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Öğe THE ACCESS RATE TO DIAGNOSIS AND TREATMENT MODALITIES IN BREAST CANCER PATIENTS IN TURKEY; MULTICENTER OBSERVATIONAL STUDY(Aves, 2011) Saip, Pinar; Keskin, Serkan; Ozkan, Metin; Kaplan, Mehmet Ali; Aydogan, Fatma; Demirag, Guzin Gonullu; Uzunoglu, SernazPurpose: We aimed to determine the elapsed time between the first notification of the disease and the accession to the diagnosis and treatment modalities and its associated factors in female patients with breast cancer in Turkey. Patients and Methods: The data was acquired by a questionnaire completed by 535 patients who applied to the 14 various oncology clinics between 1st and 28th of February 2010 in Turkey. The centers located in metrople - Istanbul, Izmir, and Ankara- were named Group 1 (n= 161), the centers located in Marmara and Central Anatolia region - Kocaeli, Bursa, Edirne and Kayseri- were named Group 2 (n= 189), and the centers located in Karadeniz and East-Southeast Anatolia region - Zonguldak, Samsun, Trabzon, Elazig and Diyarbakir- were named Group 3 (n= 185). The grouping for the centers were configured according to their socio- economic development of provinces. Results: Median age was 48 +/- 11.2 (24- 89) years, the number of patients of age less than 50 years were 282 (% 56.1). 85% of the patients detected a mass in their breast by themselves. % 27 of the patients over age 50 never had a breast ultrasound and/ or mammography done until the definite diagnosis was established. The median elapsed time between the disease noticed by the patient and the application to a health care center was 10 days, between the application and the biopsy was 19 days, between the biopsy and the surgery was 31 days. The elapsed time between recognition of the disease by the patient and the patient applying to a health care center in Group 1, Group 2, and Group 3 was 15, 10 and 14 days, respectively, and the elapsed time between the biopsy and surgery was 14, 1.5 and 12 days, respectively. The elasped time between the first recognition of the disease and applying of the patient to the health care center and the elapsed time between the biopsy and surgery in Group 2 centers was statistically significantly shorter compared to group 1 and 3 centers (p< 0.05). Conclusions: A high level of awareness of breast cancer in our country has examined through the time that is defined as 10 days between recognition of the disease and medical application. Compared with the developed countries the elapsed time between the application and biopsy, surgery and systemic therapy is longer than the expected and it has been marked differences between regions.Öğe Adrenal insufficiency caused by bilateral adrenal macrometastases: a rare case with metastatic colon cancer(Kare Publ, 2008) Cicin, Irfan; Uzunoglu, Sernaz; Karagol, Hakan; Usta, Ufuk; Temizoz, Osman; Ermantas, NilayA 42-year-old male with symptoms of weight loss, fatigue, hyponatremia, hypoglycemia, hypotension and fever was referred to our hospital. A computed tomographic scan of the abdomen and pelvis showed multiple solid masses in the liver, thickened wall of sigmoid colon and bilateral solid adrenal masses, 7x5x3 cm on the right side and 6x4.5x3.5 cm on the left side. A colonoscopic examination showed tumoral mass originating from the sigmoid colon. A biopsy was performed and adenocarcinoma was diagnosed. The patient was suspected of having primary adrenal insufficiency due to bilateral adrenal macrometastases. The diagnosis of adrenal insufficiency was confirmed by levels of ACTH serum, cortisol and ACTH stimulation test. Adrenal metastases are well-recognized, but compared with the prevalence of adrenal metastases, adrenocortical insufficiency in patients with cancer seems to be rare. We report the case of a patient with both bilateral surrenal macrometastases, which is rare in colorectal cancer, and subsequent adrenal insufficiency.