Hacioglu, Muhammet Bekir; Kostek, Osman; Hacibekiroglu, IlhanPresently described is the case of a 67-year-old male patient who presented at the urology clinic with complaints of hematuria and dysuria. Metastases of bladder cancer to the orbit, bilateral lungs, liver, and kidney were discovered. Palliative chemotherapy and radiotherapy for metastatic transitional cell carcinoma of the bladder was initiated.Öğe Prognostic Factors for Survival in Transverse Colon Cancers(Springer, 2022) Kucukarda, Ahmet; Gokyer, Ali; Sayin, Sezin; Gokmen, Ivo; Ozcan, Erkan; Kostek, Osman; Hacioglu, Muhammet BekirBackground Transverse colon cancer (TCC) is a rare condition that accounts for 10% of all colon cancers. TCC was accepted more likely right-sided colon cancers. We aimed to investigate whether TCC differs from other colon tumors by using clinical, pathological, and molecular prognostic factors known to be important in colon cancer and if it differs in its own anatomical structure. Patients and Methods We evaluated local and locally advanced TCC patients between 2007 and 2020 years for demographics data, symptoms, treatment status, and histopathological and molecular features. Results Overall, 107 TCC patients were included in this study. According to the molecular data analysis of 44, 35, and 23 patients for MSI, RAS, and BRAF status, respectively, 7 (15.9%) were MSI-H, 13 (37.1%) were RAS mutant, and 11 (47.8%) had BRAF V600E mutation. The median follow-up time was 31.5 months. Median disease-free survival (DFS) was 5.19 months, and median OS was 88.3 months for the whole study population. The tumor stage was the most significant prognostic factor for DFS and OS. Although BRAF mutation was not a significant marker for DFS, it was an independent prognostic marker for OS (HR 3.90 95% CI 1.42-10.7). There were no statistically significant differences between proximal two-thirds and distal one-third tumor location. Conclusion TCC has molecular features and prognostic factors more likely RCC and no differences between proximal and distal sub-parts. BRAF V600E mutation status is an independent predictor of survival even in the early stages of TCC.Öğe Prognostic nutritional index and its dynamics after curative treatment are independent prognostic factors on survival in non-metastatic nasopharyngeal carcinoma(Springer, 2022) Kucukarda, Ahmet; Erdogan, Bulent; Gokyer, Ali; Sayin, Sezin; Gokmen, Ivo; Ozcan, Erkan; Hacioglu, Muhammet BekirPurpose We aimed to identify the prognostic and predictive values of post-treatment prognostic nutritional index (PNI) and PNI dynamics in nasopharyngeal cancer patients (NPC) in this study. Methods One hundred seven non-metastatic NPC patients were included. PNI was calculated by using the following formula: [10 x serum albumin value (gr/dL)] + [0.005 x total lymphocyte count (per mm3)]. ROC analysis was used for determining prognostic PNI values and univariate and multivariate statistical analyses for prognostic characterization of PNI. Results The statistically significant cut-off values for pre- and post-treatment PNI were 50.65 and 44.75, respectively. Of the pre-treatment PNI analysis, PNI <= 50.65 group had shorter loco-regional recurrence-free survival (LRRFS), distant metastasis-free survival (DMFS), and overall survival (OS). Furthermore, for post-treatment PNI analysis, PNI <= 44.75 group had shorter LRRFS and OS. In univariate analysis, only pre-treatment PNI was associated with LRRFS and DMFS, while pre- and post-treatment PNI were both associated with OS. In multivariate analysis, both PNI were independent prognostic markers for OS. In the combined analysis, pre- and post-treatment PNI, differences between the groups were statistically significant, and the PNI dynamics was an independent prognostic indicator for OS. Conclusion PNI is a useful, independent prognostic marker for non-metastatic NPC patients. It is used for either pre- or post-treatment patients. Furthermore, changes in pre-treatment PNI value after curative treatment is a significant indicator for OS.