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Background/Aim: The effect of surgical intervention on the quality of life and survival of patients presenting with metastatic breast cancer is a controversial issue. In this study, we aimed to reveal the survival, clinical, and pathological differences in patients with breast cancer who had metastatic disease at diagnosis and who underwent and did not undergo surgery for the primary tumor in our clinic and to evaluate the efficacy of surgical approach on the course of the disease. Methods: In this retrospective cohort study, the data of patients with metastatic breast cancer in our clinics between January 2000 and June 2021 were retrospectively analyzed. The study included those with primary metastatic disease. The study did not include male patients, patients with primary non-breast tumors, those who died of causes unrelated to breast cancer, those who underwent surgery for metastatic foci other than the primary tumor, and those who could not be followed up regularly for various reasons. In our study, there were two groups; those who received only systemic therapy were assigned to Group 1, while those who underwent surgical treatment for the primary tumor were assigned to Group 2. The clinicopathological and survival data of the groups were examined. Results: Surgical intervention was performed on 62 of our patients. The 4-year survival rates were higher than those who did not undergo surgery (Group 1: 59.6 [14.7%], Group 2: 83.5 [6%]). The comparison of the two groups showed a longer median survival in patients in Group 2 who underwent surgery, albeit not statistically significant (77 [11.23] months in Group 1 and 84 [18.91] months in Group 2 [P=0.16]). Conclusion: In conclusion, our study showed that surgical treatment may have positive effects on survival. [ABSTRACT FROM AUTHOR]

OBJECTIVE We investigated the outcomes of radiotherapy (RT) combined with systemic chemotherapy (CHT) including carboplatin and paclitaxel in patients with locally advanced non-small-cell lung cancer. METHODS This retrospective study included 105 patients. Treatment involved concurrent carboplatin and paclitaxel with RT administered weekly followed by two cycles of consolidation carboplatin and paclitaxel administered triweekly. RESULTS Comorbid disease was present in 46 (48.6%) patients. At least four cycles of CHT in the concurrent phase and both cycles of CHT in the consolidation phase were able to be administered to 92.3% and 45.4% of patients, respectively. The most common type of toxicity in the entire treatment protocol was hematological toxicity (34.8%). The objective response rate was 71.4%. Overall, recurrence was found in 71 (67.6%) patients. The most common type of recurrence was distant metastasis, which occurred in 47 (66.2%) patients. The median progression-free survival was 14 months. The 1, 2, and 3-year progression-free survival rates were 59%, 30%, and 26%, respectively. The median overall survival was 27 months. The 1, 2, and 3-year overall survival rates were 81%, 57%, and 34%, respectively. CONCLUSION The survival outcomes in this study closely match those reported in the literature. This is notable because our study included a higher proportion of patients with additional health conditions and fewer concurrent CHT cycles during RT compared to randomized studies. These findings prompt us to consider what the ideal number of concurrent CHT cycles should be when using modern involved-field RT techniques after accurate disease staging. [ABSTRACT FROM AUTHOR]

OBJECTIVE: We compared the survival outcomes of surgery within multimodality treatment regimens with the outcomes of definitive chemoradiation treatments in patients diagnosed with clinical (c) IIIB/N2 non-small cell lung cancer (NSCLC). We investigated whether surgery within multimodality treatment provides a survival advantage at this stage. MATERIAL AND METHODS: Data from 79 patients with cIIIB/N2 between 2009 and 2016 were analyzed retrospectively. While the surgery was performed after neoadjuvant therapy in 51 cases (IIIB/Surgery Group), definitive chemotherapy ± radiotherapy was applied in 28 cases (IIIB/Definitive Group). RESULTS: In cIIIB/N2 cases, the 5-year overall survival (OS) was 27.4%, with a median OS of 24.6 months. The 5-year OS of the IIIB/ Surgery Group was 27.3% (median survival 22.5 months), while it was 28.6% (median survival 29.1 months) in the IIIB/Definitive Group (P = .387, HR = 0.798, 95% CI, 0.485-1.313). Although there was a survival advantage in the group with a pathological complete response (PCR) after surgery (n = 14) compared to the group that did not (n = 37), the observed difference was not statistically significant. (5-year OS; 42.9% vs. 18.5%, P = .104). Additionally, there was no statistically significant difference between the survival of PCR patients and the IIIB/Definitive Group in terms of OS (P = .488). CONCLUSION: Surgery performed within multimodality treatment regimens in selected cIIIB/N2 cases did not provide a survival advantage over definitive chemoradiation treatments. [ABSTRACT FROM AUTHOR]