Öğe Assessment of CA-125 area under the curve as a prognostic factor in patients with ovarian cancer(Humana Press Inc, 2013) Uzunoglu, Sernaz; Aybatli, Aysun; Kaplan, Petek Balkanli; Cicin, Irfan; Sut, Necdet; Sayin, Cenk; Varol, FusunThe goal of this study was to evaluate the efficacy of CA-125 area under the curve (CA-125 AUC) as a prognostic factor following surgical treatment for ovarian cancer patients. A retrospective analysis was conducted on ninety-five patients with ovarian cancer who had primary treatment in a tertiary center between 2000 and 2010. After either optimal or cytoreductive surgery, all patients underwent adjuvant chemotherapy. CA-125 AUC was calculated for each patient that had a minimum of three CA-125 serum measurements during the treatment period. The mean age at diagnosis and mean survival were 53.9 years (range, 16-75 years) and 35.6 +/- 22.9 months (range, 3.1-95.4 months), respectively. The mean (and median) CA-125 AUC of patients of FIGO stages I, II, III, and IV was 53.0 (42.5), 58.06 (58.06), 97.8 (54.6), and 405.2 (149.3) IU/ml day, respectively (p = 0.004). The mean CA-125 AUC was 57.7, 410.1, and 636.3 IU/ml day for patients with a complete response, partial response, and no response/progressive disease to first-line chemotherapy, respectively (p < 0.001). The CA-125 AUC cut-off level for an overall survival of >= 5 years was 99.75 IU/ml day with a sensitivity of 90.9 % (95 % CI, 70.8-98.6) with 1.27 as positive likelihood ratio. Patients who suffer from ovarian cancer, with a lower CA125 AUC, have a better overall survival than those with a higher CA125 AUC. CA-125 AUC could be used as an independent factor for evaluating the treatment efficacy and chemotherapy response.Öğe Association between specific KRAS mutations and the clinicopathological characteristics of colorectal tumors(Spandidos Publ Ltd, 2015) Kodaz, Hilmi; Hacibekiroglu, Ilhan; Erdogan, Bulent; Turkmen, Esma; Tozkir, Hilmi; Albayrak, Dogan; Uzunoglu, SernazThe aim of this study was to investigate the clinicopathological characteristics and distribution by tumor localization of KRAS point mutations in metastatic colorectal cancer. A total of 189 patients diagnosed with colorectal cancer between 2007 and 2014, who were either metastatic at the time of diagnosis or developed metastasis subsequently, were included in this study. KRAS mutation analysis was performed in the primary tumor tissues and KRAS mutations were identified in 47.6% of the patients. There was a high frequency of the p.G13D point mutation in left-colon tumors (P=0.011), while the p.G12D point mutation was more frequent in right-colon tumors (P=0.004). KRAS wild-type frequency (P=0.02) was higher among patients aged <40 years. A comparison of codon 12 and 13 mutations revealed that codon 12 mutations were more common in the >50-year-old group (P=0.03) and codon 13 mutations were more common in the <70-year-old group (P=0.04). KRAS wild-type tumors were localized in the right colon (P=0.005) and tumors with the p.G13D point mutation (P=0.018) were diagnosed at non-metastatic stages. In conclusion, KRAS point mutations in colorectal cancer exhibited a heterogeneous distribution in terms of tumor localization. In addition, the p.G13D point mutation was found to differ from other mutations in several aspects.Öğe A brief look at the evaluation of the development and effectiveness of cytotoxic chemotherapy in advanced non-small-cell lung cancer(Kare Publ, 2010) Uzunoglu, Sernaz; Karagol, Hakan; Tanriverdi, Ozgur; Cicin, Irfan; Caloglu, Murat; Kocak, ZaferSystemic chemotherapy for patients with advanced-stage non-small-cell lung cancer prolongs survival and palliates symptoms, when compared with the best supportive care alone. However, the results of standard cytotoxic regimens are not yet satisfactory. As the effectiveness in the treatment of refractory disease is low, it still remains critical to better understand and develop new treatment options for refractory disease. Within the second-line therapeutic approaches, there are new chemotherapeutic schemes as well as molecular-targeted treatment options that block the epidermal growth factor receptor or angiogenesis. Future research efforts should focus on identifying prognostic and predictive markers of benefit not only for the standard cytotoxic agents, but also for the new target-driven agents currently.