Öğe A Rare Cause of Acute Kidney Injury: Renal Arterial Thrombosis in a Small Cell Lung Cancer Patient(Kare Publ, 2017) Kostek, Osman; Hacioglu, Muhammet Bekir; Orman, Seval; Cetin, Ceren; Kodal, Nil Su; Erdogan, Bulent; Uzunoglu, SernazRenal artery thromboembolism is a rare cause of acute kidney injury. Hypercoagulable state is an important reason renal arterial thrombosis may occur. Cancer cells activate coagulation systems via various pathways, leading to the development of a prothrombogenic state. Presently described is the very rare condition of renal artery thromboembolism in a patient with extensive-stage small cell lung cancer.Öğe Regorafenib or rechallenge chemotherapy: which is more effective in the third-line treatment of metastatic colorectal cancer?(Springer, 2019) Kostek, Osman; Hacioglu, Muhammet Bekir; Sakin, Abdullah; Demir, Tarik; Sari, Murat; Ozkul, Ozlem; Araz, MuratPurposeTo assess the efficacy and safety of regorafenib versus rechallenge chemotherapy in previously treated mCRC patients in third-line setting.Materials and methodsThe data of 104 patients diagnosed with mCRC enrolledfrom2010to2017 in six oncology centers were analyzed. Tumor treatment options were obtained from follow-up and treatment files. Rechallenge chemotherapy was identified as the re-use of the regimen which was previously administered to patients in one of the therapy lines and obtained disease control, these were the patients whose disease did not progress within 3months.ResultsA total of 104 patients had received previously two lines of chemotherapy regimens for mCRC. Of these, 73 patients with mCRC who received regorafenib and 31 those who received rechallenge chemotherapy in third-line therapy were analyzed. Overall survival was better with rechallenge than it was with regorafenib (HR 0.29 95% CI 0.16-0.54, p<0.001). Median OS was 12.0months (95% CI 8.1-15.9) in rechallenge versus 6.6months (95% CI 6.0-7.3) in regorafenib group (p<0.001). Progression-free survival in the rechallenge group showed a higher median value of 9.16months (95% CI 7.15-11.18) versus with that recorded in the regorafenib group of 3.41months (95% CI 3.01-3.82), in favor of rechallenge chemotherapy. The most common adverse events of regorafenib was liver function test abnormality and hand-foot syndrome. Although grade 3 or 4 adverse events were similar, non-hematologic toxicities were more common than those of rechallenge.ConclusionsRechallenge is still a valuable option against regorafenib in patients who achieved disease control in one of the first two lines of therapy. Even though mCRC patients treated with regorafenib benefited clinically from this treatment, we revealed that chemotherapy rechallenge compared to regorafenib was more effective in the third-line treatment for mCRC patients.Öğe The relationship between FDG PET/CT-defined metabolic parameters and the histopathological subtype of oesophageal carcinomas(Int Scientific Information Inc, 2020) Korkmaz, Ulku; Hacioglu, Muhammet Bekir; Kostek, Osman; Sut, Necdet; Kodaz, Hilmi; Erdogan, Bulent; Ustun, FundaPurpose: 18F-fluorodeoxyglucose (F-18-FDG) positron emission tomography (PET) combined with computed tomography (CT) scan is accepted as a standard tool in the staging of oesophageal cancer (OC). Histological subtype of tumour is known to be a major determinant of prognosis and metabolic behaviour. In this study, we aimed to evaluate the effect of histological subtypes of OC on standard uptake value (SUVmax), metabolic tumour volume (MTV), and total lesion glycolysis (TLC) obtained by PET/CT, and also to compare this effect with prognosis. Material and methods: Images and clinical course data of 57 patients who were diagnosed with EC and treated in our hospital between 2009 and 2016 were evaluated in a retrospective manner. PET/CT images were re-analysed in terms of metabolic parameters, and observations were compared with histological subtypes. Results: No significant difference was observed between histological subtypes with SUVmax, overall survival (OS), or progression-free survival (PPS). Thus, MTV was observed to be related with histological subtype; MTV values of adenocancer patients were significantly higher than those of squamous cell cancer patients. Conclusions: Metabolic tumour volume was related with histological subtype of OC, but clinical staging, TLG, and SUVmax values were not related with histological subtype, which may suggest the use of MTV as a routine parameter for OC and inclusion of MTV observations in prognostic scoring.