OBJECTIVE This study's objective is to assess the effectiveness of treatment and the prognostic factors that affect survival in 28 patients with epithelial thymic tumors who had adjuvant or definitive radiotherapy (RT) at our facility. METHODS The study comprised 28 patients who received RT at the Radiation Oncology Department of Eskişehir Osmangazi University Faculty of Medicine between 2010 and 2021. Each patient received RT (3DCRT/IMRT/VMAT). RESULTS The median overall survival (OS), disease-free survival (DFS), and progression-free survival (PFS) at a median follow-up of 74 months were 76 (3-201), 29, and 57 (0-198) months, respectively. The median RT dose was 50 Gy (44-66). While there was no statistically significant difference between DFS and RT doses (p=0.88), there was a statistically significant difference between PFS and OS and 50 Gy and higher doses (p=0.03 vs. p=0.02). CONCLUSION Post-operative RT has been proven to be beneficial in cases of incomplete resection, even if the role of adjuvant RT in patients with complete resection remains debatable. It is well established that primary unresectable thymic tumors can be treated safely and successfully with neoadjuvant or definitive chemoradiotherapy. [ABSTRACT FROM AUTHOR]

Objective: In this study, we investigated the effects of calreticulin (CALR) and JAK2V617F mutational status on clinical course and disease outcomes in Turkish patients with essential thrombocythemia (ET). Materials and Methods: Seventeen centers from Türkiye participated in the study and CALR- and JAK2V617F-mutated ET patients were evaluated retrospectively. Results: A total of 302 patients were included, of whom 203 (67.2%) and 99 (32.8%) were JAK2V617F- and CALR-positive, respectively. CALR-mutated patients were significantly younger (51 years vs. 57.5 years, p=0.03), with higher median platelet counts (987x109/L vs. 709x109/L, p<0.001) and lower median hemoglobin levels (13.1 g/dL vs. 14.1 g/dL, p<0.001) compared to JAK2V617F-mutated patients. Thromboembolic events (TEEs) occurred in 54 patients (17.9%), 77.8% of which were arterial. Compared to CALR mutation, JAK2V617F was associated with a higher risk of thrombosis (8.1% vs. 22.7%, p=0.002). Rates of transformation to myelofibrosis (MF) and leukemia were 4% and 0.7%, respectively, and these rates were comparable between JAK2V617F- and CALR-mutated cases. The estimated overall survival (OS) and MF-free survival of the entire cohort were 265.1 months and 235.7 months, respectively. OS and MF-free survival durations were similar between JAK2V617F- and CALR-mutated patients. Thrombosis-free survival (TFS) was superior in CALR-mutated patients compared to JAK2V617F-positive patients (5-year TFS: 90% vs. 71%, respectively; p=0.001). Age at diagnosis was an independent factor affecting the incidence of TEEs. Conclusion: In our ET cohort, CALR mutations resulted in higher platelet counts and lower hemoglobin levels than JAK2V617F and were associated with younger age at diagnosis. JAK2V617F was strongly associated with thrombosis and worse TFS. Hydroxyurea was the most preferred cytoreductive agent for patients with high thrombosis risk. [ABSTRACT FROM AUTHOR]