Öğe Capecitabine-related intracranial hypotension syndrome mimicking dural metastasis in a breast cancer patient: Case report and review of the literature(Medknow Publications, 2010) Cosar-Alas, Rusen; Alas, Aykan; Ozen, Alaattin; Denizli, Bengu; Saynak, Mert; Uzunoglu, Sernaz; Aydogdu, NurettinSpontaneous intracranial hypotension (SICH) is an entity, which is secondary to iatrogenic manipulation and breaching of dura. Postural headache in patients should be suspected, cranial magnetic resonance imaging (MRI) is essential for precise diagnosis. Hallmark of MRI is regular shape of pachymeningeal gadolinium enhancement and subdural effusion. It may mimic central nervous system (CNS) metastasis. Prevention of such cases from receiving cranial radiotherapy by misinterpretation of the gadolinium enhancement as CNS metastasis is an important issue. Capecitabine is an antineoplastic agent, of which metabolites can cross blood-brain barrier in CNS via epithelial tissue. It may cause decrease in CSF production. SICH might be the clinical reflection of this decrease in CSF production. Review of the English literature revealed limited data because of the very little experience with oncologic patients suffering from intracranial hypotension. We report a case of spontaneous intracranial hypotension during capecitabine treatment. Patient was completely well following drug discontinuation and supportive treatment.Öğe Carnitine or dimethyl sulfoxide, or both, for the treatment of anthracycline extravasation in rats(Informa Healthcare, 2013) Uzunoglu, Sernaz; Cosar, Rusen; Cicin, Irfan; Ibis, Kamuran; Demiralay, Ebru; Benlier, Erol; Erdogan, BulentThis study aimed to compare the efficacy of topical dimethyl sulfoxide (DMSO), intralesional and systemic carnitine as monotherapy and in combination against ulceration in rats induced by intradermal doxorubicin extravasation. Sixty-nine 3-month-old male Wistar albino rats, weighing between 200-225 g, were used in this study. Rats were applied monotherapy or a combination of topical DMSO, intraperitoneal or intralesional carnitine. Control groups received saline or no drug. The necrotic area was measured and extravasated neutrophil leukocytes were counted in healthy tissue adjacent to necrotic areas. Monotherapy with topical and systemic carnitine did not significantly reduce the size of necrotic areas. However, topical DMSO had reduced necrotic areas and inflammatory cells significantly and the addition of systemic carnitine to topical DMSO had increased the efficacy. DMSO is an effective, safe, and easy-to-apply treatment for doxorubicin-induced extravasation. Further clinical studies are needed to evaluate the use of carnitine in combination with DMSO.Öğe A case of gastric adenocarcinoma with rectal metastasis in the form of linitis plastica presenting as primary rectum carcinoma(Aves Yayincilik, Ibrahim Kara, 2008) Uzunoglu, Sernaz; Cicin, Irfan; Karagol, Hakan; Tanriverdi, Oezguer; Genchellac, Hakan; Usta, UfukIt is often reported that metastases in the form of linitis plastica developed in the gastrointestinal system are rare cases and frequently the primary tumor is located in the stomach. We presented a case of gastric adenocarcinoma developing a metastasis in the rectum in the form of linitis plastica, which appeared as a primary local advanced rectum cancer. We discussed the clinical, radiological, and pathological characteristics of the intestinal metastases of gastric adenocarcinomas.