Öğe Relationship between prognostic nutritional index and neutrophil lymphocyte ratio with overall survival in patients with metastatic colorectal cancer receiving regorafenib(Wolters Kluwer Medknow Publications, 2023) Erdogan, Bulent; Ozcan, Erkan; Gokmen, Ivo; Gokyer, Ali; Kucukarda, Ahmet; Kostek, Osman; Hacioglu, Muhammet BekirAim: In this study, we aimed to analyze the effect of prognostic nutritional index and neutrophile lymphocyte ratio on the overall survival (OS) in patients treated with regorafenib. Materials and Methods: Metastatic colorectal cancer (CRC) patients who treated with regorafenib between 2016 and 2020 in a single center were evaluated retrospectively. ROC analysis was used for neutrophile lymphocyte ratio (NLR's) and prognostic nutritional index (PNI's) optimum cut-off value. The relationship between OS with PNI and NLR was investigated. Results: Fifty-two patient's data were analyzed. The median age was 57 years, 22 (41.5%) of the patients were female. The optimal cut-off value of PNI for OS was 45.7 according to ROC curve analysis. The median NLR value was accepted as 2.7. Median OS was 8.3 months. Patients who have high PNI value than 45.7 had longer OS (12.09 months vs. 6.31 months hazard ratio [HR]: 0.37 95% confidence interval [CI]: 0.19-0.73 P = 0.003) and there was a tendency for longer OS with low NLR value then median (12.05 months vs. 6.14 months HR: 0.54 95% CI: 0.29-1.23 P = 0.057). Primary tumor resected patients had longer OS than nonresected patients (12.05 months vs. 6.30 months HR: 0.34 95% CI: 0.17-0.66 P = 0.001). In multivariate analysis, high PNI value more than 45.7 (HR: 0.40 95% CI: 0.18-0.88 P = 0.02) and resection of the primary tumor (HR: 0.40 95% CI: 0.21-0.80 P = 0.01) were the only independent factors for longer OS. Conclusion: Metastatic CRC patients with high pretreatment PNI and primary tumor resected are more likely to have longer OS with regorafenib. PNI is more reliable index than NLR to predict OS in metastatic CRC patients treated with regorafenib.Öğe Value of MRI apparent diffusion coefficient for assessment of response to sorafenib in hepatocellular carcinoma(Imprimatur Publications, 2018) Kostek, Osman; Yilmaz, Erdem; Hacioglu, Muhammet Bekir; Erdogan, Bulent; Kodaz, Hilmi; Bekmez, Esma Turkmen; Hacibekiroglu, IlhanPurpose: Efficient and adequate evaluation of therapeutic response in hepatocellular carcinoma (HCC) is an evolving field. We aimed to evaluate apparent diffusion coefficient (ADC) values in the prediction of response to sorafenib and prognosis in patients with advanced HCC. Methods: Baseline magnetic resonance (MR) imaging was performed before treatment. After sorafenib started, clinical and radiological response were evaluated at approximately 3 months later. ADC measurements were performed by a 12year experienced radiologist who evaluated MR before and after sorafenib therapy. Results: A total of 17 patients (median age 60 years, range 51-66 and M/F ratio= 3.25/1) were analyzed. A significant increase in ADC levels in responders was observed 3 months after sorafenib therapy. Baseline and post-sorafenib ADC values were not significantly associated with mortality (hazard ratio/HR baseline ADC = 1.003, p = 0.98) and after sorafenib (HR 0.480, p = 0.48, respectively). Conclusion: Advanced HCC patients with a favorable response to sorafenib had a significant increase in ADC value at the first radiological evaluation. The predictive and prognostic role of ADC for overall survival is still unknown and further research is needed to investigate any possible association.