Background: Colorectal cancer is the third most common and second deadliest cancer globally. Increasingly, early‑onset colorectal cancer is diagnosed in those under 50 years, leading to some countries advising screenings from ages 40 or 45 years. The ’position of the tumor, right or left, impacts the characteristics and prognosis of early‑onset colorectal cancer. Objectives: Investigating the 5‑year disease‑free and overall survival and histopathologic nature of left‑ and right‑sided early‑onset colorectal cancer. Design: Retrospective study. Setting: Koc University and VKF American Hospital. Materials (Patients) and Methods: Our population includes patients under 50 years with invasive colon cancer treated in two tertiary Turkish hospitals from 2014 to 2019. Of 178 patients, 74.3% had left‑sided tumors. Sample Size: One hundred and seventy‑eight patients. Main Outcome Measures: Histopathological features of left‑ and right‑sided colorectal tumors, and the 5‑year disease‑free and overall survival rate in patients under 50 years of age. Results: The 5‑year disease‑free survival was higher in right‑sided tumors(78.2% vs. 53.1%), but overallsurvival wassimilar. No significant histopathological differences were noted between left‑ and right‑sided tumors, but right‑sided tumors had more mucinous adenocarcinoma and high microsatellite instability (MSI). Conclusion: Our data did not show a difference in survival between right‑ and left‑sided tumors in the age group <50 years contrary to other published literature. Limitations: Retrospective nature and inclusion of a single center, which usually serves Turkiye population with a higher socioeconomic status. The retrospective nature of the study makes it susceptible to selection bias. The small sample size precludes robust group matching and diminishes the statistical power, increasing the risk of Type II errors. [ABSTRACT FROM AUTHOR]

Objectives: In this study, the relationship between response to second-line nivolumab treatment in advanced nonsmall cell lung cancer (NSCLC) and systemic immune inflammation index (SII) was investigated. Methods: One hundred and twenty-nine patients with advanced NSCLC who received nivolumab in second line between July 2018 and July 2023 were included. The optimum cutoff value for neutrophil/lymphocyte ratio (NLR), SII, platelet/lymphocyte ratio (PLR) and body mass index (BMI) was calculated. Progression free survival (PFS) and overall survival (OS) were evaluated. Univariate and multivariate analysis were performed for all parameters for prognostic evaluation. Results: In univariate analysis, patients with low SII found longer PFS and OS (HR = 1.762 for PFS, 95% CI 1.053-2.949, p=0.031, for OS HR=1.433, 95% CI 1.011-2.031, p=0.043). However, in multivariate analysis, no significance was found between low SII and OS (HR=1.614 for OS, 95%CI 0.984-2.648, p=0.058). No statistically significant relationship was found between NLR, PLR, BMI and Glasgow prognostic score (GPS) with OS and PFS. OS was found to be longer in patients with programmed cell death ligand 1 (PD-L1) of 1% and above and without liver metastasis (p=0.031 and p=0.040, respectively). Conclusion: Low SII before nivolumab treatment was associated with long PFS. A significant correlation was found between PD-L1 of 1% and above and OS. [ABSTRACT FROM AUTHOR]

Objective: To review the 10-year experience of pediatric Hodgkin lymphoma at a single center in Türkiye. Material and Methods: This study is a retrospective analysis of 82 pediatric Hodgkin lymphoma patients up to 18 years of age treated between 2009 and 2020. Results: The mean age of the patients was 11 years (range 3-17 years), and 68% of the patients were male. The distribution of patients by stage was as follows: stage I, n=2 (2%); stage II, n=32 (39%); stage III, n=35 (43%); and stage IV, n=13 (16%). The trend in histopathology was predominantly mixed cellularity at 49%. The most common treatment protocol was ABVD (adriamycin, bleomycin, vincristine, doxorubicin), used in 83% of cases. The majority of patients (n=76, 93%) received involved-field radiotherapy following chemotherapy. Complete remission was achieved with firstline chemotherapy in 90% of cases. The 2-year overall survival (OS) and event-free survival (EFS) rates were 97.5% and 92%, respectively. There was no significant difference in OS and EFS in terms of gender, stage, and the presence of B symptoms. Conclusion: Our data shows an excellent outcome for pediatric Hodgkin lymphoma, with results comparable to those of developed countries. Future studies should focus not only on treatment efficacy but also on identifying the best approaches to reduce long-term negative side effects. [ABSTRACT FROM AUTHOR]