Öğe A case of Guillain-Barre syndrome in a patient with small cell lung cancer treated with chemotherapy(Kare Publ, 2014) Turkmen, Esma; Erdogan, Bulent; Hacibekiroglu, Ilhan; Kodaz, Hilmi; Uzunoglu, Sernaz; Celik, Yahya; Cicin, IrfanGuillain-Barre syndrome (GBS) is an acute inflammatory demyelinating polyradiculoneuropathy characterized by bilateral progressive symmetrical paralysis. GBS is rarely seen neuropathy in cancer patients. In the literature some cases of GBS associated with anticancer chemotherapy. In this case; the guillain-barre syndrome developed after the treatment of a 59-year-old male patient with metastatic small cell lung carcinoma who admitted to hospital with neutropenic fever after cisplatin/etoposide chemoteraphy regime is presented. The patients complained of bilteral progressive symmetrical paralysis in upper and lower limbs with depressed deep tendon reflexes and hypoesthesia. There was no pathological findings on electromyography. There was no a sign at radiological imaging that explained cranial and spinal mestastasis. The cerebrospinal fluid had albuminocytologic dissociation. Decline in tumoral lesions were detected on chest radiography. Accompanied by clinical and laboratory findings, a diagnosis of Guillain-Barre syndrome was considered. Semptoms completely disapperared after intravenous immunoglobulin for five days. Recurrence did not during follow-up. The patients was administered a total of 4 cycles of cisplatin/etoposide chemotherapy. The patient died due to disease progression six months later. We think that, in this case GBS was not a paraneoplatic syndrome because there was more than 50% tumor shrinkage. We propose GBS was induced by infection and chemotherapy rather than malignancy.Öğe A case of non-Hodgkin's lymphoma presenting as a large chest wall mass(Kare Publ, 2008) Uzunoglu, Sernaz; Tanriverdi, Ozgur; Karagol, Hakan; Cicin, Irfan; Caloglu, Vuslat; Tokatli, FusunMalignant lymphoma as a solitary chest wall mass is rare. Although surgical resection is the main treatment modality for malignant chest wall tumors, the treatment of primary chest wall lymphomas is controversial. A 65-year-old male patient with an enlarging mass on the left side of his chest wall, which had first appeared four months before, applied to our hospital. The patient was directed to our polyclinic with a diagnosis of large B-cell lymphoma after the biopsy. Following the clinical investigation, stage IIEB extranodal am-Hodgkin's lymphoma was determined, and after a palliative radiotherapy, eight cycles of chemotherapy were planned. However, shortly after the completion of the sixth cycle of chemotherapy, poor performance status developed secondary to chemotherapy and the patient was diagnosed with pulmonary embolus. Following the stop of chemotherapy after six cycles, a complete clinical remission and a nearly complete radiologic remission were achieved. The patient is still under follow-up and was free of disease at four months.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 Comparative analysis of the efficacy and safety of modified FOLFOX-6 and DCF regimens as first-line treatment in advanced gastric cancer(Spandidos Publ Ltd, 2015) Hacibekiroglu, Ilhan; Kodaz, Hilmi; Erdogan, Bulent; Turkmen, Esma; Esenkaya, Asim; Onal, Yilmaz; Uzunoglu, SernazThe aim of this study was to retrospectively compare the efficacy and toxicity of the oxaliplatin + 5-fluorouracil (5-FU) + leucovorin (LV) regimen [modified (m) FOLFOX-6] with that of the docetaxel + cisplatin + 5-FU regimen (DCF) in patients with advanced gastric cancer (AGC). A total of 72 patients received DCF (75 mg/m(2) docetaxel and 75 mg/m(2) cisplatin on day 1 and 750 mg/m(2) 5-FU on days 1-5) every 21 days, whereas 54 patients received mFOLFOX-6 (85 mg/m(2) oxaliplatin and 400 mg/m(2) LV as a 2-h infusion, followed by a 5-FU bolus of 400 mg/m(2) and 2,400 mg/m(2) 5-FU as a 46-h continuous infusion) every 14 days. In the DCF arm, 55 (76.4%) of the patients received prophylactic granulocyte colony-stimulating factor (G-CSF), 48-72 h following completion of chemotherapy. The median follow-up of the study was 12.1 months. The overall response rate (ORR) was 37.0% for mFOLFOX-6 and 40.3% for DCF (P=0.72). The median time to progression was 6.5 and 6.2 months in the mFOLFOX-6 and DCF arms, respectively (P=0.70). The median overall survival was 11.4 and 13.5 months in the mFOLFOX-6 and DCF arms, respectively (P=0.72). The rates of hematological toxicity did not differ between the two arms. However, in the subgroup analysis, grade 3-4 neutropenia and febrile neutropenia were significantly more common among patients who had not received G-CSF prophylaxis in the DCF arm. The incidence of grade 3-4 nausea/vomiting and diarrhea were significantly higher in the DCF arm. In conclusion, the present study demon-strated that the efficacy of the mFOLFOX-6 regimen was comparable to that of the DCF regimen in AGC patients. In addition, the benefit of G-CSF prophylaxis in conjunction with the DCF regimen was demonstrated.Öğe The comparison of weekly and 3-weekly cisplatin chemotherapy concurrent with radiotherapy in patients with previously untreated inoperable non-metastatic SCCHN(Oxford Univ Press, 2006) Uygun, Kazim; Karagol, Hakan; Caloglu, Murat; Cicin, Irfan; Caloglu, Vuslat Y.; Uzunoglu, Sernaz; Saip, Pinar[Abstract Not Available]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 A Destroyer Immunologic Cause in Small Cell Lung Carcinoma: Ectopic Cushing's Syndrome(Ekin Tibbi Yayincilik Ltd Sti-Ekin Medical Publ, 2010) Cicin, Irfan; Uzunoglu, Sernaz; Ermantas, Nilay; Usta, Ufuk; Temizoz, Osman; Karagol, HakanEctopic secretion of adrenocorticotropic hormone (ACTH) related Cushing's syndrome (CS) is more frequently observed than many other paraneoplastic syndromes in patients with small cell lung cancer. Suppression of the cellular immune system in these patients is severe problem for both patients and physicians. In addition, the chemotherapy has been caused to severity and higher rate of hematological toxicity. We present a case of small cell lung cancer having a very poor prognosis, with a compressed humoral and cellular immune system due to an ectopic secretion of ACTH related CS. We report a rare case of combined immunosuppression in a case with small cell lung cancer in this paper. In addition, in the light of this special case and literature, we suggest treatment strategies for small cell lung cancer patients with CS.Öğe Dural sinus vein thrombosis in a patient with colon cancer treated with FOLFIRI/bevacizumab(Wolters Kluwer Medknow Publications, 2009) Ozen, Alaattin; Cicin, Irfan; Sezer, Atakan; Uzunoglu, Sernaz; Saynak, Mert; Genchellac, Hakan; Karagol, HakanThe adverse effects of regimes in cancer treatment have forced us to change to new targeted therapy options. Understanding these side effects, which can lead to discontinuation of the new therapy strategies, will allow the clinical management of these side effects and result in continuing therapies with effective medications. Bevacizumab, which is an IgG1 antibody against vascular endothelial growth factor, has side effects such as proteinuria, hypertension, venous and arterial thromboembolic events, and hemorrhage. This is the first reported case of dural sinus vein thrombosis, during the treatment with bevacizumab.Öğe Efficient and safe application of a FOLFIRI/bevacizumab combination to a patient with locally advanced rectal cancer and severe chronic renal failure(Karger, 2007) Cicin, Irfan; Karagol, Hakan; Uzunoglu, Sernaz; Uygun, Kazim[Abstract Not Available]Öğe Extrapulmonary small cell carcinoma localized in lymph nodes: Is it a different clinical entity?(Taylor & Francis Ltd, 2009) Cicin, Irfan; Usta, Ufuk; Karagol, Hakan; Uzunoglu, Sernaz; Kocak, ZaferBackground. Extrapulmonary small cell carcinomas (EPSCC) can clinically progress differently depending on the primary site of disease involvement. This review is focused on patients with small cell carcinoma (SmCC) exclusively localized in a lymph node or in multiple lymph nodes without any evidence of a primary tumor in any other organ. Methods. We searched the period 1980 to 2007 in the PubMed database and idendified 11 publications in the English language presenting at least one case of SmCC. In total 28 individual patients were included in the present study. They were scrutinized in terms of epidemiology, clinical presentation, staging, pathology, etiology, treatment and prognosis. Results. Characteristics such as age, gender and smoking were similar to those seen in other EPSCCs. Median survival was not reached (42+, range, 9.1 to 100 months). The survival rate was found to be 79% at 3 years. Seventy-seven percent of the patients had limited stage disease. These patients completely responded to surgical therapy, chemotherapy, radiotherapy or to a combination of these treatments. Seventy-one percent of the patients with limited stage SmCC localized in lymph nodes were recurrence-free during the study periods. Discussion. Our review patient group with SmCC localized in lymph nodes exhibited an excellent clinical behavior and survival results when compared to other patients with pulmonary and non-pulmonary SmCCs. SmCCs localized in lymph nodes may be a separate clinical entity.Öğe Extrapulmonary small-cell carcinoma compared with small-cell lung carcinoma - A retrospective single-center study(Wiley, 2007) Cicin, Irfan; Karagol, Hakan; Uzunoglu, Sernaz; Uygun, Kazim; Usta, Ufuk; Kocak, Zafer; Caloglu, MuratBACKGROUND. The study was conducted with the aim of reviewing the clinical features, therapy, and natural course of patients with extrapulmonary small-cell carcinoma (EPSCC) and small-cell lung carcinoma (SCLC) to better define current concepts regarding EPSCCs. METHODS. The medical records of patients with proven diagnosis of small-cell carcinoma (SmCQ between January 1999 and May 2006 were retrospectively reviewed. A total of 65 SmCC cases were included in the study (11 [17%] cases of EPSCC and 54 [83%] cases of SCLQ. RESULTS. Progression-free survival of all patients with EPSCC and patients with-extensive EPSCC disease was 7 months (95% confidence interval 10], 0.58-13.42) and 7 months (95% Cl, 4.71-13.29), respectively. Overall survival of all patients with EPSCC and patients with extensive EPSSC disease was 32 months (95% CI, 18.74-45.26) and 28 months (95% Cl, 12.24-43.76), respectively. Progression-free survival and overall survival for all patients with SCLC were 5 months (95% Cl, 2.26-7.74) and 10 months (95% Cl, 5.95-14.05), respectively. Progression-free survival and overall survival for patients with extensive disease were 3 months (95% Cl, 4.71-13.29) and 5 months (95% CI, 3.33-6.67), respectively. Overall survival was significantly better in all patients with EPSCC and in patients with extensive EPSCC disease compared with A patients with SCLC and patients with extensive SCLC disease (P =.014, P -.004, respectively). Early death and brain metastasis were observed in a higher number of patients with SCLC compared with EPSCC) however, these results were not statistically significant (P 33 and P =.076, respectively). Smoking history was significantly less in the FPSCC group (P <.0001). CONCLUSIONS. EPSCC is usually treated similarly to SCLC. However, this study suggests some differences such as etiology, clinic course, survival, frequency of brain metastases, and early death between these entities. These possible differences may influence the choice of therapeutic approach. Cancer 2007; 110: 106&76. (c) 200 7 American Cancer Society.Öğe The Importance of Using PET/CT Investigation in Case of Recurrence in an Ovarian Cancer Case with Lymph Node Metastasis Without any Lesions That can be Scanned via Conventional Methods(Galenos Yayincilik, 2008) Tanriverd, Ozgur; Uzunoglu, Sernaz; Karagol, Hakan; Cicin, Irfan; Cosar Alas, Rusen; Tokatli, Fusun; Altaner, SemsiAlthough lymph node involvement is common in ovarian cancer, axillary and supraclavicular lymph node involvement is quite rare. In the 55-year-old patient without any lesions that are scannable via conventional methods, in which increase of CA-125 level was detected during follow-up, recurrence was detected via combined positron emission tomography and computed tomography investigation. This case recurring with intraabdominal and supraclavicular and axillary lymph node (which are rare regions of involvement) metastasis has been discussed with literature information. In this article, the importance of combined positron emission tomography and computed tomography investigation in patients with suspected recurrence in whom no tumor detectable via conventional methods has been identified was highlighted.
